Newborn-Infant Physical PDF

Lecture by: Dr. Rachel Rogers, M.D. Slides adapted from: Amanda Fleenor, MMS, PA-C Clinical Skills  Newborn/Infant - From birth to first 4 weeks (28 days) of life  Pre-term – Birth before 37 weeks gestational age  Term/Full-term – Birth 37 weeks- 41 weeks 6 days...

Lecture by: Dr. Rachel Rogers, M.D. Slides adapted from: Amanda Fleenor, MMS, PA-C Clinical Skills  Newborn/Infant - From birth to first 4 weeks (28 days) of life  Pre-term – Birth before 37 weeks gestational age  Term/Full-term – Birth 37 weeks- 41 weeks 6 days gestational age  Post Term- 42weeks or > gestational age Definitions  Dry and Suction the newborn  Determine APGAR Scores  Initial Exam – Airway, General, chest, abdomen  Complete exam delayed until infant admitted to nursery  Vitamin K Administration – 1 mg IM  Ophthalmic ointment application - infection prophylaxis  Glucose Evaluation Stabilization in delivery room   Assesses newborn immediate adjustment to extrauterine life  Determined at 1 minute and 5 minutes of life  If score is or has reached 20 minutes of life Apgar Score Born SVD to a G2 P2 26yo, no complications At 1 min: Comes out crying and vigorous but color is still blue. HR 150BPM. When you bulb syringe the baby he gets mad! At 5 min: Crying off and on, pink with blue hands and feet, good flexion, HR 140’s. Baby A Mom 35, G1P1, vacuum assisted delivery. At 1 min: Infant is floppy, HR 120, when you bulb syringe baby turns away, color is blue and the breathing is slow & irregular At 5 min: There is now some flexion, HR 180, coughing, pink with AC, good breathing but not crying Baby B  Periods of reactivity  Stage 1: Initial Period of activity - birth to 30 min  Stage 2:Period of relative inactivity 30m -2 hours  Stage 3: Second period of reactivity 2-6 hours  Stability period 6-24 hours  Actual times vary by baby, but there should always be a pattern of activity/sleep/activity  Presence of periods of reactivity indicate a positive adjustment to extrauterine life Transition from uterine to extrauterine life  Warm environment  Good lighting and very little noise  Be flexible with order of exam Before you start.. Vital Signs  Low Birth Weight (LBW):