1. Newborn Assessment : Fine Tuning Your Assessment Skills Kim McCullen, NNP-BC Munson Medical Center

2. Organizing the Newborn Exam The significance of OBSERVATION Tools used to complete the Physical Exam (PE) – Auscultation – Palpation – Percussion – http://newborns.stanford.edu/PhotoGallery/VSD4. html

3. Perinatal History Brief review of the Perinatal History for “clues” to potential pathology The newborn’s history begins with conception and includes events that occur throughout gestation, labor, and delivery. Categorization of High-Risk Pregnancy Factors - Socioeconomic Factors, Demographic Factors, Medical Factors, Current Maternal Obstetric Status, Habits

4. Basic Newborn Assessment of the Term Neonate

5. Skin PE of the skin, what does and can it mean? – Cutis Marmorata – Harlequin Color Change – Ecchymosis – Macule – Petechiae – Vesicle – Pustule

6. Cutis Marmorata

7. Harlequin Color Change

8. Ecchymosis (Bruising) Increases Risk for Jaundice

9. Macule

10. Petechiae

11. Vesicle

12. Pustule

13. Head to Toe Assessment!

14. Head Measurement: Microcephaly? Macrocephaly? Shape: molding?

15. Skull: fontanels and sutures

16. Face

17. Ears

18. Eyes

19. Nose

20. Mouth

21. Chest

22. Heart Murmur? 4 limb Blood Pressure Pulses

23. Fetal Circulation

24. Normal Heart

25. PDA

26. Coarctation of the Aorta

27. Abdomen Size Shape Movement

28. Abdomen

29. Genitourinary

30. Hypospadius

31. Hymenal Tag

32. Musculoskeletal

33. Late Preterm Newborn Hypothermia Hypoglycemia Respiratory distress Apnea Hyperbilirubinemia Feeding difficulties

34. Medications At Birth

35. Vitamin K http://www.cdc.gov/ncbddd/blooddisorders/ documents/vitamin-k.pdf

36. Hepatitis B Vaccine http://www.cdc.gov/hepatitis/B/

37. Public Health Services Newborn Screen CCHD Screen Hearing Screen

38. Questions?

39. Newborn Assessment: Fine Tuning Your Assessment Skills Interactional reference for physical examination: http://newborns.stanford.edu/PhotoGallery/ Vitamin K reference: http://www.cdc.gov/ncbddd/blooddisorders/doc uments/vitamin-k.pdf http://www.cdc.gov/ncbddd/blooddisorders/doc uments/vitamin-k.pdf Hepatitis B Vaccine reference: http://www.cdc.gov/hepatitis/B/