Assignment On Newborn Assessment

Assignment on Newborn Assessment
Introduction
Newborn assessment is done as soon as after birth is possible, the mother should be
allowed to spend some time with the baby immediately after birth to initiate the
bonding process.
Definition
Health assessment is throw inspection or a detailed study of entire body or to some
part of the body to determine the general physical or mental condition of the body.
Purpose
 To understand the physical and mental will being of the child.
 To detect diseases in early stage.
 To determine the causes; effect of the disease.
 To teach child and parents.
 To measure the health in future.
 To determine the nature of treatment of care needed for the child.
Health assessment
Assessment of the newborn as soon as possible after birth and subsequent
assessment in the neonatal period are responsibility of the nurses working in the
hospital and in the community.
Phases assessment
 Initial
 Transitional
 Assessment of gestational age
 Systemic physical examination
Initial assessment
The most frequent used method to assess the newborns immediate assessment is
done in newborn life including Apgar scoring system.
Apgar Score
In 1953 Virginia Apgar introduced a simple systemic assessment of intrapartum
stress of neurologic depression at birth.
Sign Score=0 Score= I Score = II
Heart rate Absent Below -100 per Above 100 per mm
mm
Respiratory effect Absent Weak irregular of Good, crying
gasping
Muscle tone Flaccid Some flexion of Well fixed, active,
arm and leg extreme
Reflex/Irritability No response Grimace or weak Good cry
cry
Color Blue all over, or Body pink, hand Pink all over
pale and feet blue
Causes of low Apgar score
 Asphixia
 Maternal drug
 Central nervous system disease
 Congenital muscular disease
 Prematurity
 Fetak sepsis
Transitional assessment
1st Stage
Lasts for 6 hours, first 30 minutes awake , remaining hours baby will be sleeping.
2nd Stage
6 to 12 hours observation should be made until the vital signs are established.
Assessment of gestational age
1. Dubouitz Scale
It is an important criteria because prenatal morbidity, mortality are related to
gestational age and birth weight. A frequently used method is by the use of
determine gestational age is by the Dubouitz Scale.
2. Ballard Scale
The new ballard scale is a revised scale of dubouitz scale.
3. Neuromuscular maturity include

Posture, square, window, arm recoil, head to ear
4. Physical maturity
Skin language, plantar surface, breast, eye, ear, genital (male and female)
General and Physical Assessment
Vital signs
 Temperature
 Neonatal normally responded to infection with low temperature.
 Normal temperature - 36.5 - 37.5° C
 Hypothermia- 36°C
 Hyperthermia - 41°C
Respiration
 Normal- 35 breath/ min

 Tachypnea- 740 breath/ min
 Bradycardia- < 20 breath/ min
Pulse
 Apical pulse are more reliable for infant between 4th and 5th intercoastal.
 Pulse is counted for one full minute in infants and young children.
Blood pressure
Manual blood pressure, monetary is not routinely done in neonatal recessory but in
certain circumstances with oscilometry. The average systolic/ diastolic pressure is
65/44 mm Hg at 1 to 3 days of age.
Anthropoetic Measurement
1.Purpose
To access the bodies size against known standard for the population.
To compare the body's size with estimated period of life.
To provide the baseline against which subsequent progress can be measured.
2.Weight
Average weight for term babies is about 2.5 kg to 3.5 kg
3.Length
The average length of newborn is 48 to 50 cm.
4.Head circumferences
Normally head circumference is 33 to 35 cm in a term baby.
Head circumference is 2 to 3 cm larger than chest circumference.
5.Chest circumferences
It is measured around ruffle line in mid expiration .Normal chest circumference is
30 to 33 cm.
6.Abdominal circumferences
It will be same as that of the chest circumference.
Systemic Assessment
A careful general examination of a newborn baby provide more information of the

condition of the baby.
The system to be examined include:-

 Examination of CVS (Cardiovascular System)
 History of drug cleft lip/ cleft palate, cataract, polydactyl.
 Respiractory rate:- normal/ increase/ decrease/ type of breathing
 Pulse :- 120-160 beats/ min optical pulse normally taken.
 Average BP :- term baby 70/45 mm Hg
Pre-term baby 60/20 mm Hg
Examination of Respiratory System

 History of cough- Pneumonia
 Diabetes mellitus - RDS
 Polyhydramnios- Asphyxia, respiractory distress
 Preterm - RDS
 Character- dyspnea, tachypnea, apnoea, grunting
Examination of Central Nervous System
Examination of neonatal reflexes

 Conventional examination- consciousness ,immediate and delayed response
to external stimuli
 Neurological examination for the assessment of gestational age.
Reflexes of Normal Newborn
Swallowing
 Accompanies the sucking reflex.
 Food reaching the posterior of the mouth is swallowed substance placed on
the anterior position of tongue.
Sneezing and coughing

 Foreign substances entering the upper or lower airways, clearing of the
upper air passages by sneezing, clearing the lower passages by swallowing.
Blinking
 Exposure of eyes to bright light.
 Sudden movement of objects toward eye.

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Assignment on Newborn Assessment

Causes of low Apgar score

3. Neuromuscular maturity include

 Normal- 35 breath/ min

A careful general examination of a newborn baby provide more information of the

The system to be examined include:-

Examination of Respiratory System

Examination of Central Nervous System

Examination of neonatal reflexes

Sneezing and coughing

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