powerpoint_Neonate Assessment_with Narration

Key Topics

Head and Face

• Fontanelles

  • Soft spots on an infant's head.

  • Should feel firm and slightly inward.

  • Signs of Concern:

    • Sunken Fontanel: indicates dehydration; check skin turgor (elasticity)

    • Bulging Fontanelle: could indicate inflammation or increased intracranial pressure (ICP).

    • Bulging during crying or vomiting is common but should return to normal when calm.

• Caput Succedaneum

  • Fluid collection between skin and periosteum due to trauma during delivery.

  • Characteristic: Crosses suture lines.

• Choanal Atresia

  • Congenital disorder with blockage at the back of the nasal passage; caused by abnormal tissue and failed recanalization of the nasal fossae during development

• Pierre Robin Sequence

  • Condition at birth with a small lower jaw and falling back of the tongue, causing breathing difficulties.

  • Management includes positioning prone and using oral airways as needed.

• Cleft Lip/Palate

  • Congenital deformities affecting the upper lip and/or the roof of the mouth.

  • cleft lip and cleft palate can occur together or separately

  • high risk of aspiration when feeding, due to the opening in the hard and soft palate, and the nasal cavity

  • Requires surgical intervention.

Cardiovascular System

• Patent Ductus Arteriosus

  • Persistence of a fetal blood vessel that should close after birth.

  • Can lead to heart failure if untreated.

Respiratory System

• Periodic Breathing

  • Normal in infants, characterized by short pauses and irregular rates in breathing during sleep.

Body and Gastrointestinal Concerns

• Jaundice

  • Common in newborns, characterized by yellowing of skin and sclera due to high bilirubin levels from red blood cell breakdown.

  • Typically resolves within 1-2 weeks but may require phototherapy (a special light the breaks down bilirubin molucules in water soluble isomers that are excreted by the body)

  • breastfeeding, increased nutrients and stimulate bowels

  • blood transfusion, albumin protein

  • High bilirubin can lead to encephalopathy if untreated, resulting in serious neurological issues.

• Diaphragmatic Hernia

  • Abnormal opening in the diaphragm, affecting breathing.

  • Most common left-sided; mortality can be high (up to 50%).

  • Signs: Decreased breath sounds and a scaphoid abdomen.

  • DO NOT USE A BVM, it introduces air, distending the intestines

  • positive pressure ventilations needed, use advanced airway

  • requires surgical correction

• Omphalocele and Gastroschisis

  • Gastroschisis: Notable defect in the abdominal wall with freely exposed content.

  • Omphalocele: Intestines protrude through the umbilical area, covered by membranes.

  • Both conditions require surgical intervention and careful management.

Neurological and Musculoskeletal Assessment

• Myelomeningocele

  • A severe type of spina bifida with spinal canal opening.

  • Protected from pressure; hold the newborn on the side or prone.

Neonate Reflexes

• Reflex Assessments

  • Moro Reflex: Startle reflex when startled.

  • Palmar Grasp Reflex: Grasping when the finger is placed in palm.

  • Rooting Reflex: Turning towards a stimulus around the mouth for breastfeeding.

Breastfeeding

• Assess positioning and latch, especially in postpartum hemorrhage situations.

Diaper Output Monitoring

Average Output

Assessment upon Entry

• Record observations and ask parents about:

  • Gestational age and pregnancy complications.

  • Feeding patterns and neonatal outputs.

  • Overall health of the household.