Download - Emma 3 Week Oldgirl
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Emma 3-week old girl
Visit agenda
Resources (forms, book chapters, etc.) *links to these!:
Well Baby Information Resources: http://www.rourkebabyrecord.ca/parents/
- great parent resource website where they can look up age specific information
regarding whether their child is healthy and growing/developing normally, as well as
breasting feeding, nutrition, colic, weaning, etc
- Also information for HCP
Guidelines for development that focus on parental health and child health:
https://brightfutures.aap.org/materials-and-tools/guidelines-and-pocket-guide/Pages/default.a
spx/
Chapter 9-10 from course textbook (Newborn + 1st year)
Key questions relevant to age, gender, development, etc.:
RED FLAGS:
- How are the feeding? sucking poorly, feeds slowly
- How active are they in movements? rarely move, stiffness OR excessively
loose/floppy
- How is the mom doing? any sadness?
Key Questions:- How often are they feeding? Every 2-3 hours, up to 8-12x/day
- Are you and baby taking vitamin D?
- How many wet diapers do they have a day? 6-8/day
- What is your Baby’s routine and schedule like now?
- Is your baby sleeping well?
- Can your baby hear sounds?
- Does your baby look at your face?
- When crying, can your baby be calmed?
Relevant screening exams, objective tools (questionnaires, lab work, etc.):
Length, Weight, Head Circumference
Head: head deformities
Primary Reflexes:
- grasping: touch palm → grasps tightly
- Moro: sudden movement/loud noise → startles, arms legs shoot out then back in
- Rooting: stroke cheek → turns to source
https://brightfutures.aap.org/materials-and-tools/guidelines-and-pocket-guide/Pages/default.aspx/https://brightfutures.aap.org/materials-and-tools/guidelines-and-pocket-guide/Pages/default.aspx/http://www.rourkebabyrecord.ca/parents/
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- Tonic neck: lay on back, turn head to one side → ipsilateral arm extension;
contralateral flexion
- Parachute: suspend child by trunk, forward flexion → upper extremity extension, does
not appear until 6-9months
Vision: red light reflex, clarity of cornea, response to bright lightHearing: startle to loud noise
Heart: auscultation for murmurs, palpate femoral pulse
Abdomen: masses, note healing on umbilicus
MSK: Ortolani and Barlow maneuvers (https://www.youtube.com/watch?v=imhI6PLtGLc )
Any modifications for physical exams:
RED FLAGS:
- Bright light shown: no blink- Doesn’t focus/follow an object moving side to side
- Don’t respond to loud sounds
Use distraction and play while examining the infant-- they can only pay attention to one thing
at a time, so while they focus on the distraction, you can complete your examination.
- keep infant on parents lap
- do the examination in whatever order the infant will allow you, saving the mouth and
ear for final exam
BP should only be taken in high risk infants, otherwise wait until 3 YOA
HR: 90-190, average 140 bpmRR: 30-60
Temp: auditory canal most accurate
Head: examine sutures and fontanelles, scalp veins for dilation, skull symmetry and head
circumference
Lung, Heart and Abdomen are similar to adults, just start with a good inspection to look for
signs of issues before proceeding.
Relevant anticipatory guidance:
Parenting: address response to crying, maternal rest/diet, holding and support
- When an infant cries, they are trying to communicate something→ you can’t spoil
them at this age, they need to build a trust bond
- Use of skin on skin contact, baby-wearing
Breastfeeding
- Discuss latch, expression and storage of milk, general breast care
https://www.youtube.com/watch?v=imhI6PLtGLc
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Sleep Safety
- Supine vs Prone, Firm sleep surface
- Co-Sleeping is fine as long as the surface is firm without pillows for possible
smothering
- SIDS Modifiable and Non-Modifiable Risk Factors
Car Seats + Safety- ensuring up to date, well working condition
Chemical Exposure
- personal care products for both mom and baby
Others: Diaper rash, fever, vaccines
Establishing schedules, Routines
- this is when they learn there is a routine to life (day time is awake time, night time is
sleep time)
- At 3 weeks: 8.5 hours of night time sleep, 8 hours of day time sleep