“The text is… a core text for any program preparing individuals for advanced practice roles in perinatal and neonatal care, and it should be a resource in every setting providing care to neonates. At all levels of practice, it serves as a convenient reference to normal parameters, common variations, and less commonly seen abnormalities.”
--Susan Tucker Blackburn, RN, PhD, FAAN
Author of Maternal, Fetal, and Neonatal Physiology: A Clinical Perspective
From the Foreword
The newly revised, 25th Anniversary Edition of this definitive publication on neonatal care continues to illustrate how to systematically and accurately gather assessment data and interpret results. Because even normal newborns feature a tremendous range of physical variation, subtle signs that indicate internal malformations or syndromes may escape notice without a proper assessment. Many problems in the neonate can be noticed early by an astute nurse, nurse practitioner, or physician with honed assessment skills, long before electronic monitors or other equipment can detect them.
Physical Assessment of the Newborn, Sixth Edition addresses the physical, physiologic, neurologic, and behavioral implications of a thorough assessment, and explains how healthcare providers can reduce the risks associated with the transition to extrauterine life and the neonatal period. Grounded with a scientific basis and rationale, each system assessment represents the most up-to-date clinical content. Because assessment skills are such an integral aspect of practice, many individuals take them for granted, yet all health professionals who perform newborn examinations, including nurses, neonatal and pediatric nurse practitioners, nurse-midwives, physicians, and therapists can benefit from the essential content presented in this book, as well as students preparing for advanced practice roles in neonatal care.
New to the Sixth Edition:
Provides clinical updates throughout
Presents an Enhanced Art Program
Offers an all-new chapter on the Opioid-Dependent Neonate
Includes an Image Bank and Power Points
Key Features:
Addresses all key aspects of newborn assessment
Provides a well-organized evaluation of individual body systems
Assist practitioners in identifying infant state, behavioral clues, and signs of pain
Examines the tremendous range of variation among newborns of different gestational ages
Provides Antepartum Tests and Intrapartum Monitoring
Written in an easy-to-read, user-friendly style
Contains tables, figures, and numerous full color photos and illustrations
Author(s): Ellen P. Tappero, Mary Ellen Honeyfield
Edition: 6th Edition
Publisher: Springer Publishing Company
Year: 2018
Language: English
Pages: 328
Tags: Neonatology
Cover......Page 1
Title......Page 2
Copyright......Page 3
Contents......Page 4
Contributors......Page 6
Foreword......Page 8
Preface......Page 10
Acknowledgments......Page 12
Share Physical Assessment of the Newborn: A Comprehensive Approach to the Art of Physical Examination, Sixth Edition......Page 13
Observation......Page 14
Percussion......Page 15
Transillumination......Page 17
Basics of Physical Assessment......Page 18
Palpation......Page 19
Ophthalmoscope......Page 20
References......Page 21
Importance of the History......Page 22
The Supplemental Interview......Page 23
Interim History......Page 24
Intrapartum History......Page 25
Maternal Medical History......Page 29
Family Medical History......Page 32
Remaining Elements......Page 33
References......Page 34
Chapter 3: Gestational Age Assessment......Page 36
Historical Perspective......Page 39
Anterior Vascular Capsule of the Lens......Page 40
Neuromuscular and Physical Criteria......Page 42
Timing of the Physical Examination......Page 49
Evaluation of Growth Indices......Page 50
Summary......Page 53
References......Page 54
Anatomy and Physiology......Page 58
Beginning the Examination......Page 59
Color Variations......Page 61
Common Newborn Skin Lesions......Page 62
Common Pigmented Skin Lesions......Page 63
Skin Lesions Secondary to Trauma
......Page 65
Vascular Skin Lesions......Page 66
Inspecting the Nails......Page 70
References......Page 71
Skull......Page 74
Head Size......Page 79
Face......Page 80
Ears......Page 81
Eyes......Page 83
Nose......Page 85
References......Page 89
History......Page 92
General......Page 93
Respirations......Page 94
Components of the Chest and Respiratory System Airways......Page 96
Normal Breath Sounds......Page 98
Adventitious Sounds......Page 99
Overall Structure......Page 101
Patient-Triggered Ventilation......Page 102
References......Page 103
Reviewing Maternal, Family, and Birth Histories......Page 106
Observing Appearance and Behavior......Page 107
Pallor/Mottling/Perfusion......Page 109
Palpating Peripheral Pulses......Page 110
Precordium......Page 111
Apical Impulse......Page 112
Heart Rate......Page 113
Cardiac Rhythm and Regularity......Page 114
Heart Sounds......Page 115
Murmurs......Page 116
Evaluating Blood Pressure......Page 118
Normal Values......Page 119
Screening for CHD With Pulse Oximetry......Page 121
References......Page 122
Skin......Page 124
Shape and Movement......Page 125
Umbilical Cord......Page 126
Abdominal-Wall Defects......Page 127
Perianal Area......Page 128
Auscultation......Page 129
Organs......Page 130
Masses......Page 131
Groin and Femoral Area......Page 132
References......Page 133
Related Findings......Page 134
Abdomen......Page 135
Male Genitalia......Page 136
Female Genitalia......Page 138
Abdominal Distention......Page 139
Abdominal-Wall Defects......Page 140
The Penis......Page 141
The Scrotum......Page 144
Abnormalities of the Female Genitalia......Page 146
Disorders of Sexual Development......Page 147
References......Page 148
Prenatal History......Page 152
General Survey......Page 153
Length......Page 154
Observation......Page 155
Hand......Page 157
Spine......Page 159
Hips......Page 160
Legs......Page 163
Anomalies of the Neck......Page 165
Upper Extremity Anomalies......Page 167
Lower Extremity Anomalies......Page 170
Conditions Affecting Upper and/or Lower Extremities......Page 173
References......Page 177
Observation......Page 180
Examination of the Head......Page 184
Postural Tone......Page 185
Assessment of Developmental Reflexes......Page 187
Moro Reflex......Page 188
Assessment of Sensory Function......Page 190
Assessment of the Autonomic Nervous System......Page 191
Trigeminal—Cranial Nerve V......Page 192
Hypoglossal—Cranial Nerve XII......Page 193
Neonatal Encephalopathy......Page 194
Maternal Drug Use......Page 195
Defects in Closure of the Anterior Neural Tube......Page 196
Defects in Closure of the Posterior Neural Tube......Page 197
Primary Subarachnoid Hemorrhage......Page 199
Subdural Hemorrhage......Page 200
Periventricular–Intraventricular Hemorrhage......Page 201
Extracranial Hemorrhage......Page 202
Seizures......Page 203
References......Page 204
Chapter 12: Behavioral Assessment......Page 206
Approach to Behavioral Assessment......Page 208
Identifying States of Consciousness......Page 209
Sleep States......Page 210
Awake States......Page 211
Organization......Page 213
Recognizing the Sensory Threshold......Page 214
Observing Behavioral Cues......Page 215
Habituation......Page 216
Evaluating Consolability......Page 217
Identifying Temperament......Page 218
Term Newborn Behavioral Assessment......Page 219
Case Assessment of a Full-Term Infant......Page 221
Preterm Infant Behavior Assessment......Page 222
Case Assessment of a Healthy Preterm Infant......Page 223
Case Assessments of Immature Preterm Infants......Page 225
Other Emerging Infant Assessment Tools......Page 227
References......Page 228
Maternal and Family Histories......Page 232
Head......Page 233
Nose and Mouth......Page 234
Genitalia......Page 235
Trunk and Spine......Page 236
Problems in Morphogenesis......Page 237
Genetics......Page 238
Syndromes......Page 239
Trisomy 18 (Edwards Syndrome)......Page 240
45,X (Turner Syndrome)......Page 241
Charge Syndrome......Page 242
Potter Oligohydramnios Sequence......Page 243
Arthrogryposis (Multiple Joint Fixations)......Page 244
Anticonvulsants......Page 245
Infants of Diabetic Mothers......Page 248
References......Page 249
Data Collection......Page 252
Systematic Approach to Evaluation......Page 254
Assessment of Pain......Page 255
Assessment Tools......Page 256
Elga Infants......Page 259
Neurologically Impaired Infants......Page 260
Infants With Persistent or Chronic Pain......Page 261
Infants at End of Life......Page 262
Infants With Diseases or Conditions Warranting Pain Assessment......Page 263
Parents’ Views on Pain......Page 264
References......Page 265
Chapter 15: Assessment of the Newborn With Antenatal Exposure to Drugs......Page 268
Biologic Specimens......Page 269
Cocaine......Page 270
Opioids......Page 271
Clinical Presentation......Page 272
Assessment Tools......Page 273
References......Page 274
Biophysical Profile......Page 276
Doppler Velocimetry......Page 277
Fetal Fibronectin Levels......Page 278
Maternal Serum Estriol Levels......Page 279
Ultrasound......Page 280
FHR Monitoring......Page 281
References......Page 282
Glossary of Terms......Page 284
Glossary Compiled and Verified Using the Following Sources......Page 306
Index......Page 308
