medical notes

Apr 16th, 2015
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NEWBORN ASSESSMENT AND CARE: IMMEDIATE, FIRST FEW HOURS AND CLINICAL ESTIMATION OF AGE.A full term newborn is a baby born at 37 weeks or more gestation.IMMEDIATE ASSESSMENT OBJECTIVES1. Do not require circulatory or respiratory support.2. Have no birth related trauma or congenital anomalies requiring immediate intervention.3. Are transitioning as expected to extra-uterine life.NURSERY (FIRST FEW HOURS) OBJECCTIVES1. Determine maturity.2. Evaluate growth and development.3. Identify signs of acute illness or underlying congenital.IMMEDIATE ASSESSMENT AND CARE OF THE NEWBORNExtra person is needed for the baby. Clamping and ligature of the cord.Apgar rating at 1 and 5 minutes.Apgar scoreSIGNS123ColourBlue or paleBody pink extremeties blueCompletely pinkHeart beat per min.absentSlow (<100)Over 100Reflex irritabilityNo responsegrimaceCry or coughMuscle tonelimpSome flexion of extremetiesActive motionRespiratory effortabsentSlow, irregularGood, cryingReflects the cardiorespiratory and neurologic status at those time points.Prematurity, maternal medication and congenital disease can adversely impact scores.Newborn resuscitationMore than 90% of babies do not require resuscitation.1. Vigorous and crying- dry the baby and put next to the mother or on a radiant warmer.2. Ensure airway is patent- put in sniffing position (underextension or hyperextension will block airway). Suction mouth and then nose.3. Stimulation by rubbing the back.4

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