Olds Newborn Assessment Notes

Front 1

describe the 1st assessment. where is it done? what does it consist of?

Back 1

done in the birthing area. concerned with need for resuscitation or other interventions.

Front 2

describe the 2nd assessment. where is it done? what does it consist of?

Back 2

done in the nursery.
phys exam to estimate gestational age and evaluate adaptation to extrauterine life. NO LATER THAN 2 h AFTER BIRTH.

Front 3

phys characteristics of gestational age tools

Back 3

sole creases
amount of breast tissue
amount of lanugo
cartilaginous dev. of ear
testicular descent
scrotal rugae or labial dev.

Front 4

neuroologic maturity progresses in a _________ direction

Back 4

caudocephaled direction (tail to head)

Front 5

signs of respiratory distress syndrome (RDS)

Back 5

flaccid, edematous, assuming a "froglike posture"

Front 6

describe lanugo

Back 6

a fine hair covering. lanugo is greatest from 28 to 30 weeks, then disappears, first from the face, then from the extremities.

Front 7

in newborns of ____ descent, sole creases may be less developed at term.

Back 7

african

Front 8

nails develop in the nailbed at ___weeks gestation

Back 8

20 weeks

Front 9

elements of neuromuscular assessment

Back 9

1. square window sign (angle of wrist flexion)
2. recoil (arms, legs)
3. popliteal angle
4. scarf sign
5. heel-to-ear extension
6. ankle dorsiflexion
7. head lag
8. ventral suspension
9. major reflexes such as sucking, rooting, grasping, Moro, tonic neck, Babinski

Front 10

arm recoil detail

Back 10

hold arms out for 5 sec, then release.
preterm: elbow angle will be greater than 90 degrees with slow recoil.

full term: elbow angle will be less than 90 degrees and recoil will be fast.

Front 11

leg recoil detail

Back 11

stretch out legs parallel, then release.

preterm will not move or recoil slowly.

Front 12

popliteal angle

Back 12

degree of knee flexion. infant is flat on his back, nurse uses index finger to lift ankle until resistance is met. angle of knee measured.

Front 13

scarf sign

Back 13

nurse draws the arm across the chest like a scarf until resistance is met, notes position of elbow relative to midline.

preterm: elbow will cross midline
full term: elbow will not cross midline

Front 14

heel to ear extension

Back 14

nurse allows knee to bend and brings up heel in direction of ear until resistance is felt.

preterm: heel will go to ear or past.

Front 15

ankle dorsiflexion

Back 15

nurse uses thumb to push on sole of foot while fingers support the back of the leg. angle measured.

Front 16

head lag

Back 16

(neck flexors) pull baby up to sitting position and see the degree to which it can support its head.

preterm: total head lag.
term: momentary support
post-term: will hold head in front of the body line.

Front 17

ventral suspension

Back 17

nurse holds newborn prone on hand and notes position of head, back, and degree of flexion in the arms and legs.

some flexion: 36-38 weeks
full flexion: term infant.

Front 18

SGA infant requires:

Back 18

frequent glucose monitoring and early feedings.

Front 19

average birth weight?

Back 19

7 lb 8 oz.

Front 20

ethnicities of smaller birth weight?

Back 20

asian, african, mexican

Front 21

after first week and up to 6 mo, the baby's weight will increase by _oz per week

Back 21

7 oz.

Front 22

during initial newborn period (3 to 4 days) the newborn will lose ______% of his body weight.

Back 22

5 to 10% from fluid loss.

Front 23

avg length and range?

Back 23

50 cm with range of 48-52 cm.

Front 24

newborn will grow an avg of ____ per month for first 6 mo.

Back 24

1 inch.

Front 25

normal head circumference range

Back 25

32-37 cm

Front 26

avg chest circumference and range

Back 26

32 cm, range from 30-35 cm

lower edge of scapulas around nipple line

Front 27

newborn temp will stabilize after...

Back 27

8 to 12 hours

Front 28

range of normal newborn weight

Back 28

5 lb 8 oz. - 8 lb. 13 oz.

Front 29

newborn axillary temp range

Back 29

97.5 - 99 F

Front 30

temp variations of more than ___ may indicate infection

Back 30

2 deg. F

Front 31

choanal atresia

Back 31

congenital blockage of the passageway between the nose and pharynx.

Front 32

mottling

Back 32

lacy pattern of dilated blood vessels under the skin, occurs as a result of general circulation fluctuations.
may be related to chilling, prolonged apnea, sepsis, hypothyroidism.

Front 33

harlequin sign

Back 33

deep color develops on one side of the newborn body while the other sign remains pale.

vasomotor disturbance where vessels of one side constrict while the other side dilates.

last 1-20 minutes, clinically insignificant.

Front 34

jaundice advances in _______direction and resolves in a _______ direction

Back 34

jaundice advances in a head to toe direction and resolves in a toe to head direction.

Front 35

signs of newborn jaundice

Back 35

nurse blanches tip of nose, gum line, forehead, or sternum and looks for yellow tint.

any jaundice noted before 24 h should be reported to physician or NP.

Front 36

erythema toxicum

Back 36

lesions surrounding a hair follicle. ("newborn rash", "flea bite dermatitis")

usu over trunk or diaper area. unknown cause, usu. 24-48 h after birth, no treatment is necessary.

Front 37

milia

Back 37

exposed sebaceous glands. appear as white spots on face, esp. nose. no treatment is necessary, resolves within 1 mo.

Front 38

vernix caseosa

Back 38

the white cheeselike substance that covers fetus in utero and lubricates skin of newborn.

Front 39

forceps marks

Back 39

disappear after 1-2 days. usu around cheeks and jaws.

Front 40

telangiectatic nevi

Back 40

(stork bites) appear as pale pink or red spots are are frequently found on the eyelids, nose, lower occipital bone, nape of neck. no clinical significance, usually fade by second birthday.

Front 41

nevus flammeus

Back 41

(port wine stain) is a capillary angioma directly below the epidermis.
does not grow in size, does not fade, does not blanch.

if convulsions accompany, may be sturge-weber syndrome with involvement of 5th cranial nerve.

Front 42

nevus vasculosus

Back 42

(strawberry mark) a capillary hemangioma. newly formed and enlarged capillaries in the dermal and subdermal layers. raised, clearly dilineated, rough-surfaced birthmark usu. in the head region.

grow rapidly in first 2-3 weeks of life, shrink and resolve spontaneously several weeks to months after they reach their peak growth.

Front 43

describe molding

Back 43

asymmetry caused by the overriding of the cranial bones during labor and birth. diminishes after a few days.

because of this, a 2nd circumference measurement is needed a few days after birth.

Front 44

craniosynostosis

Back 44

premature closure of the cranial sutures. needs to be surgically corrected to allow for brain growth.

Front 45

plagiocephaly

Back 45

asymmetry caused by pressure on the fetal head during gestation.

Front 46

describe the two fontanelles

Back 46

anterior fontanelle - diamond shaped, should be 3-4 cm long by 2-3 cm wide. located at the juncture of the frontal and parietal bones.
anterior fontanelle closes within 18 MONTHS.

posterior fontanelle - smaller and triangular. formed by the parietal bones and the occipital bone. should be .5 cm by 1 cm. closes within 8 12 weeks.

Front 47

cephalhematoma

Back 47

cephalhematoma is a collection of blood resulting from ruptured blood vessels b/w the surface of a cranial cone and the periosteal membrane.

emerges as defined hematoma in first and second day. Does not increase in size when the newborn cries. May be unilateral or bilateral.

DOES NOT CROSS SUTURE LINES.

relatively common in vertex births and disappears within 2 weeks to 3 months.

may be associated with physiologic jaundice.

Front 48

caput succedaneum

Back 48

localized, easily identifiable soft area of the scalp, usu resulting from a long and difficult labor or vacuum extraction.
compression of local blood vessels. venous return is slowed. fluid from the caput is reabsorbed within 12 h to a few days after birth.
OVERRIDES SUTURE LINES.

Front 49

facial paralysis usually disappears....

Back 49

within a few days to 3 weeks.

Front 50

eye color is usually established at approx. ___

Back 50

3 MO.

Front 51

subconjunctival hemorrhages

Back 51

10% of newborns. associated with changes in vascular tension or ocular pressure during birth. remain for a few weeks, and are of no clinical significance.

Front 52

doll's eye phenomenon

Back 52

present for 3 to 10 days after birth. as head position is changed, the eyes move to the opposite direction. results from underdeveloped integration of head-eye coordination.