maternal unit 1

gestastional age

time of conception to birth

parts of gestational age assessment

external physical characteristics

neurological/neuromuscular development

preterm (skin)

thin + transparent with prominent veins

postterm (skin)

long hair +. nails, no lanugo or vernix

term (skin)

opaque and disappearance of the vernix caseosa

vernix caseosa

waxy, white, cheese like coating

lanugo hair

found all over except hands and soles of feet

decreases as gestational age increases

when should sole creases be assessed

first 12 hours of life (age increase = more)

term (breast bud)

should measure between 0.5 and 1 cm

preterm (ear)

shapeless and flat w/ no recoil

term (ear)

some cartilage and slight incurving of upper pinna (good recoil)

preterm (male genitals)

small scrotum, few rugae, testes are palpable in inguinal canal

term (male genitals)

testes in the lower scrotum which is usually covered with rugae

preterm (female genitalsj

clitoris is prominent; labia majora are small and widely seperated while labia minora is protrude

term (female genital)

labia majora covers the labia minora and clitoris

what is a nutritional indicator for term females

presence of female genitals

term (posture)

fully flexed

preterm (posture)

fully extended

preterm (square window)

90 degrees

term (square window)

30-40 degrees to 0 degrees

term (recoil of arms)

increased recoil d/t increased gestational age

term (popliteal angle)

more resistance

term (scarf sign)

arm does not cross midline

preterm (scarf sign)

arm will cross over midline

term (heel to ear)

will not touch ear

preterm (heel to ear)

will touch and can possibly go beyond ear

where to test skin turgor

forearm, thigh, abdomen

head size

proportionally larger than body

shape of angerior fontanelle

diamond

shape of posterior fontanelle

triangular

depressed fontanelle =

dehydratiom

bulging fontanelle =

increased intracranial pressure

what can crying do to frontanelle

bulge

why crying with no tears

no mature lacrimal structures

breathing function

through nose ONLY

if ears are not level with eyes

indication for many syndromes & chromosomal abnormalities

breast engorged from

mother’s hormones

respirations

30 to 60 per min

heart rate

110 to 160 per min

when are bowel sounds present

1 hr after birth

umbilical cord findings

2 arteries and 1 vein

umbilical cord vessels meaning

congenital heart abnormalities

female genitalia

labia majora covers labia minora

labia majora covers labia minora unless

inadequate nutritional status

male genitalia

testes descended

what to look for in legs

make sure creases are even

measuring weight

5 to 10% weight loss

when does weight loss occur

first 3 to 4 days

measuring length

1 in monthly

measuring head circumference

2cm > chest

how to measure chest circumference

over nipple line/scalpula

measuring abdominal girth

around the umbilicus

temperature

97.7 to 99 F

precocius teeth

remove if loose

epstein’s pearls

keratin containing cysts

how long do epstein’s pearls last

couple weeks

thrush

caused from infected vaginal canal, poor hand washing

acrocyanosis

blue hands/feet

acrocyanosis means

normal first 24 hrs d/t blood going to organs

mottling

lacy pattern of blood vessels

mottling means

cold or sepsis

not normal

jaundice 1st

face/mucous membranes

jaundice 2nd

hands/feet

how to assess jaundice

screen for bilirubin on forehead

what causes jaundice

high amounts of bilirubin

when to be concerned about jaundice

first 24 hrs

erythema toxicum

“newborn rash”

caused from environment

milia

exposed sebaceous glands

no tx

forcep marks seen with

circular marks

when do forcep marks go away

1 to 2 days

stork bites seen

by eyes, nose, nape

noticeable when crying

when do stork bites go away

2nd bday

blue grey spots seen on

guttocks/lower back

blue grey spots common with

darker skin tones

blue grey spots significance

none

port wine stain

doesnt blanch, fade, or grow in size

strawberry mark

grows until 6 month then fades

cephalohematoma

does not cross sutures + grow when crying

when does cephalohematoma go away

in weeks to months

caput succedaneum

does cross suture line

when does caput succedaneum go away

within hrs to days via reabsorption

low set ears =

chromosomal/genetic disorder

subconjunctival hemorrhage

ocular pressure during birth

1 to 2 wk duration

transient strabismus

poor neuro muscular control

gone in 3 to 4 months

dolls eye syndrome

underdeveloped head eye coordination

lasts 10 days

webbing of the neck =

abnormal

xiphoid cartilage injury

occurs dung birth

very pronounced

signs of resp distress

nasal flaring @ grunting

intercostal/xiphoid retractions

grunting on expiration

apnea > 15 secs

tachypneic (>60 secs)

normal respiratory variations

apnea <15 secs

nasal flaring

low pitched murmur

normal

takes 12 days

vaginal tag

disappears in wks

pseudomensturation

white mucous discharge d/t withdrawal of maternal hormones

smegma

do not remove

white cheese like substance between labia

hypospadias

meatus on ventral surface

epispadias

meatus on dorsal surface

phimosis

small foreskin opening = cannot retract

hydrocele

fluid around testes in scrotum

testicular torsion

spermatic cord strangulation

cryptorchidism

testes fail to descent

palpate for pea like structures

dropping baby’s shoulders onto mattress =

startle