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Definitions

Neonatal: The time from birth to 29days of life.

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Initiation of Respirations

Fetal Respiratory

Lungs do not oxygenate the blood; blood oxygenates the lungs.

Lungs filled with fluid in order to keep alveoli expanded during pregnancy.

Needs surfactant to maintain expansion after birth.

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Initiation of Respiration

Neonatal Respiratory:

The first breath requires greater negativepressure that subsequent breathing

Causes: Chemical

Mechanical

Thermal Sensory

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Cardiovascular System

Fetal Circulation Review

Neonatal Cardiovascular Adaptation

Ductus Venosus Foramen Ovale

Pulmonary blood vessels

Ductus Arteriosus

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ThermoregulationEvaporation Conduction RadiationConvection

Decreased body temperature and coldstress

Productionof acids

Useof

O2

Metabolic Rate Metabolism of Brown Fat Vasoconstriction

Productionof

Surfactant

Use ofGlucose

Hypoglycemia

MetabolicAcidosis

Displacementof bilirubin

from albumin

binding sites

Pulmonaryvessels

Peripheralvessels

Jaundice

Pale, Cold,mottled

Skin

Respiratory Distress

Hypoxemia

Return to fetal

circulationpatterns

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Assessments in the Newborn

Immediate assessment is cardio-respiratory status, thermoregulationand the presence of anomalies.

Infant should be crying Infant heart rate should be more than100

Infant should be pink on the trunk

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Assessments in the NewbornApgar Score 0 1 2

Heart Rate Absent Below 100/min Above 100/min

Respiration No spontaneousrespirations

Slow Respiration

or weak cry

Spontaneous resp

& strong, lusty cry

Muscle tone Limp Min Flexion of extwith sluggishmovement

Flexed bodyposture; spont

vigorous move

Reflex ResponseNo response to suction

or gentle slap on soles

Min response to

suction or flicking

feet

Responds promptly

to suction or

flicking feet

Color Pallor or cyanosison Trunk Bluish hands andfeet only Pink throughout.

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Assessments in the Newborn

Initial Assessment Vital Signs

Temperature 97.7 to 99.5 Axillary

Heart Rate 120-160

BP Average 65-95 Systolic30-60 Diastolic

Resp Rate 30-60 Average is 40

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Lungs & Hearthttp://newborns.stanford.edu

Select Professional Education

Select Photo Gallery Select Lungs

Go through and you can hear the different lung sounds. Itis very good.

Select Heart

Go through and you can hear the different heart sounds

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Inspect Chest Shape

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Resp Distress

Intercostal Retractions Subcostal Retractions

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Mottling

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Mottling (Cutis Marmorata)

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Measurments

Weight 2500-4000 grams Length 48-53 cm or 19-21 inches

SGA and LGA

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Assessments in Newborn

Measurement (Cont) Head Circumference 33-35.5 cm13-14 inches

Chest Circumference 30.5-33 cm12-13 inches Should be 2-3 cm less than head

circumference

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Head Circumference

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Molding

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Bruising

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Caput Succedaneum

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Caput Succedaneum

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Cephalhematoma

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Eyelid Edema

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Ears Etc

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prohibited. Utilization and copying of the materials foreducating those who care for newborns is permitted withproper citation of source.http://newborns.stanford.edu/PhotoGallery/

Positional Nasal Deformity

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Mouth

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Cleft Palate Cleft Lip

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Ankyloglossia

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Normal Tongue

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Natal Teeth

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3 Vessel Umbilical Cord

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Hips

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Hypospadias

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Hydrocele

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Undescended Testes

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Female Genitalia

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Ambiguous Genitalia

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Hands

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Toes

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Positional Deformities

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Club Foot

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S l i i

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Sacral examination

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Facial Palsy

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Erb's Palsy

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k

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Skin

The downy hair seenover the shoulder islanugo. Although this ispresent to a muchgreater degree in

premature infants, termbabies also have variableamounts of lanugopresent at birth, asevidenced in this photo

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Skin

A dry, flaky, peelingappearance of the skinis very common innewborns. Althoughthis can be distressing

to parents, it does notneed treatment and willspontaneously resolve.

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k M l

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Skin -- Mongolian Spots

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Salmon Patches

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Port Wine Stain

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Milia

Sebaceous

Hyperplasia

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Erythema Toxicum

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P t hi

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Petechiae

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Petechiae

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a central area of telangiectasiasurrounded by a halo of pallor.

Hemangioma

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d

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Jaundice

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Meconium Stools First stool excreted by the newborn Greenish black with a thick, sticky,

tarlike consistency.

Usually passes in the first 12 hours

Failure to pass meconiumsuspectobstruction

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Wh t b t thi ??

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What about this??

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What caused this??

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What caused this??

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