1. A newborn is considered full term if born between 38-42 weeks gestation. Physical characteristics of newborns include their weight, height, head and chest circumference. They possess several reflexes that disappear with age as they develop. 2. Assessment of newborns includes initial assessment using APGAR scores and measurements, transitional assessment of changes in first 24 hours, physical exam, and gestational age assessment using the Ballard score which examines external and neuromuscular signs. 3. Nursing care of normal newborns focuses on maintaining airway, temperature, vital signs, hygiene and bonding with parents. Common minor problems are vomiting, constipation, excessive crying and skin conditions.

1. New Born
Type of Assessment

2. • Full term baby is deliver at 38-42 weeks. If baby
deliver before 28 weeks known as preterm. Baby
cries just after birth and establish rhythmic
respiration.
• The new born are more prone for infection as
they have less immunity.
• Physical character of new born-
• Weight -2.5-3.5 kg
• Height-45-50cm
• Head Cir.-35cm
• Chest Cir.-32-33 cm
• Mid arm cir.-12-13 cm

3. • Body Proportion-1.7:1
• Presence of lanugo, vernix caseosa, meconium
• Ext auditory canal is short and straight
• Physiological characteristics-
Temp-36.5-37.5
Pulse-120-160/min
At sleep pulse is 100/min
Resp-30-60/min
Bp- systolic-60-80 mm Hg
Diastolic 25-40 mm Hg

4. Reflexes Beginning age Disappearance age
Sucking reflex At birth At 6 months
Rooting reflex At birth 4-7 months
Gagging At birth Does not disappear
Swallowing At birth Does not disappear
Blinking At birth Does not disappear
Sneezing and coughing At birth Does not disappear
Dolls eye At birth 3 months
Stepping or dance At birth Diminish 3-4 weeks
Moro At birth 3-4 months
Parachute 7-9 months Some time Not disappear
Tonic neck 2 month 6-9 month of age
Palmer grasping At birth Diminish by 3 month age
Planter grasp At birth Diminish by 8 month
Pincer grasp 8-9 month Diminish at 11 month

5. • Assessment of new born:
• Assessment of new born helps to screen
disease in initial stage at new born. There are
4 types of assessment-
• 1.Initial assessment (by APGAR score &
anthropometric measurement):
• 2.Transitional assessment:
• 3.Physical assessment:
• 4. Gestational age assessment:

6. • 1.Initial assessment (by APGAR score &
anthropometric measurement):
• Appearance (skin coloration)
• Pulse (heart rate)
• Grimace response (medically known as "reflex
irritability")
• Activity and muscle tone
• Respiration (breathing rate and effort)

8. • 2.Transitional assessment: first 24 hrs are very
critical for new born, it require a lot of care.
• There are changes in heart rate, respiration,
ms tone, motor activity etc. first 24 hrs known
as period of reactivity.
• i. first period of reactivity- first 6-8 hrs after
birth called first period of reactivity. During
this ms tone should be active
• ii. Second period of reactivity- 9-24 hr of first
day. The nurse should observe abnormal
physiology of nervous system, respiratory sys,
muscular system

9. • 3.Physical assessment of new born-
• SHE ENT MNC HAG RE
• 4. Gestational age assessment:
• This hepls us to identify about gestational age
of baby. On the basis of this we can identify
about preterm and term baby.
• The method is known as New Ballard score.
The nurse should observe 2 types of signs in
neonate.

10. External Physical sign: ( HSE BGP)
1. Hair texture
2. Skin texture and opacity
3. Ear cartilage
4. Brest nodules and nipple formation
5. Planter creases
6. Genitalia- male/female

11. • Neuromuscular sign:
1. Body posture
2. Square window
3. Arm recoil
4. Popliteal angle
5. Scarf sign
6. Heel to ear (PSA PSE)

12. • 1. Posture
• Total body muscle tone is reflected in the
infant's preferred posture at rest and
resistance to stretch of individual muscle
groups
• To elicit the posture item, the infant is placed
supine (if found prone) and the examiner
waits until the infant settles into a relaxed or
preferred posture.

13. posture

14. • 2. Square Window
• Wrist flexibility and/or resistance to extensor
stretching are responsible for the resulting angle
of flexion at the wrist.
• The examiner straightens the infant's fingers and
applies gentle pressure on the dorsum of the
hand, close to the fingers. From extremely pre-
term to post-term, the resulting angle between
the palm of the infant's hand and forearm is
estimated at;
• >90°, 90°, 60°, 45°, 30°, and 0°.
• The appropriate square on the score sheet is
selected.

15. square window

16. • 3. Arm Recoil
• This maneuver focuses on passive flexor tone
of the biceps muscle by measuring the angle
of recoil following very brief extension of the
upper extremity.
• With the infant lying supine, the examiner
places one hand beneath the infant's elbow
for support. Taking the infant's hand, the
examiner briefly sets the elbow in flexion,
then momentarily extends the arm before
releasing the hand.

17. arm recoil

18. • 4. Popliteal Angle
• This maneuver assesses maturation of passive
flexor tone about the knee joint by testing for
resistance to extension of the lower extremity.
With the infant lying supine, and with diaper
re-moved, the thigh is placed gently on the
infant's abdomen with the knee fully flexed.
After the infant has relaxed into this position,
the examiner gently grasps the foot at the
sides with one hand while supporting the side
of the thigh with the other.

19. popliteal angle

20. • 5. Scarf Sign
• This maneuver tests the passive tone of the
flexors about the shoulder girdle.
• The examiner nudges the elbow across the
chest, felling for passive flexion or resistance
to extension of posterior shoulder girdle flexor
muscles.

21. scarf sign

22. • 6. Heel to Ear
• The examiner supports the infant's thigh
laterally alongside the body with the palm of
one hand. The other hand is used to grasp the
infant's foot at the sides and to pull it toward
the ipsilateral ear.

23. heel to ear

27. • Nursing management or care of normal new
born:
• A. establishing & maintain patent airway
• B. maintain normal body temperature
• C. monitoring vital signs
General care :
i.weighing
ii.bowels and urinary passage
iii. care of eyes
iv.care of cord
v. care of skin

28. • Vi. Administration of Vit. K
• Vii. Care of genital
• Viii. Prevention of infection
• Ix. Adequate nutrition
• X. clothing of baby
• Xi. Baby bath
• Xii. Immunization
• Xiii. Psychological bonding with parents
• Xiv. Parents health education and follow up

29. • Minor problems of neonate:
• i. vomiting:
• Ii. Constipation
• Iii. Diarrhea
• Iv. Excessive crying
• V. Evening colic
• Vi. Excessive sleepiness
• Vii. Sneezing and nose block
• Viii. Hiccups
• Ix. Napkin rash
• X. breathing holding spells

30. • Xi. Cradle cap
• Xii. Obstructed naso lacrimal duct
• Xiii. Umbilical granuloma
• Xiv. Mastitis neonatrum
• Xv. Vaginal bleeding and mucoid secretion
• Xvi. Physiologic phimosis
• Xvii. Mongolian blue spots
• Xviii. Milia
• Xix. Predeciduous teeth
• Xx. Umbilical hernia
• Xxi. Congenital hydrocele xxii. Bowed legs