You are on page 1of 24

Health assessment in child development

Submitted by:Joesun darwin Tendencia Submitted to:mrs Joy bellen Domingo

Acrocyanosis (peripheral cyanosis): Normal for 12 hours after birth. Vernix caseosa: White, cheesy substance of sebum and desquamated epithelium, seen in small amounts in skin

mottled (cutis marmorata). Milia Stork bite .Integumentary Skin Inspect skin. color. smooth. edematous. note. Skin may be red. lesions.

normal abnorma . ■ Cheesy substance (vernix caseosa) decreases as baby’s gestational age increases to term. ecchymosis. ■ Physiological jaundice occurs after 24 hours. ■ Desquamation (peeling).skin Hands and feet may be cyanotic (acrocyanosis). ■ Color may change with position (harlequin sign).

■ Mongolian spots (bluish discoloration in sacral area) are commonly seen in African. ■ Telangiectatic nevi. ■ Flat hemangiomas (“stork bites”) may be present at nape of neck. and Native American babies. Latin.Miliaria or audamina (papules or vesicles on face) are caused by blocked sweat ducts. Telangiectatic nevi mongolian spots Miliaria audamina . Asian.

and petechiae may occur from trauma during delivery. ecchymosis. . Physiological jaundice occurs after 24 hours.Flat hemangiomas (“stork bites”) may be present at nape of neck Desquamation (peeling).

Hands and feet may be cyanotic (acrocyanosis). HAIR Inspect hair. and note distribution Nails ■ Inspect neonate’s nails .

. As skin dries after delivery.Desquamation Desquamation (peeling of skin). peeling is normally seen within 2 days.

Cutis marmorata Cutis marmorata (mottled skin): Seen in early infancy. If it persists. it may indicate congenital problems Normal abnormal .

Harlequin Harlequin sign: Dependent side red and nondependent side pale. .

and back. downy hair on face. shoulders. and temporary scalp and skull swelling may occur. .Lanugo ■ Lanugo: Fine. lacerations. Head ■ Bruises.

■ Anterior fontanel: Diamond . ■ Gently palpate fontanels. ■ Molding in birth canal may cause asymmetry of face and skull and should resolve within 1 week. Abnormal head/face ■ Inspect facial features and movements.Head/Face ■ Inspect head and fontanels.

. ■ Short neck. ■ Able to hold head up with “pull-to-sit” test. ■ Test tonic neck reflex.Neck Inspect and palpate the neck. ■ Positive tonic reflex.

color of sclera. position. ■ Antimongolian slant. ■ Positive corneal reflex.Eyes ■ Inspect eyes. parallel alignment. ■ Eyes equal and symmetrical. ■ Test red light reflex. . ■ Positive blink reflex. ■ Blue-gray or brown iris. ■ Positive red light reflex. edema. and equality. exudates. ■ Eyes may be edematous after vaginal delivery. pupil size. white or bluish-white sclera. Mongolian slant seen in Asian infants. ■ Test corneal/blink reflex.

extrusion and swallowing reflexes. aligns with external canthus of eyes. Mouth/Throat ■ Inspect mucous membranes. tongue. rooting. ■ Test hearing. . and palate. ■ Positive startle reflex. position. and drainage. ■ Mucous membranes pink and moist. lips.Ears ■ Inspect shape. without deformity. ■ Frenulum of tongue and lip intact. ■ Pinna flexible. ■ Test sucking. gag.

■ Nose may be flattened and bruised from birth. ■ Nares patent. ■ Small amount of thin white mucus. NORMAL abnormal .Nose ■ Inspect nares.

■ Auscultate breath sounds. drainage. ■ Clear or milky liquid from nipples (“witch’s milk”) develops from maternal hormones in utero. and chest excursion. Resperatory ■ Equal chest excursion. Inspect breast size.CHEST Inspect shape. . ■ Breast engorgement. ■ Anteroposterior:lateral (1:1). symmetry. ■ Supernumerary nipples are a benign finding.

■ Note hernias or diastasis recti. ■ Gently palpate abdomen and femoral pulse.Cardiac and Abomen Cardiac ■ Auscultate heart sounds. normal rhythm with respiratory variations. S2. ■ Auscultate bowel sounds. ■ Positive bowel sounds. ■ S1. ■ Inspect abdomen and umbilical cord. ■ PMI fourth left intercostal space midcostal line. ■ Abdomen round. .

Breathing helps remove birth fluids from respiratory tract. Newborns begin nose breathing immediately at birth. periodic breathing required for extrauterine life.Respiratory Rapid. . Respiration permits oxygenation.

.Circulatory ■ Onset of breathing stimulates transportation of oxygen. Shortly after first cry. heart rate accelerates.

red cell production. and coagulation. often after a feeding. Stomach capacity is 50 to 60 mL. Gastrointestinal ■ Newborn has necessary enzyme activity and peristalsis to digest simple carbohydrates. liver takes a major role in iron storage. bilirubin conjugation. and protein.Hepatic ■ At birth. carbohydrate metabolism. . Stools are passed. fat.

. Musculoskeletal Increased body movements are noted during reactive. awake phases.Urinary Urination often occurs at birth or shortly after.

which consumes oxygen and may cause respiratory distress. Normal abnormal . The large body mass enhances heat loss.Thermoregulation Newborn strives to maintain body temperature.

newborn is awake and alert. Normal abnormal . ■ A sleep phase occurs after 30 minutes.Neurologic ■ During first period of reactivity. newborns are alert and active. ■ During second period of reactivity.