Return Demonstretion Onnewborn Examination
Return Demonstretion Onnewborn Examination
Return Demonstretion Onnewborn Examination
INTRODUCTION
Life begins at conception about 9 months before delivery.Maternal health and events during pregnancy
have profound effect on well being of baby. Newborn physical examination is a means to assess the
health and wellbeing of the neonate.
DEFINITION:
A detailed and systemic whole body examination of a stabilized newborn during the early hours
of life.
PURPOSE:
1. To determine the normalcy of different body systems for healthy adaptation to extrauterine life.
2. To detect significant medical problems for immediate management.
3. To detect any congenital problems for early management and parent education
SPECIAL POINTS:
1. Friendly approach to the newborn and to the informant is important.
2. Information to be recorded clearly and orderly immediate after the collection.
3. Complaints to be written in informants own words rather than medical terms.
4. System review should be done to exclude any missing problem of any system.
PRINCIPLE OF ASSESSMENT:
1. Physical examination is the head to foot examination of an individual along with examination
of different system to exclude the abnormalities present in them
2. It includes anthropometric examination.
3. Method used for physical examination is inspection, palpation, manipulation, percussion and
auscultation.
ARTICLES REQUIRED:
ARTICLES PURPOSES
A. A tray containing:
1. Articles for temperature taking 1. To ascertain temperature.
PREPARATION OF ARTICLES:
GENERAL INSTRUCTIONS:
1. The newborn must be stabilized before starting the assessment procedure, i.e. normal body
temperature and colour.
2. The newborn should be protected from harmful processes such as chilling or nosocomial
infection.
3. Examination should be done systematically.
1. For examination of the head and neck put the child on mother to hold the newborn firmly, or
use mummy restraint.
2. For examination of the chest and abdomen use modified mummy restraint exposingthe chest
and abdomen or have the babylie on the bed, steadying him/her with your hands.
3. For examination of arms, leg-restraints can be use or continue to lie on the bed.
4. For examination the back-place the neonate in prone position.
PROCEDURE:
Steps Rationale
Face
To assess presence or absence of facial palsy
Symmetry /swelling Or injury
Eyes
Discharge- present/not
To assess presence of infection
Nares: bilaterally present/absent
To assess patency of nasal passage
Nasal passage: patent /not
Nasal flaring –present/absent
Ears
Oral cavity
To assess hydration level
Mucous membranes: moist/dry
Pink/pale
Chin shape and size in proportion with face
Palate: without arching intact (determine by
palpating)
To assess congenital anomaly
Cleft lip/palate-present/absent.
Tongue: size in proportion with mouth
Tongue: midline/tongue tie is present
Uvula: midline rises with crying/not
Neck
Chest
Shape and size: Round/Barrel shaped To identify any abnormality
To assess maturity
Chest circumference: To assess respiratory status of the new born
Ribs: Symmetric/asymmetric
Breast tissue : nipple spacing on the line
without extra nipples To assess presence of respiratory infection
Areola: raised and without discharge
Respiratory effort: easy, unlabored /difficult
Respiratory rate
Rhythm; regular/ irregular, but
Chest movement-Bilateral symmetrical or
not
Breath sound: normal/grunting/wheezing/
Heart rate;
Rythm: regular/irregular
Murmurs: present/absent To assess caediac function
(initially may hear slight murmur until
ductus arteriosus closes)
Apical pulse at fourth or fifth intercostals
space, mid clavicular line, left anterior chest
/on right side.
Thrill: present/not To assess normal location of heart.
Abdomen
Upper extremities
Length: in proportion to each other extremities
and body symmetrical To assess range of movement
Full range of joint motion
Scarf sign: elbow short of midline (grasp
infant’s hand and gently pull hand around neck
To assess gestational maturity
toward the opposite shoulder; observe position
of elbow to chest; grade position according to
gestational chart)
Arm recoil: (quickly fled neonate’s forearms for To assess gestational maturity
5 seconds, next pull them to full extension, then
release; recoil time is graded)
Palm: creases
Nails: extend beyond nail beds
Nail beds: pink, brisk capillary refill (<3
seconds, equal bilaterally
To assess congenital anomaly
Fingers: 10 digits/oligodactile/syndactile/polydactile
Genitalia
(Female)
Hips:
without clicks and full range of motion To assess hip dislocation
(Ortolani’smaneuver: flex newborn’s hips and
knees, then abduct and adduct hip to detect a
slipping of the hip out of the acetabulum or an
even motion unilaterally;
Barlow’s maneuver: flex newborn’s hips and
knees, then place finger on the femur and
trochanter, put hip through full range of joint
motion and listen for audible click)
Lower extremities
In following aspects
2.preventiion of hypothermia
3.Prevention of infection
4.Immunization
5. Follow up
Impression:
Baby is active, alert
Vitals are normal
Anthropometric measurements are normal
Reflexes are normal
No congenital anomalies
Feeding well
CONCLUSION:
So a simple rapid quick assessment of newborn help to find the path to manage the neonatal
complications,assure mother of baby’s normalcy and prevent medicolegal problem
PROCEDURE GUIDESHEET
ON
NEWBORN EXAMINATION
Submitted to
Madam M. Roy
Senior lecturer
Govt College of Nursing, Burdwan
Submitted by
Anupama Jash
M. Sc Nursing Final year
Govt College of Nursing, Burdwan