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Flashcards in Neonate's Postnatal Examination Deck (12)
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1
Q

What are the 10 key stages of the postnatal examination?

A
  1. Introduction to examination
  2. General Wellbeing and Acknowledgment of Individual Context
  3. Head
  4. Eyes
  5. Mouth
  6. Skin
  7. Umbilical Cord
  8. Genitalia & Elimination
  9. Feeding Support
  10. Health Education & advice
2
Q

What are the 3 features of introduction to examination (1)?

A

a. Verbal introductions and obtains consent
b. Washes hands before examination
c. Gives brief explanation of examination to the mother and checks baby is warm

3
Q

What are the 3 features of general wellbeing and acknowledgement of individual context (2)?

A

a. Demonstrates awareness and sensitivity of individual needs in a non-judgmental way e.g. culture / ethnicity / younger mothers
b. Acknowledges relevant history e.g. blood results; previous history with sibling; PROM; mode of birth; Apgar score at birth; resuscitation; feeding issues
c. Establishes normal behaviour i.e. good tone / alert when awake / sleeping & feeding patterns

4
Q

What are the 2 features of head (3)?

A

a. Palpates anterior fontanelle. Verbalises rationale and findings to mother e.g. sunken / raised and what this may indicate
b. Observes for signs of any trauma e.g. cephalhaematoma / bruising following instrumental birth; marks from fetal scalp electrode/ scalpel/ amnihook

5
Q

What are the 4 features of eyes (4)?

A

a. Identifies any abnormalities with the eyes e.g. sticky eyes; colour of sclera; petechial haemorrhages
b. Educates the mother about newborn eye care e.g. wiping from the nose toward the ear / use cotton wool only once
c. Verbalises signs of infection to the mother and when to inform staff e.g. green / yellow discharge / swelling / redness
d. Verbalises appropriate management of potentially infected eyes e.g. basic eye care / swab for culture / referral

6
Q

What are the 2 features of mouth (5)?

A

a. Verbalises to the mother the rationale for inspecting her baby’s mouth and possible complications e.g. oral thrush; ankyloglossia (tongue tie); dehydration
b. Inspects the baby’s mouth

7
Q

What are the 4 features of skin (6)?

A

a. Establishes baby’s general colour e.g. red / yellow / cyanosed / pallor verbalising underpinning knowledge related to potential changes in baby’s general colour (as above) and demonstrates an awareness of when to seek assistance or refer
b. Demonstrates a basic awareness of physiological jaundice e.g. how to recognise signs & symptoms / timing of onset / when to refer / advice to a mother
c. Demonstrates a basic awareness of common types of rashes that may be identified in neonates and when to refer
d. Demonstrates the ability to provide evidence-based information to the mother about neonatal skin care

8
Q

What are the 2 features of umbilical cord (7)?

A

a. Visually inspects the umbilical cord e.g. for signs of infection / bleeding around stump. Articulates the signs of separation to the mother and can verbalize the signs of infection and when to refer
b. Demonstrates knowledge of relevant research relating to cord care and the ability to provide evidence-based cord care advice to the mother

9
Q

What are the 3 features of genitalia & elimination (8)?

A

a. Asks the mother about baby’s elimination e.g. bowels open / passing urine and discusses normal patterns of elimination e.g. changes in stool; frequency of micturition
b. Recognizes / articulates advice related to nappy changing e.g. vaginal bleed or discharge for female infant / urates
c. Can provide the mother with evidence-based information regarding basic hygiene and prevention of nappy rash e.g.use of barrier creams

10
Q

What are the 8 features of feeding support (9)?

A

a. Ascertains feeding method, mother’s previous experience & knowledge
b. Establishes when baby last fed and feeding patterns e.g. frequency / length of feed/ volume of milk consumed
c. Ensures mother’s knowledge / experience is up to date;
d. Offers advice to the mother regarding community support for infant feeding;
If breast feeding:
e. Establishes knowledge related to positioning and latching and provides advice & support re latching & positioning (if appropriate and at an appropriate time);
f. Demonstrates knowledge of relevant evidence-based information relating to breast feeding;
If bottle feeding:
g. Establishes knowledge related to positioning, settling and winding when bottle feeding and provides advice & support as needed
h. Demonstrates knowledge of relevant evidence-based information relating to artificial feeding e.g. safe preparation of milk feeds / sterilization

11
Q

What is the feature of health education & advice (10)?

A

a. Provides health education regarding Sudden Infant Death Syndrome (SIDS) e.g. positioning in cot / temperature advice (room and baby) / smoking / co-sleeping

12
Q

What are the 9 features of overall assessment and safety?

A
  • Informal but professional approach, Appropriate language used e.g. non-medical terminology
  • Good use of interpersonal skills e.g. verbal and non-verbal communication
  • Appropriate handling of baby demonstrated throughout assessment, baby examined whilst in cot
  • Basic hygiene demonstrated e.g. hands are washed at appropriate intervals - after changing nappy
  • Thorough, systematic and safe approach to the assessment including full visual examination of undressed baby performed
  • Student demonstrates an understanding of ambient temperature (if appropriate) e.g. closes windows; re-clothes baby in a timely fashion
  • Student ensures two identification labels are in situ (or takes steps to replace if necessary)
  • Maintains legible, safe and accurate records
  • All educational opportunities utilized and ability to reflect on own performance