Beruflich Dokumente
Kultur Dokumente
1.
Bactericidal substance
2.
Antibiotic substance
3. Alcohol (70%)
4. Cleansed with mild soap solution
5. Air dry
c.Scoring
(1)Evaluations
SCORE INTERPRETATION
NORMAL: 7-10
Good adjustment; vigorous; No intervention required
IMMEDIATE: 4-6
Moderately depressed infant; newborns condition is
guarded and may need airway clearance and
supplementary oxygen
LOW- 0-3
Severely depressed infant; newborn is in serious
danger and id need of resuscitation.
34 35 cm
Temperature
36.5 C 37.5 C
Chest Circumference
32 33 cm
Heart Rate
Respirations
30 60 bpm
Weight
2.5 to 3.4 kg
Length
46 to 54 cm
(1)Measure
the infant
1.
Convection
Convective heat loss is the transfer of heat from a body to
moving molecules such as air or liquid
Evaporation
Evaporative heat loss is the vaporization of water from the
body or a mucosal surface, which uses the latent heat of
vaporization of water as its source
Conduction
Conduction refers to heat transfer between two surfaces
that are in direct contact
Radiation
Radiant heat loss refers to transfer of heat between two
objects of different temperatures that are not in contact
with each other (e.g., radiation is the mechanism by which
the sun warms the earth)
WEIGHT
Varies depending on:
1. Race
2. Nutritional
status
3. Intrauterine factor
4. Genetic factor
1.
2.
Diuresis
3.
4. Breastfed newborns
1.
2.
3.
AIRWAY
1. Respiratory
Observe for:
1. Periodic breathing
2. Apnea
How to asses ?
1. By closing the infants mouth and occluding
one nostrils at a time and observe for
breathing while each nostril is occluded
2. Placing a cold metal object under the
nostrils and observe for fogging
3. Passing a catheter (fr.5 or 8) thru each nostril
to check for patency
Color
1. Pallor indicates slight hypoxia or anemia
2. Ruddy color ( plethora) an excessive
number of RBC ( >65%)
Heart sounds
Auscultate for rate, rhythm and presence of
murmurs or abnormal sounds
Method:
1. Doppler UTZ
Average BP:
Systolic 65 95 mmHg
Diastolic 30 60 mmHg
Capillary Refill
Method:
1. Axillary
2. Rectal
Types of Thermometer
1. Mercurial
2. Digital
3. Disposable
4. Tympanic
Plastic Strips
Craniosynostosis
- a hard ridged area that is not a result of
molding due to premature closure of the
cranial sutures before or shortly after birth
which may impair brain growth and shape
2. Coronal(co-RO-nul)Suture Synostosis /
Plagiocephaly
- The coronal suture is located on the side of
the head and extends from the soft spot to
an area just in front of the ear. It allows the
forehead and the frontal lobe to grow and
expand forward.
3. Metopic (mih-TOP-ick)
SutureSynostosis/
Trigonocephaly
- This midline suture is located in the middle
of the forehead and extends from the soft
spot to the root of the nose. It allows both
frontal lobes to expand forward and sideways
as well as the eye socket to move to either
side.
2.2 Posterior
- Is a triangular area where the occipital and
parietal bones meet
- Measures 0.5 to 1cm
- Closes by the time the infant is 2 to 3 months
3. Caput succedaneum
- Due to the pressure against the mothers
cervix and it interferes the blood flow in the
area causing localized edema which crosses
suture lines
4. Cephalhematoma
- Bleeding between the periosteum and the
skull
Face
assessed for:
- Symmetry
- Positioning of facial features
- Movement
- Expression
Mouth
assessed for:
cleft lip/palate
Precocious teeth
Epsteins pearl
- (1)
- is larger than the arteries and resembles a slit
D. Extremities
- normally a term infant should remain sharply
flexed & resist extension during examination
Poor muscle tone results in a limp or floppy infant
Continued poor muscle tone may result from
prematurity or neurologic changes
Nails :
- in term infants it should extend to the end of the
fingers or slightly beyond
Creases :
- normally, two long transverse creases extend most of
the way across the palm
Check for:
Spina bifida - (Latin: "split spine") is a developmental
congenital disordercaused by the incomplete closing of the
embryonicneural tube. Somevertebraeoverlying the spinal cord
are not fully formed and remain unfused and open. If the opening
is large enough, this allows a portion of the spinal cord to
protrude through the opening in the bones. There may or may not
be a fluid-filled sac surrounding the spinal cord.
Classification:
1.
3. Meningocele
- The least common form of spina bifida is a
posteriormeningocele(ormeningeal cyst).
-
4. Myelomeningocele
- In this, a serious and commonform, the unfused
portion of the spinal column allows the spinal cord to
protrude through an opening. The meningeal
membranes that cover the spinal cord form a sac
enclosing the spinal elements.
I.
Neurologic system
a.
Reflexes
hemiplegia,
brachial plexus palsy
fractured clavicle.
A.
Ears
assessed for :
1. Placement
2. Appearance
3. Maturity
Expected findings:
Slate gray or blue eye color
No tears
Fixation at times - with ability to follow objects to
midline
Red reflex
Blink reflex
Distinct eyebrows
Cornea bright and shiny
Pupils equal and reactive to light
Discharges
Opaque lenses
Absence of Red Reflex/Bruckner reflex
Epicanthal folds
Reflexes absent
"Doll's Eyes" Reflex(beyond 10 days of age):
When the head is moved slowly to the right or left, the
eyes do not follow nor adjust immediately to the position
of the head. This reflex should not be elicited once fixation
is present. The persistence of the Doll's Eyes Reflex
suggests neurologic damage.
1. Staphylococcus
2. Chlamydia
3. Neisseria
gonorrhoea
Signs:
1. Irritability high pitched cry
2. Lethargy
3. Seizure / jitteriness
4. Sweating
5. Poor sucking
6. Respiratory distress :
- Tachypnea
- Dyspnea
- Apnea
7. Discoloration / Cyanosis
8. Poor appetite
9. Excessive drowsiness
Causes of Hypoglycemia:
1. Maternal diabetes
2. Prematurity
3. Infection / Illness
4. Intrauterine growth retardation (IUGR)
Treatment
If the baby can eat and the blood glucose
level is not too low, giving formula, sugar
water or breastmilkwill raise blood glucose
levels in most cases.
Babies who can't eat or those with very low
blood glucose levels need intravenous
infusion of dextrose, a type of sugar, to raise
their blood sugar.
Infants receiving glucose infusions may
develop temporary hyperglycemia, or blood
glucose levels over 125 mg/dL, which usually
requires no treatment,
Prevention
-
B. Newborn Jaundice
Jaundice is a yellow discoloration of the skin and
the white part (thesclera) of the eyes. It results
from having too much of a substance
calledbilirubinin the blood.
Bilirubin is formed when the body breaks down
oldred blood cells. Theliverusually processes and
removes the bilirubin from the blood.
Jaundice in babies usually occurs because their
immature livers are not efficient at removing
bilirubin from the bloodstream.
Causes:
1. Physiologic
4. Polycythemia
5. Cephalohematoma
6. Sometimes a baby swallows blood during birth
7. A mother who hasdiabetes
8. Crigler-Najjar syndrome
9. Lucey-Driscoll syndrome
Symptoms:
As a baby's bilirubin levels rise:
jaundice moves from the head to include the arms,
trunk, and finally the legs.
bilirubin levels are very high :
a baby will appear jaundiced below the knees and
on the palms of his or her hands.
How to Assess?
- One easy way to check for jaundice is to press a
finger against your baby's skin, temporarily pushing
the blood out of it. Normal skin will turn white when
you do this, but jaundiced skin will stay yellow.
Laboratory Tests:
1. First, the total serum bilirubin level will be
checked. Based on this test, the doctor may
request that more tests be done.
2. A Coombs test checks for antibodies that
destroy an infant's red blood cells.
3. Acomplete blood count may be done.
4. Areticulocyte count checks to be sure your
baby is making enough new red blood cells.
5. Certainred blood celldiseases are found in
people of Mediterranean descent. In such
cases, it may be necessary to check blood
samples for a condition known asG6PD
deficiency.
Treatment
Self-Care at Home
* Sunlight helps to break down bilirubin so that a
baby's liver can process it more easily.
Placing
Types of Jaundice
The most common types of jaundice are:
Physiological (normal) jaundice:occurring in
most newborns, this mild jaundice is due to the
immaturity of the baby's liver, which leads to a
slow processing of bilirubin. It generally appears
at 2 to 4 days of age and disappears by 1 to 2
weeks of age.
a. Vaginal
A. Male infants
Assess for descended testicles.
Care following circumcision
Care of the uncircumcised infant
B. Female infants
Labia may be swollen.
May have blood-tinged discharge.
Teach peri-care.
ASSESS for:
1. Harlequin coloration
- a clear color division over the body from the head
to the abdomen with one half deep pink or red
and the other half pale or of normal color
- indicate shunting of blood with cardiac problems
or sepsis. Redness may occur on the lower side
when the infant lies on the side
3. Vernix caseosa
- A thick ,white substance that resembles cream
cheese
- Provides a protective covering for the fetal skin
in utero
4. Lanugo
- Fine hair that covers the fetus during
intrauterine life
5. Milia
- Are white cysts, 1-2 mm in size resulting from
distention of sebaceous glands that are not yet
functioning properly
6. Erythema toxicum
- A red, blotchy areas that may have white or
yellow papules or vesicles in the center
- Commonly called as fleabite or newborn rash
7. Birthmarks
- Assess the size and location and should be
carefully documented
7.1 Mongolian spots are bluish-black marks that
resembles bruises
- Usually found in sacral area but may appear in arm
andshoulder
7.2 Nevus simplex also called salmon patch, stork
bite or telangiectatic nevus
- a flat, pink or reddish discoloration from
capillaries that occur over the eyelids, just above
the bridge of the nose or at the nape of the neck.
TOOLS:
DUBOWITZ SCORING- is an in-depth, detailed
assessment tool that includes examination of
physical, neurological and behavioral; characteristics
I.
a.
b.
c.
d.
Neuromuscular Characteristics
Posture posture and degree of flexion of the
extremities are scored
Square Window- is elicited by bending the hand at
the wrist until the palm is as flat against the
forearm as possible with gentle pressure
Arm recoil nurse hold the neonates arms fully
flexed at the elbows for 5 seconds, then extends
the am by pulling the hands straight down to the
sides and released quickly and the degree of
flexion is measured
Popliteal Angle newborns lower leg is folded
against the thigh, with the thigh on the abdomen
the lower leg is straightened just until resistance
is met
d. Breasts
Assess:
- Nipple
- Areola
- Size of breast bud
f. Genitals
Assess:(Female)
- Size of clitoris
- -labia majora and minora
Male: location of testes and rugae of scrotum
THANK YOU!!!!!!!!!!!
and
GOD BLESS U