CARE OF THE NEWBORN
NURSING COMPETENCY AUDIT 1
NEWBORN ASSESSMENT
INDICATIONS:
○ Immediately after birth
○ Before discharge from maternity unit
○ Whenever there is any concern
about the infant’s progress.
GUIDELINES:
○ HANDWASHING
○ Keep the newbornwarmduring the
examination
○ Maximize the light. MInimize the
noise
○ Begin with general assessment that
are least disturbing to the newborn
APGAR SCORE:
GESTATIONAL AGE ASSESSMENT:
○ Is performed to estimate a
newborn’s postconceptual age.
○ Gestational Age can be assessed in
4 ways:
a.MATERNAL MENSTRUAL
HISTORY
b. ULTRASOUND
EXAMINATION
BALLARD ASSESSMENT
c.
LENS VASCULARITY ( the
d.
disappearance of anterior
lens capsule vascularity), a
normal embryological
process has a high
correlation with gestational
age at delivery among
○ In 1952, Dr. Virginia Apgar, preterm neonates.
anesthesiologist, came up with the - Smartphone
standard of practice for assessing Ophthalmoscope of
and documenting the infant’s Lens Vascularity to
response to birth. estimate GA
○ Scoring is done 1 minute and 5 - Low income countries
minutes after birth
Postnatal gestational age dating methods are
needed in low/middle income settings as ultrasound
, ○ Estimates gestational age by
neuromuscular and physical maturity
of an infant
○ 13 parameters, including neonatal
postures and postural angles ande
developmental hallmarks such as
plantar creases and genital
characteristics
○ The total score reflects an assigned
GA
A VALID SCREENING:
○ Is one in which blood is drawn after
the baby is 48 hours of age and has
been on protein feedings for 24
hours
○ Repeat screening is request when
an invalid screening occurs
As of now it can detect to up to 28 disorders, however, it is
expensive
GENERAL APPEARANCE
A. POSTURE
○ Full term neonate assumes
NEWBORN SCREENING symmetric posture; face turned to
side; flexed extremities; hands tightly
○ Testing is done by heel- stick shortly
fisted with thumb covered by fingers
after birth
○ keep his or her fists clenched,
○ For early identification of those
babies affected by certain genetic,
elbows bent, hips and knees
metabolic, hormonal and/or flexed, and arms and legs held
functional conditions for which there close to the front of his or her
is effective treatment with early body. This position is similar to
intervention the fetal position during the last
HOW TO PERFORM: months of pregnancy.
○ Using dried filter paper, blood ○ Infants who are bornprematurely
samples are taken from the heel of may display several differences in
the newborn prior to discharge from their posture, appearance,
the hospital. activity, and behavior compared
○ Blood collection from the heel is the with full-term newborns.
standard for newborn screening. The
NURSING COMPETENCY AUDIT 1
NEWBORN ASSESSMENT
INDICATIONS:
○ Immediately after birth
○ Before discharge from maternity unit
○ Whenever there is any concern
about the infant’s progress.
GUIDELINES:
○ HANDWASHING
○ Keep the newbornwarmduring the
examination
○ Maximize the light. MInimize the
noise
○ Begin with general assessment that
are least disturbing to the newborn
APGAR SCORE:
GESTATIONAL AGE ASSESSMENT:
○ Is performed to estimate a
newborn’s postconceptual age.
○ Gestational Age can be assessed in
4 ways:
a.MATERNAL MENSTRUAL
HISTORY
b. ULTRASOUND
EXAMINATION
BALLARD ASSESSMENT
c.
LENS VASCULARITY ( the
d.
disappearance of anterior
lens capsule vascularity), a
normal embryological
process has a high
correlation with gestational
age at delivery among
○ In 1952, Dr. Virginia Apgar, preterm neonates.
anesthesiologist, came up with the - Smartphone
standard of practice for assessing Ophthalmoscope of
and documenting the infant’s Lens Vascularity to
response to birth. estimate GA
○ Scoring is done 1 minute and 5 - Low income countries
minutes after birth
Postnatal gestational age dating methods are
needed in low/middle income settings as ultrasound
, ○ Estimates gestational age by
neuromuscular and physical maturity
of an infant
○ 13 parameters, including neonatal
postures and postural angles ande
developmental hallmarks such as
plantar creases and genital
characteristics
○ The total score reflects an assigned
GA
A VALID SCREENING:
○ Is one in which blood is drawn after
the baby is 48 hours of age and has
been on protein feedings for 24
hours
○ Repeat screening is request when
an invalid screening occurs
As of now it can detect to up to 28 disorders, however, it is
expensive
GENERAL APPEARANCE
A. POSTURE
○ Full term neonate assumes
NEWBORN SCREENING symmetric posture; face turned to
side; flexed extremities; hands tightly
○ Testing is done by heel- stick shortly
fisted with thumb covered by fingers
after birth
○ keep his or her fists clenched,
○ For early identification of those
babies affected by certain genetic,
elbows bent, hips and knees
metabolic, hormonal and/or flexed, and arms and legs held
functional conditions for which there close to the front of his or her
is effective treatment with early body. This position is similar to
intervention the fetal position during the last
HOW TO PERFORM: months of pregnancy.
○ Using dried filter paper, blood ○ Infants who are bornprematurely
samples are taken from the heel of may display several differences in
the newborn prior to discharge from their posture, appearance,
the hospital. activity, and behavior compared
○ Blood collection from the heel is the with full-term newborns.
standard for newborn screening. The
