ASSESSMENT PROTOCOL FOR WELL BABY CHECK-UP, NEONATAL PERIOD (Logic Tree No. 33-A) DIREcn ON: Determine/identify which of tl1e following symptoms/ signs (S/S) or history dal'a (Hx D) m-e present and follow the flowchart for tht: approp i-iate plan of mannge. ment. RED GREEN S/S or H)(Q 5/S or Hx D Patient has not had first bowel Patient had first bowel movement movement or urine within 72 hours within 72 hours from birth then from birth followed by greenish soft stools Weak. unsustalned cry Patient has urinated within the first 72 Poor suck (patient could hardly hours of life finish one ounce of milk formula) Strong, sustained cry Weak or unequal movement of the Good suck extremities Patient cries and shows increased Convulsion or twitching activity when he is hungry or Patient is lethargic uncomfort able (wet, etc. ) but Marked increase in head circumfe rence becomes quiet and relaxed after he (more than 1/2 im:h in one month) is fed or made comfort able Yellowish color of the skin or eyes, Patient is active with generalized especially If noted Immediately activity when awake after birth or if observed to be Slight yellowish color of the skin noted intensifying instead of \ubsiding, on the second day of life but begins starting the fifth day of life or it to subside starting the fifth day and persists beyond two weeks of life completely disappear after two Bluish or whitish color of the skin, lips weeks and inner aspect of the eyelids Pinkish color of the skin Full or tense fontanelle or sunken Fontanelle Oat and soft fontanelle Vigorious crying when stimulat ed Weak. unsustained cry when started or Patient shows violent startle response when stimulated when loud noise is made Foul-smelllng umbilical cord No startle response to loud noise Inequality in the movement of the e Ktremlties 280 