aa. Inspect the male infant's genitalia. The penis should be checked for location
of the urinary meatus. The scrotum may appear edematous and proportionately large.
bb. Inspect the female infant's genitalia. The labia majora may appear
edematous and cover the clitoris and the labia minora.
cc. Observe the infant's spontaneous or involuntary movements for symmetry,
spasticity, or rigidity. Gently straighten his arm or leg. Release it and observe whether
it returns to its normal position. If the extremity remains limp, the infant may be
hypotonic. If the extremity is difficult to straighten and rapidly flexes when released, he
may be hypertonic.
dd. Dress the infant carefully and return him to his bassinet.
ee. Record all significant nursing observations in the infants' health record.
Report your observations to the Charge Nurse.
A phenylketonuria (PKU) test is done to check for rising levels of phenylalanine.
Phenylalanine is a naturally occurring amino acid essential to growth. After milk or
formula (both contain phenylalanine) feedings begin, levels rise due to a deficiency of
the liver enzyme that converts phenylalanine to tyrosine. Due to this metabolic
deficiency, poisons build up in the bloodstream and cause mental retardation. If the
infant is found to have rising levels of phenylalanine, many protein foods can be
withheld from the diet and synthetic foods substituted. The following steps are
performed to collect a blood specimen for a PKU test on the newborn infant.
a. Ensure that the infant has been on milk or formula feeding for three full days.
Four days are preferred.
b. Explain to the parents the purpose of the test
c. Perform a heel stick to obtain needed specimen (see figure 8-11).
d. Place one drop of blood on each of the three circles on the filter paper or in
accordance with local policy.
e. Label and transport the specimen to the laboratory.
f. Notify the parents of follow-up care of the infant, if the infant is discharged
prior to his third or fourth day of life. This test must be done.