Neonatal Assessment NUR 134 NEO114

M. Johnston, RN-BC, M.Ed.OB Clinical Instructor

NSCC

Immediate Post Delivery

Establish Airway:Suction with bulb syringeStimulate

Check Color: Acrocyanosis

Prevent Hypothermia:Clean, stimulateProvide dry blankets

Check Tone:Flexion of extremities

Drying to prevent hypothermia

Apgar ScoringFive categories: score 0-2

Assessed at: 1 minute 5 minutes

Apgar Scoring Charts

Apgar Scoring

Dr. Virginia Apgar

"Nobody, but nobody, is going to stop breathing on me!"

Weight Measure lengthHead circumference

Newborn ExamWarm, dry surfaceAdequate lightingCalm infant

Check vital signsHR range 110-160 bpmResp rate 30-60 minTemp. 36.5 – 37.5 C

Normal Findings

Umbilical cord3 vessels2 arteries, 1 vein

(AVA)Wharton’s jelly

Umbilical Cord Healing7-10 days Keep clean and dryObserve for infection

Fontanels

anteriorposterior

Sutures

Head Molding

Vernix CaseosaSebaceous gland secretionsWhite, cheesy protective coatingDevelops 3rd trimesterDecreases as fetus develops

Miliasebaceous glands, usu. found on face, nose and chin subsides spontaneously , reassure parents

Telangiectatic Nevi “Stork Bites”

Erythema ToxicumMost common face, trunk, extremities

Found in 70% of newborns

Peaks at 24-48 hours old

LanugoFine, downy hair

Develops after 20 wks gestation

Mostly disappears by 40 wks gestation

Meconium

Mongolian spots

Moro or Startle Reflex

Normal Newborn Reflexes

Abnormal Findings

Neonatal JaundicePhysiological Pathologic Phototherapy

Phototherapy

Cephalohematoma Does not cross suture line

Caput Succedaneumextends across the suture lineusually disappears in 3-4 days

Tongue-tie occurs in approx. 4% of infants

Simian Crease

(Single palmar crease)

Club Foot

(Talipes Equinovarus)

Pilonidal opening Sacral skin tag

Preterm Neonates

Maternal Infant Bonding

Family Bonding