Post delivery intact care
- Suction airway
- Keep below mothers heart until cord severed
- Save cord blood
- Test Rh status
- Wash, clean, weigh & asses
- Breast feeding within 1 hr
APGAR
Assessed at 1 & 5 min
- Appearance (Color)
- Pulse (>100)
- Grimace (response to nasal catheter)
- Activity (musc tone)
- Respirations (crying)
Gestational age
- Based on LMP
- In weeks and days
- Ex: 29wk, 5 days
Fontanelles
Anterior: Closes 9-18 mo
Posterior: Close 1-2 mo
Caput succedaneum
- Fades 7-10 days
- Subcutaneous edema over presenting part of head
- Common in newborns
Cephalohematoma
- Subperiostal collection of blood
- Shearing forces during labor
- Bounded by suture line
- Resolves spontaneousy
Cephalohematoma
- Subperiostal collection of blood
- Shearing forces during labor
- Bounded by suture line
- Resolves spontaneously
Breastfeeding
First 6 months at least
- Contraindicated with TB, galactosemia & HIV
Bottle feeding
- Supplemented iron if formula
- Breast milk best
- Avoid bottle propping
Solid foods
Around 6 months
- Wide variety
- Healthy snacking after 9 months
- Encourage self feeding, drinking
Asymmetric tonic neck
- Fencing position
- 8 months
Rooting
Head turns to side of facial stimulation
- 3-4 months
Babinski
- Toes fan, great toe dorsiflexion
- 2 yrs
Palmar grasp
- Holding finger
- 4 months
Startle (moro)
- Allow head to drop and arms abduct, extend and fingers spread
- 3 months
Placing/ stepping
- Suspended intact, touch of foot & imitates walking
Placing/ stepping
- Suspended intact, touch of foot & imitates walking
Circumcision- Benefits
- Prevent phimosis, decreased CA & bladder infections
- Decreased HIV, HPV & HSV
Circumcision- Procedures
- Plastibell: plastic ring + string
- Glompco: Bell shaped, quick, foreskin dissected
- Mogen- Dont do! Not visulized
Circumcision- Contraindications & risks
- Bleeding, infection, hematoma, pain, stress
- Unhealthy neonate, genital abnormalities, fam hx of bleeding disorder
Anticipatory guidance- categories
- Diet
- Injury prevention
- Development & behavior
- Health promotion
Anticipatory guidance- categories
- Diet
- Injury prevention
- Development & behavior
- Health promotion
Never development screening
- Cognitive & behavior screening in preschoolers
- Social contact
- Fine motor skills
- Language
- Gross motor skills
Denver development screening
- Cognitive, neurologic & behavior screening- birth to 6 yrs
- Social contact
- Fine motor skills
- Language
- Gross motor skills
