Scribd Logo
Upload

Welcome to Scribd!

  • 155 views

    F. Physical Assessment: 5. Eyes

    Uploaded by

    Juliane
    This document describes a complete physical assessment of a newborn, including assessment of eyes, ears, nose, mouth, neck, chest, skin, abdomen, genitals, back, and extremities. Key findings and abnormalities that may be observed are outlined for each body system. Common birthmarks like hemangiomas and Mongolian spots are also described. The assessment provides a comprehensive overview of what should be evaluated in a newborn physical exam.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    F. Physical Assessment: 5. Eyes

    Uploaded by

    Juliane
    155 views47 pages
    This document describes a complete physical assessment of a newborn, including assessment of eyes, ears, nose, mouth, neck, chest, skin, abdomen, genitals, back, and extremities. Key findings and abnormalities that may be observed are outlined for each body system. Common birthmarks like hemangiomas and Mongolian spots are also described. The assessment provides a comprehensive overview of what should be evaluated in a newborn physical exam.

    Original Title

    04.1-Newborn_02

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    This document describes a complete physical assessment of a newborn, including assessment of eyes, ears, nose, mouth, neck, chest, skin, abdomen, genitals, back, and extremities. Key findings and abnormalities that may be observed are outlined for each body system. Common birthmarks like hemangiomas and Mongolian spots are also described. The assessment provides a comprehensive overview of what should be evaluated in a newborn physical exam.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    155 views47 pages

    F. Physical Assessment: 5. Eyes

    Uploaded by

    Juliane
    This document describes a complete physical assessment of a newborn, including assessment of eyes, ears, nose, mouth, neck, chest, skin, abdomen, genitals, back, and extremities. Key findings and abnormalities that may be observed are outlined for each body system. Common birthmarks like hemangiomas and Mongolian spots are also described. The assessment provides a comprehensive overview of what should be evaluated in a newborn physical exam.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    You are on page 1of 47

    F.

    Physical Assessment

    5. Eyes
    - usually cries without tears
    - small subconjunctival hemorrhage
    due to pressure during birth causing
    rupture of capillaries in the sclera
    - completely absorbed in 2-3 weeks
    - periorbital edema remain for the
    first 2-3 days of life
    - eyesight is between 20/200 to
    20/400
    - sensitive to bright light
    F. Physical Assessment

    6. Ears
    - top part of the external ear should be
    in line with the outer canthus of the
    eye
    - small tags of skin may be associated
    with abnormalities but are isolated
    findings
    - test hearing by ringing a bell 6-inch
    beside each ear
    - NEWBORN HEARING SCREENING
    TEST
    - Otoacoustic Emissions Test (OAEs)
    - Auditory Brainstem Response Test (ABRs)
    F. Physical Assessment

    7. Nose
    - may appear large for the face
    - test for choanal atresia
    - has presence of milia
    - small pinpoint white or yellow dots
    usually found in the nose, forehead
    and cheeks
    Transnasal Endoscopic Surgery
    Milia
    F. Physical Assessment

    8. Mouth
    - Epstein pearls – small, round,
    glistening, well circumscribed cysts
    on the palate
    - thrush – a Candida infection, white
    or gray patches on the gums, roof of
    the mouth, tongue and sides of the
    cheeks
    - blowing bubbles of mucus –
    suggestive of TEF (tracheoesophageal
    fistula)
    - natal teeth – teeth present at birth
    - neonatal teeth – teeth that erupted
    within the first month of life
    Epstein Pearls
    Thrush / Oral Thrush
    Tracheoesophageal
    Milia Fistula (TEF)
    Natal Teeth
    F. Physical Assessment

    9. Neck
    - short and chubby with creased skin
    folds
    - not strong enough to support the
    weight of the head yet
    - head should rotate firmly on the neck
    and should be able to flex forward
    and back
    F. Physical Assessment

    10. Chest
    - symmetrical
    - breasts may be engorged
    - witch’s milk – thin, watery fluid
    secreted by the newborn’s breast
    - retraction should not be present
    - abnormal sounds:
    1. rhonchi – gurgling sound caused by
    air passing through mucus at the
    back of the throat
    2. grunting – suggestive of RDS
    3. high crowing sound- suggestive of
    stridor or immature tracheal
    development
    F. Physical Assessment

    11. Skin
    A. COLOR
    - normally with ruddy complexion
    - generalized mottling
    - cyanosis
    F. Physical Assessment

    11. Skin
    A. COLOR
    1. Acrocyanosis – pink body, blue
    extremities (and lips); normal during the
    first 24-48 hours after birth
    2. Central cyanosis – cyanosis of the
    trunk, tongue and mucous membranes
    of the mouth and cheek
    - indicates underlying disease state or
    oxygenation problems
    F. Physical Assessment RBC

    11. Skin Heme Globin


    A. COLOR
    3. Jaundice – yellowing of the skin and
    sclera due to hyperbilirubinemia Iron Protoporphyrin
    - neonate’s immature liver is unable to
    conjugate bilirubin
    Indirect
    a. Pathologic jaundice – present 24
    hours after birth bilirubin

    b. Physiologic jaundice – from the


    2nd or 3rd to the 7th day of life Glucuronyl
    - breastfed babies have long transferase
    periods of physiologic jaundice
    because the human milk has
    pregnanediol which depresses
    the action of glucuronyl Direct bilirubin
    transferase
    Jaundice in Newborn
    F. Physical Assessment

    11. Skin
    Kernicterus
    - brain damage due to the buildup of
    bilirubin
    - bilirubin moves into the
    bloodstream to the brain tissue
    - permanent neurologic damage,
    including in cognition
    Phototherapy (Bili Light)
    F. Physical Assessment

    11. Skin
    4. Pallor
    - usually caused by anemia

    5. Harlequin Sign
    - a newborn that has been lying on his
    side will appear red on the dependent
    side of the body and pale on the upper
    side
    F. Physical Assessment

    1!. Skin
    B. BIRTHMARKS

    Hemangiomas
    – vascular tumors of the skin

    Three types:
    1. Nevus flammeus
    - macular purple or dark red lesions
    - a.k.a. port wine stain
    - typically on the face but also found on
    the thighs
    F. Physical Assessment

    11. Skin

    2. Stork’s beak mark


    - a nevus flammeus lesions that is
    lighter pink in color
    - sometimes called telangiectasia
    - typically on the back of the neck
    F. Physical Assessment

    11. Skin

    3. Strawberry hemangioma
    - elevated areas formed by immature
    capillaries and endothelial cells
    - may be present at birth or appear
    within the first 2 weeks of life
    - may continue to enlarge until the
    first year of life
    - after 1 year old, it begins to be
    absorbed by the body and shrinks in
    size
    - hydrocortisone ointment may be
    applied
    F. Physical Assessment

    11. Skin

    4. Cavernous hemangioma
    - dilated vascular spaces
    - looks like strawberry hemangiomas
    but they don’t fade with age
    - may be surgically removed
    F. Physical Assessment

    11. Skin
    B. BIRTHMARKS

    Mongolian spots
    - collections of pigment cells
    (melanocytes) that appear as
    slate-gray patches across the
    sacrum or buttocks and possibly
    the arms and legs
    - fade without treatment during
    school age
    F. Physical Assessment

    11. Skin
    C. VERNIX CASEOSA

    - a white, cream cheese-like substance


    that serves as a skin lubricant.
    - takes the color of the amniotic fluid:
    yellow = bilirubin
    green = meconium
    F. Physical Assessment

    11. Skin
    D. LANUGO

    - fine, downy hair that covers the


    shoulders, back, and upper arms
    - may also be found on the forehead
    and ears
    - usually disappears after two weeks
    due to rubbing against clothes and
    beddings
    F. Physical Assessment

    11. Skin
    E. DESQUAMATION

    - within 24 hours from birth, extreme


    skin dryness may occur, especially on
    the palms and soles
    - causes peeling of the skin
    - no treatment needed
    F. Physical Assessment

    11. Skin
    F. ERYTHEMA TOXICUM

    - newborn rash
    - usually appears in the 1st to 4th day of
    life and up to 2 weeks
    - a.k.a. flea bite rash
    - no treatment
    F. Physical Assessment

    11. Skin
    G. SKIN TURGOR

    - feels resilient if the underlying tissue


    is well hydrated
    - good: skin is elastic and falls back
    when pinched
    - decreased or poor: skin remains e
    levated when pinched or falls back
    slowly
    F. Physical Assessment

    12. Abdomen

    - slightly protuberant
    - bowel sounds should be present
    within an hour after birth
    - assess the umbilical cord
    stump
    F. Physical Assessment

    13. Anogenital

    - passage of meconium during


    the first 24 hours
    - check the patency of the anus
    F. Physical Assessment

    13. Anogenital

    Male Genital Area

    - penis appears small (less than 2 cm)


    - scrotum may be edematous and has rugae
    - both testes should be present
    - cryptorchidism – one or both testicles are not present
    - elicit cremasteric reflex to test for the integrity of spinal
    nerves T8 to T10
    - may be absent in newborns less than 10 days old
    Cryptorchidism
    F. Physical Assessment

    13. Anogenital

    Male Genital Area

    - urethral opening should be at the tip of the glans

    Epispadias – opening at the dorsal surface


    Hypospadias – opening at the ventral surface
    Epispadias, Hypospadias, Normal Urethral Opening
    F. Physical Assessment

    13. Anogenital

    Female Genital Area

    - vulva may be swollen


    - may have a mucus vaginal
    secretion, sometimes blood-tinged
    (called pseudomenstruation)
    F. Physical Assessment

    14. Back

    - flat lumbar and sacral


    areas
    - observe for spina bifida
    F. Physical Assessment

    15. Extremities

    - arms and legs appear short


    - hands are plump and clenched into fists
    - hold the arms down to the side and note the length:
    the fingertips should cover the proximal thigh
    - unusually short arms could indicate achondroplastic dwarfism
    - observe for simian crease (single palmar crease)
    - associated with Down syndrome
    Achondroplastic dwarfism
    Simian crease
    F. Physical Assessment

    15. Extremities

    - arms and legs should be symmetrical

    Erb-Duchenne palsy (Erb’s palsy)


    - the result of a severe tear to a
    newborn’s brachial plexus nerves due
    to a shoulder dystocia delivery
    F. Physical Assessment

    15. Extremities

    - arms and legs should be


    symmetrical

    Congenital hip dysplasia


    - a.k.a congenital hip dislocation
    - neonate is born with an unstable
    hip
    - abnormal formation of hip joint
    F. Physical Assessment

    15. Extremities

    - assess for digit (fingers and toes)


    abnormalities

    Syndactyly
    - webbing of fingers and/or toes

    Polydactyly
    - extra fingers and/or toes
    F. Physical Assessment

    15. Extremities

    Talipes deformity
    - a.k.a. clubfoot
    - the feet does not align readily or
    will not turn to a definite midline
    position

    You might also like