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A Typical Newborn
Flexed Puffy Molded Nose breathers Irregular HR and
RR Acrocyanosis Periods of
reactivity
Apgar score: What does it tells us?
HR, Resp. effort, tone, reflexes, color
1 min & 5 min 0-10 Good: 7-10
They do all kinds of weird things
Cross their eyes Holes in their
heads Have dry skin
(after the vernix absorbs)
They sneeze Like being
wrapped up tightly Don’t get spoiled
Know your Patients history!
Prenatal: IDM?, GBS+?, mother’s bld type, significant labs or tests, gen. history
Intrapartum: length of labor, PROM, medications received, anoxia, assisted birth, FSE,
Determining Gestational Age
Neuromuscular Physical
skin lanugo plantar surface breast eye/Ear Genitals
Score: i.e. 30=36 wks
Newborn Screening
Hypothyroidism PKU Galactocemia Sickle cell (most
common) CF Congenital adrenal
hyperplasia (CAH)
Pulse Oximetry: CDC recommendation
Well newborn screening >24 hours old or at discharge if early discharge.
To detect asymptomatic critical heart defects
At least 95% in right hand or foot and < 3% difference between R hand and foot
Algo hearing test
50% congenital 50% environment
OAE: otoacoustic emissions testing
ABR: auditory brainstem response
They have to be calm and quiet!!!
On a scale of 1-10 rate your pain!
Obvious Subtle
Grimace, eye squeeze, brow contraction, nasolabial furrows
Flexed and rigid Really quiet or
restless Pain scales for Infants:
CRIES or NIPS
Circumcision
Informed consent from parents
Pain medication for patient Before and after)
Post op care Check for
bleeding, voiding