Physical Examination of the Newborn at a Glance

Denise (Dee) Campbell, Principal Lecturer and Programme Lead in Midwifery (retired), University of Hertfordshire, Hatfield, UK. Evelyn Dolby, Senior Lecturer in Midwifery, University of Hertfordshire, Hatfield, UK; Senior Lecturer in Midwifery, University of Northampton, Northampton, UK.

Preface ix

Part 1 Professional issues 1

Section 1 Professionalism

1 Public health screening 2

2 Quality and standard setting 4

3 Record keeping and professional competency 6

4 Safeguarding 8

5 Health promotion and education 10

Section 2 Communication skills

6 Communication during the examination 12

7 Communicating concerns to parents 14

Part 2 Neonatal physiology and pathophysiology 17

Section 3 Adaptation

8 Adaptation to neonatal life 18

9 Thermoregulation 20

Section 4 Emergency management

10 Resuscitation of the newborn 22

11 Hypoglycaemia 24

Section 5 Jaundice

12 Physiological jaundice 26

13 Pathological jaundice 28

Section 6 Disorders

14 Metabolic disorders 30

15 Jitteriness, seizures and hypotonia 32

16 Congenital infection and sepsis 34

17 Anaemia and polycythaemia 36

Section 7 Birth complications

18 Intrapartum injury/trauma 38

Part 3 Allied assessments 41

Section 8 Routine care

19 Initial examination at birth – overview 42

20 Daily examination of the newborn – overview 44

Section 9 Screening

21 Newborn blood spot screening 46

22 Hearing screening 48

Part 4 Prior to the physical examination 51

Section 10 Preparation

23 Preparing to examine 52

24 Infection control 54

Section 11 History awareness

25 Relevant history and risk factors 56

26 Feeding 58

27 Excretion 60

Part 5 Top to toe physical examination 63

Section 12 Broad assessment

28 Newborn and infant physical examination – overview 64

29 Neurological assessment 66

30 Reflexes 68

31 Common skin conditions 70

32 Atypical skin conditions 72

Section 13 Head and neck

33 Head 74

34 Facies 76

35 Eyes 78

36 Mouth 80

37 Neck and clavicles 82

Section 14 Upper body

38 Chest appearance 84

39 Cardiovascular assessment 86

40 Respiratory assessment and hypoxia 88

41 Upper limbs and hands 90

42 Abdomen 92

43 Back, spine, buttocks and anus 94

Section 15 Pelvis and lower body

44 Developmental dysplasia of the hips 96

45 Genitalia – female 98

46 Genitalia – male 100

47 Lower limbs and feet 102

Part 6 Revision and self-assessment 105

Section 16 Revision

48 Syndromes and signs 106

49 Scenarios 108

Section 17 Self-assessment

Crosswords and multiple choice questions 109

Crosswords and multiple choice questions – answers 112

References 114

Index 117