COMMUNITY HEALTH NURSING

PHYSICAL EXAMINATION NEW BORN BABY

QUESTION ?

EXPLAIN THE PHYSICAL EXAMINATION FOR

NEW BORN

PURPOSE

1. To identify characteristics of the normal newborn.

2. To identify congenital abnormalities of birth injuries.

3. To facilitate early treatment of baby to avoid complication

4. To obtain baseline data for continuous assessment.

ASSESSMENT

1. Observe general condition of baby : -skin colour-centrally pink, present lanugo

and vernix -Baby active or not (hand and leg

movements) -Strong cry or not

ASSESSMENT

2. Perform anthropometry -Body weight (2.5-4.0 Kg) -Length(46-56 Cm) -Head circumference (32-37 Cm)

ASSESSMENT3.Check baby’s head: Moulding , caput

succedaneum ,cephalohematoma Size of fontanalle: - Anterior(can admit 2 finger,closes at 18month) -Posterior(can admit 1 finger and close at 2- 3 month)Birth injuries(bruises,wound on scalp)

ASSESSMENT

4.Examine:• Face for characteristics of Down’s syndrome

like:• Upward slanting of eyes with thick epicqnthic

folds• Small mouth with thick tounge and always

sticking out• Nose-flattened• Low set ears

ASSESSMENT

5.Eyes:• Has 2 eyeballs• Lens clear and without cataract• Can open eyes spontaneously• No bleeding in the sclera

ASSESSMENT

6.Mouth• No cleft lip• Feel inside baby’s mouth to identify for signs

of cleft palate• Presence tongue tie• Check for presence teeth

ASSESSMENT

7.Nose• Has 2 nostrils

• Any nasal flaring

ASSESSMENT

8.Ears• Check position of ears : upper notch pinna

same level of the canthus of the eye.• Check if auditory meatus(canal) is patent.• Has ear lobes

ASSESSMENT

9.Check neck-by lifting chin up to observe for:• Enlargement of thyroid gland• Sternomastoid tumour (palpate side of neck)

ASSESSMENT

10.Check hands• Both hand same length • Both hand can move• Palm of hand has 3 normal creases and not

the “simian crease”• Any fracture,dislocation and paralysis• Check for grasp reflex

ASSESSMENT

11.Check chest for:• Chest movement during respiration to identify

for sterna/ intercostals recession.• Pigeon chest(chest appears to be higher)• Nipple well formed and no extra nipple

ASSESSMENT

12.Check abdomen :• Shape-convex• Soft • Umbilical cord(has 2 arteries and 1 vein)• No bleeding should be clamped properly• No umbilical hernia• Exomphalus/gastrochiasis

ASSESSMENT

13.Check genitalia :• Identify sex and ensure if it is not ambigous

Male female

Both testis descended Has labia majora and minora and vaginal orife

No epispadias,hypospadias A little of whitish mucus is normal

No hydrocele,no phimosis Presence of smegma in labiaminora is normal

ASSESSMENT

13.Check feet:• Both leg are of same length• No fracture and paralysis • No talipes • Both legs have sufficient toes and no decrease

number of digits on the toes.

ASSESSMENT

14.Check baby’s back :• Turn baby to the side and ensure baby’s back

is straight and flat.• Use the fingers and check from neck to

sacrum• Ensure there is no dimples curves,lumps ‘hair

tuft’ and spinal bifida.

ASSESSMENT

15.Anus :• Check to ensure anus patent• Insert rectal temperature into the anus as far

as 2.5cm• Place baby in lateral position for this

procedure

ASSESSMENT16.Basic neurological test :

Grasp reflexMoro reflex

Sucking reflexRooting reflex

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