This document provides guidance on performing a newborn examination. It begins by classifying newborns by gestational age and birth weight. It then describes how to assess vital signs, growth measurements, and the different body systems. Key parts of the examination are classified including the skin, head, eyes, chest, heart, abdomen, genitals and nervous system. Important reflexes are outlined to assess neurological development. The document emphasizes the importance of estimating gestational age and recognizing normal and abnormal findings during the newborn examination.
Normal newborn care, by Dr Amal Khalil, Dean of Nursing college, Port said University, Port said. Presented in the NICU nursing workshop, organized by Nursing syndicate in Suez canal & Sinai in cooperation with Port said university college of nursing & Port said neonatology society, December,2014 Port said
Normal newborn care, by Dr Amal Khalil, Dean of Nursing college, Port said University, Port said. Presented in the NICU nursing workshop, organized by Nursing syndicate in Suez canal & Sinai in cooperation with Port said university college of nursing & Port said neonatology society, December,2014 Port said
This power-point includes content on brief introduction and classification & management of pneumonia based on Integrated Management of Neonatal & Childhood Illness (IMNCI).
childhood hypertension is unique presentation by Dr. Hemraj Soni,
very compressive, complied,upgraded, presentation......will definative helpfull for paediatrician n resident doctor............
Health Assessment of the Newborn
The newborn requires thorough skilled observation to ensure a satisfactory adjustment to extra uterine life.
Health assessment of newborn after delivery can be divided into:
1. Initial Assessment
2. Transitional Assessment
3. Assessment of gestational age
4. Behavioural asessment
5. Systemic physical examination
Initial Assessment:
Initial assessment is done by using the APGAR scoring system.
APGAR score: It is method use to assess the newborn’s immediate adjustment to extra uterine life.
• The score based on five signs
1. Appearance (colour)
2. Pulse (Heart rate)
3. Grimace (Reflex irritability )
4. Activity (Muscle tone)
5. Respiratory rate
• Each item is given a score 0, 1, or 2
• 0-3 severe distress
• 4-6 moderate difficulty
• 7-10 no difficulty adjusting to life
• Evaluations of all five categories are made on 1-5 min after birth.
APGAR score:
Sign 0 1 2
Appearance (colour) Blue or pale Body pink, Extrimities Blue Completely Pink
Pulse (Heart rate) Absent Slow (<100 /> 100/m
Grimace (Reflex irritability ) No response Grimace Cough Or Sneeze
Activity(Muscle tone Limp Some flexion Active movement
Respiratory rate Absent Slow, Irregular Good, Crying
Other initial assessment are-
• Stabilization
• Measuring weight.
Transitional Assessment during the period of reactivity
First period of reactivity (6- 8 hours after birth):
During the first 30 minutes the newborn is very alert, cries vigorously, may suck a first greedily, and appears very interested in the environment. Physiologically the respiratory rate can be as high as 80 breaths/ min, crackles may be heard, heart rate may reach 180 beats/min, bowel sound are active, mucus secretions are increased and temperature may decrease slightly.
Second period of reactivity:
Began when the newborn awake from the deep sleep, it lasts about 2-5 hours. The newborn is alert and responsive, heart and respiratory rate are increased, gastric and respiratory secretions are increased, and passage of meconium commonly occurs.
Following this stage is a period of stabilization of physiologic systems & vacillating patern of sleep & activity.
This power-point includes content on brief introduction and classification & management of pneumonia based on Integrated Management of Neonatal & Childhood Illness (IMNCI).
childhood hypertension is unique presentation by Dr. Hemraj Soni,
very compressive, complied,upgraded, presentation......will definative helpfull for paediatrician n resident doctor............
Health Assessment of the Newborn
The newborn requires thorough skilled observation to ensure a satisfactory adjustment to extra uterine life.
Health assessment of newborn after delivery can be divided into:
1. Initial Assessment
2. Transitional Assessment
3. Assessment of gestational age
4. Behavioural asessment
5. Systemic physical examination
Initial Assessment:
Initial assessment is done by using the APGAR scoring system.
APGAR score: It is method use to assess the newborn’s immediate adjustment to extra uterine life.
• The score based on five signs
1. Appearance (colour)
2. Pulse (Heart rate)
3. Grimace (Reflex irritability )
4. Activity (Muscle tone)
5. Respiratory rate
• Each item is given a score 0, 1, or 2
• 0-3 severe distress
• 4-6 moderate difficulty
• 7-10 no difficulty adjusting to life
• Evaluations of all five categories are made on 1-5 min after birth.
APGAR score:
Sign 0 1 2
Appearance (colour) Blue or pale Body pink, Extrimities Blue Completely Pink
Pulse (Heart rate) Absent Slow (<100 /> 100/m
Grimace (Reflex irritability ) No response Grimace Cough Or Sneeze
Activity(Muscle tone Limp Some flexion Active movement
Respiratory rate Absent Slow, Irregular Good, Crying
Other initial assessment are-
• Stabilization
• Measuring weight.
Transitional Assessment during the period of reactivity
First period of reactivity (6- 8 hours after birth):
During the first 30 minutes the newborn is very alert, cries vigorously, may suck a first greedily, and appears very interested in the environment. Physiologically the respiratory rate can be as high as 80 breaths/ min, crackles may be heard, heart rate may reach 180 beats/min, bowel sound are active, mucus secretions are increased and temperature may decrease slightly.
Second period of reactivity:
Began when the newborn awake from the deep sleep, it lasts about 2-5 hours. The newborn is alert and responsive, heart and respiratory rate are increased, gastric and respiratory secretions are increased, and passage of meconium commonly occurs.
Following this stage is a period of stabilization of physiologic systems & vacillating patern of sleep & activity.
Topic 03: Health Assessment of the Newborn
The newborn requires thorough skilled observation to ensure a satisfactory adjustment to extra uterine life.
Health assessment of newborn after delivery can be divided into:
1. Initial Assessment
2. Transitional Assessment
3. Assessment of gestational age
4. Behavioural asessment
5. Systemic physical examination
Initial Assessment:
Initial assessment is done by using the APGAR scoring system.
APGAR score: It is method use to assess the newborn’s immediate adjustment to extra uterine life.
• The score based on five signs
1. Appearance (colour)
2. Pulse (Heart rate)
3. Grimace (Reflex irritability )
4. Activity (Muscle tone)
5. Respiratory rate
• Each item is given a score 0, 1, or 2
• 0-3 severe distress
• 4-6 moderate difficulty
• 7-10 no difficulty adjusting to life
• Evaluations of all five categories are made on 1-5 min after birth.
APGAR score:
Sign 0 1 2
Appearance (colour) Blue or pale Body pink, Extrimities Blue Completely Pink
Pulse (Heart rate) Absent Slow (<100 /> 100/m
Grimace (Reflex irritability ) No response Grimace Cough Or Sneeze
Activity(Muscle tone Limp Some flexion Active movement
Respiratory rate Absent Slow, Irregular Good, Crying
Other initial assessment are-
• Stabilization
• Measuring weight.
Transitional Assessment during the period of reactivity
First period of reactivity (6- 8 hours after birth):
During the first 30 minutes the newborn is very alert, cries vigorously, may suck a first greedily, and appears very interested in the environment. Physiologically the respiratory rate can be as high as 80 breaths/ min, crackles may be heard, heart rate may reach 180 beats/min, bowel sound are active, mucus secretions are increased and temperature may decrease slightly.
Second period of reactivity:
Began when the newborn awake from the deep sleep, it lasts about 2-5 hours. The newborn is alert and responsive, heart and respiratory rate are increased, gastric and respiratory secretions are increased, and passage of meconium commonly occurs.
Following this stage is a period of stabilization of physiologic systems & vacillating patern of sleep & activity.
Gestational Age Assessment
An accurate assessment of age is important for 2 reasons
• Age and growth patterns appropriate to that age aid in identifying neonatal risks
• Help in developing management plans
Gestational age can measure by weight for gestational age chart.
Gestational Age Number of weeks that have elapsed since the first day of the last menstrual period to the time of birth. This is usually retrieved from mother’s Antenatal History.
Gestational Age:
• SGA- small for gestational age-weight below 10th percentile •
• AGA-weight between 10 and 90th percentiles
• LGA-weight above 90th percentile
Behavioural Assessment
While babies may not speak their first word for a year, they are born
A group of Pediatricians from Chandigarh discussing common OPD problems in office practice.
5 minutes per topic for the speaker ONLY, discussing 15-20 topics every time !
Newborn Examination
History taking
General Examination
Systemic Examination
Newborn reflexes
Reference : Paediatric clinical examination by Dr Santhosh Kumar
Prepared by Binisha Sebby,
Final year Medical Student,
Dr SMCSI Medical College,
Karakonam, Trivandrum, Kerala
baby born before 37 weeks of gestation calculating from the first day of last menstural period is defined as preterm baby/ premature baby.
These babies are known as preemies
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
2. Today’s Learning Objectives
Classification of newborn
Understand Apgar score
Assess growth measurements
Assess vital signs
Estimate the gestational age
Assess the different body systems
Recognize normal findings in newborn examination
Recognize common newborn problems
Remember to Wash your hand prior to examination
3. Classification of newborn
Classification by
Gestational Age
Preterm <37 wks
Full term 37-40 wks
Post term >42 Wks
Classification By
Birth Weight
LBW < 2500 g
VLBW < 1500 g
ELBW < 1000 g
Classification By
Weight Percentiles of GA
AGA 10th-90th
SGA < 10th
LGA >90th
4.
5. Examination of newborn
Should be done within 24 h. after birth
Complete physical exam.includes:
1. Vital signs
2. Physical exam
3. Neurological exam
4. Estimation of gestational age
9. General examination
• Well or in Distress?
• Skin colour
– Pink is Normal
– Pallor associated with low hemoglobin or shock
– Plethora associated with polycythemia
– Blue Bruised part or cynosis
– Jaundice
– Common skin rashes
• Erythema toxicum, mongolian spot, Benign Pustular Melanosis
20. Neck & Facial Features
• FACE : Any obvious abnormalities
Shape of the nose, mouth and chin
Presence of any syndromic features
• NECK : Shape
Range of motion
Webbing
Palpate for masses
– Brachial palsy
– Erb’s palsy
– Fractured clavicle
• EARS : Unusual shape,
Low set ears
Periauricular skin tags (papillomas)
Hairy ears.
26. Ear Examination
Assess for asymmetry or irregular shape
– Auricular or pre-auricular pits,
fleshy appendages, lipomas, or
skin tags.
– Low set ears
• Below lateral canthus of eye
• Associated with genitourinary
anomalies.
– Malformed ears
• Can be associated with Downs
or Turners Syndromes
38. Heart and vascular system
• Tachypnea,tachycardia
• Increased pericordial activity
• Cyanosis: hyperoxia test
• Auscultation of heart sounds, murmurs
• Perfusion: Capillary refill time
•Palpate femoral pulsation: absent in coarctation of the aorta
•Bounding pulses often indicated PDA
39. Abdomen
• Organomegaly: liver may be palpable
• Masses
• Distension , scaphoid abdomen
• Umbilical stump: bleeding , meconium straining, granuloma,
discharge, inflammation
• Omphalocele and Gastroschisis
42. Male Genitalia
•In full term,scrotum is well developped, both
testes are in the scrotum
•In preterm,scrotum is small with few rugae.
Testes are absent or high in the scrotum
44. Female genitalia
• In full term,labia majora completely cover labia
minora
• In preterm,labia majora is widely separated and labia
minora protruded
46. Anus
• Meconium should pass in the first 48h after birth
• Delayed passage of meconium may indicate
imperforate anus or intestinal obstruction
• Urine should pass in the first 24h of life
48. Nervous System
• Observe for any abnormal
movement/ excessive
irritability
• Muscle tone
– Hypotonia : Floppiness
– Hypertonia : Extended arms &
legs, hyperextension of back &
tightly clenched fists.
49. Neonatal reflexes
• Also known as primitive reflexes.
• Autonomic behaviors that do not require higher level
brain functioning
• Provide information about integrity of C.N.S.
• Their absence indicate C.N.S depression
• They are often protective and disappear as higher
level motor functions emerge.
50. Moro Reflex
• Most important reflex in
neonatal period
• Onset: 28-32 weeks GA
• Disappearance:4-6
months.
Neonatal reflexes
51. Significance of Moro
Bilateral absence:
• CNS depression by narcotics or
anesthesia
• Brain anoxia and kernicterus
• Very Premature baby
Asymmetric response:
• Erbs palsy , fracture clavicle or
humerus
Persistence beyond 6th month:
• CNS damage
Neonatal reflexes
52. • Suckling Reflex
Appears at 32 wk &
disappears by 3 – 4 m
• Rooting Reflex
Appears at 32 wk &
disappears by 3 – 4 m
Neonatal reflexes