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1new Born Assessment
1new Born Assessment
1new Born Assessment
DURATION : 1 hour
On the completion of class, students will be able to gain knowledge regarding the concept of newborn assessment and will also be able
to demonstrate the techniques of newborn assessment which will help to develop a positive attitude towards it and utilize the same in
practice setting in future.
SPECIFIC OBJECTIVES
List down 2 mits FREQUENCY OF ASSESSMENT: Lecture cum Listening What are the
the Detailed newborn assessment is conducted at discussion to the objectives of
frequency 1. Birth topic new born
and its 2. Weight in 24 hours assessment?
objectives 3. At the time of discharg
OBJECTIVES OF NEWBORN ASSESSMENT:
a. To ensure that the lung is expanded (at birth).
b. To assess the satisfactory pulmonary respiration at birth and
assess for any obstruction in their passage.
c. To diagnose life threatening congenital malformation and birth
injuries.
ASSESSMENT OF NEWBORN:
HEALTH HISTORY:
1. Demographic data
Name
Age /sex
Gestational age at birth
Ward/unit
Room no/bed no
IP no
Date of admission
Diagnosis
2. Chief complaints
3. History of present illness
4. History of past illness
5. Obstetric history
a. Previous obstetrics history:
Past history still birth, neonatal death, preterm delivery,
LBW babies, congenital malformation, Rh
immunization etc.
b. Prenatal history:
Antenatal check up (regular/ irregular)
c. Intranatal history:
Expected date of conferment / actual date of birth (mode
of delivery/prolonged rupture of membrane/duration of
labor/maternal fever/ meconium stained or foul smelling
amniotic fluid/ fetal distress/ birth asphyxia/ APGAR
Score 1min, 5min, 10 min)
d. Post natal
First cry after birth, feeding, birth weight, passage of
meconium and urine for first time, any illness or
complication during the neonatal period.
6. Nutritional status:
Type of feeding: exclusive breast feeding/ breast feeding
and formula feeding/ parental feeding/ others.
7. Immunization status:
VACCINE DATE OF
ADMINISTRATION
BCG
OPV
HEPATITIS B
PHYSIAL ASSESSMENT:
Demonstrate 30 Teacher is Group is Demonstrate
1. General assessment
the new mits a. Term / preterm / post term demonstrating observing the new born
b. Alertness : alert and active/ dull/ sleeping
born assessment
c. Posture : flexion of head and extremities/ extended legs
assessment and technique
extremities.
technique including
d. Birth injuries / congenital anomalies
including PROCEDURE RATIONALE vital signs,
vital signs, general
general 1. Vital signs examination
examination a. Respiration &
The respiration must be Normal respiration rate is
& conducted for full 1 30-60 beats/ min. neurological
minute by looking at the Sign of respiration distress
neurological examination?
chest and noting the include nasal flaring,
examination respiration. retraction or grunting with
respiration.
2. Anthropometry
b. Length
Measure the crown to Normal length is 45-55cm
rump and crown to heal Length <45 cm or >55cm
length. may indicate the
chromosomal abnormality
c. Head circumference
Head is measure as the Small head if less than 32
greater diameter i.e cm is microcephaly and
occipito frontal may be due to TORCH
circumference. infections.
Tape should be placed
above the eyebrows over In hydrocephaly HC is more
the tape of the ears and and sutures are found
around fullest part of the widely separated and ICP is
occiput. high.
It measure 32-36 cm and
is approximately 2-3cm
more than the chest
circumference.
d. Chest circumference
The tape should be The chest circumference
placed across the lower less than 30cm indicate the
border of scapula and prematurity.
over the nipples.
Usually it is 2cm less
than the head
circumference and
average between 30-
33cm.
3. Skin
a. Colour Blueness of body part is
Assess the color to cyanosis may be due to
cyanosis and pallor. hypothermia, respiratory
Generally the newborn is origin.
pink in color and it
varies with ethnic origin. Pallor may due to anemia,
birth asphyxia or shock.
In peripheral cyanosis (
bluish skin with pink lips
and tongue ). It may be due
to drugs or hereditary.
b. Molting
c. Herlequine sign
One side of the body is It is also due to the
pink and the other side is vasomotor instability.
pale .
d. Prethora
A deep red discoloration It may be seen in over
of skin. It is often heated or over oxygenated
exaggerated by crying infants.
e. Jaundice
Yellowish discoloration Bilirubin level >5mg/dl
of the skin and sclera.
Inspection of skin for
any rashes like
4. Head
Absence of molding
Absence of molding indicate prematurity, breech
(round appearance of presentation or caesarean
head few days after birth. section.
-Anterior frontanells /
brigma
It is diamond shape
measure of 3-4cm long
and 2-3cm wide closed by
18-24momhs.
-Posterior frontanells
-Cephal hematoma
Collection of blood
between the periosteal
membranes and the
cranial bone.
5. Eyes
Upto 3cm is normal.
Imagine shape and
symmetry in size and
shape. Normal eye balls are equal
Estimate the distance size, both round and firm.
between 2 eyes.
The epicanthal folds
Assess the eye lids for suggest the presence of
size movement and blink. Down’s syndrome.
Yellowish discoloration of
Coloboma lesion sclera.
6. Nose
Observe for shape,
placenta patency and
configuration of bridge of
nose.
9. Ears
Evaluate the ears for
position, placement, size,
shape and firmness of the
cartilage.
Low placement of ears
indicate downs syndrome,
The top of the ear should mental retardation and
be at or above the level kidney disorder.
of imaginary line drawn
from inner or outer canter
of the eye to the ear. They are isolated finding.
It can be removed and
Check the audibility with separated.
loud noise (stratile
reflex).
12. Abdomen
13. Genitals
Syndactyl (fusion of
digits)
Polydactyl
NEUROLOCICAL ASSESSMENT:
PROCEDURE RATIONAL
1. More Reflex
2. Rooting reflex:
6. Grasp reflex
A palmar grasp is
detected by placing a
finger or pencil in the
palm of baby hand. The
finger response is
checked by stroking the
base of the toes (plantar
group).
7. Walking or stepping
reflex
8. Asymmetrical tonic
neck reflex
In the supine position the
limbs on the side of the
body to which the head in
turned, are extended
while those on the
opposite side flex.
9. Traction response
CONCLUSION:
RECAPITULATION:
REFERENCE:
1. Snehlata manocha. “procedure and practice in
midwifery”, kumar publishers page no: 145-168.
2. DC. Dutta“ Text book of obstetrics”, 8th edition, Jaypee
Publication, page no : 514-517.