Infant Assessment

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  1. Inspection:
    • 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.
  2. Auscultation:
    • 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!
  3. Percussion:
    • 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.
Card Set
Infant Assessment
Developmental Care of the Infant
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