Assessment newborn
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Assessment newborn

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physical examination

physical examination

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    Assessment newborn Assessment newborn Presentation Transcript

    • COMMUNITY HEALTH NURSINGPHYSICAL EXAMINATION NEW BORN BABY
    • QUESTION ?EXPLAIN THE PHYSICAL EXAMINATION FOR NEW BORN
    • PURPOSE1. To identify characteristics of the normal newborn.2. To identify congenital abnormalities of birth injuries.3. To facilitate early treatment of baby to avoid complication4. To obtain baseline data for continuous assessment.
    • ASSESSMENT1. 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
    • ASSESSMENT2. 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)
    • ASSESSMENT4.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
    • ASSESSMENT5.Eyes:• Has 2 eyeballs• Lens clear and without cataract• Can open eyes spontaneously• No bleeding in the sclera
    • ASSESSMENT6.Mouth• No cleft lip• Feel inside baby’s mouth to identify for signs of cleft palate• Presence tongue tie• Check for presence teeth
    • ASSESSMENT7.Nose• Has 2 nostrils• Any nasal flaring
    • ASSESSMENT8.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
    • ASSESSMENT9.Check neck-by lifting chin up to observe for:• Enlargement of thyroid gland• Sternomastoid tumour (palpate side of neck)
    • ASSESSMENT10.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
    • ASSESSMENT11.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
    • ASSESSMENT12.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 femaleBoth testis descended Has labia majora and minora and vaginal orifeNo epispadias,hypospadias A little of whitish mucus is normalNo hydrocele,no phimosis Presence of smegma in labiaminora is normal
    • ASSESSMENT13.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.
    • ASSESSMENT14.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.
    • ASSESSMENT15.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 : Moro reflex Grasp reflex Rooting reflex Sucking reflex
    • -han-