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- Abdomen - protuberant, symmetrical; may see umbilical
- hernia at 2-3 wks, esp. w/ crying - dissappears by 1 yr;
- diastasis recti - separation of rectus muscle along
- midline. Visible peristalsis, abdominal breathing.
- Skin - fine, superficial venous pattern.
- Umbilical cord - white at birth surrounded by wharton's
- jelly; Dries within 1 week, hardens, falls off by 10-14
- days; skin covers area by 3-4 wks.
- Bowel sounds normal
- No vascular sounds should be heard
- Abnormal sounds - bruit or venous hum.
- Succussion splash - very loud splash in upper abdomen when rocked side to side - increased air/fluid in stomach - pyloric obstruction or large hiatus hernia.
- Marked peristalsis - w/ projectile vomiting in newborn - pyloric stenosis - appears in 3rd-4th wk. After eating, peristalic waves L to R, projectile vomiting, olive-shaped mass in RUQ. Refer promptly!
- Flex baby's knees with one hand while palpating the other OR hold upper back and flex neck slightlly with one hand.
- Offer pacifier if crying.
- RUQ - liver may be palpable at edge (1-2cm below rib).
- RLQ - rectum may be palpable - feels like sausage in left inguinal area.
- Stools - 1st should be meconium within 24 hrs of birth. Day 4 - breast-fed are brown-yellow, firmer, and fecal smelling.
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