Nursing Component Task
Nursing procedures & clinical learning

Public Health Nursing (PHN)

PHYSICAL EXAMINATION OF BABY AT A CHILD WELFARE CLINIC (CWC)

This is an activity carried out by the Public/Community health nurse at CWC where the baby is assessed physically from head to toe.

Purpose

  • Identify and confirm any abnormalities on the baby for intervention
  • Inform mother/caregiver on findings on the baby and counsel accordingly
  • Refer baby to appropriate service delivery centre when the need arises
  • Educate and give parental reassurance

Indications

  • Client requires baby at child welfare clinic (cwc) assessment or care.

Equipment

  • Furniture which includes chairs, tables, bulletin board
  • Child health record book
  • Flat surface for examination
  • Weighing tally sheet
  • Weighing scales
  • Master chart for grading nutritional status
  • Hand washing facilities- veronica bucket, plastic bowls, soap in a dish, hand towels
  • Electronic/manual visual aids for education
  • Blue and red pens, pencils, eraser and rule

Preparation

  • Review client records and history.
  • Gather necessary equipment and supplies.
  • Plan the visit timing and logistics.

Procedure steps

  • Explain procedure to mother and apply alcohol rub to the hands
  • Ask mother to place baby on her lap/flat surface for physical examination
  • Observe the size and shape of the head
  • Feel the skull for anterior and posterior fontanelles, and observe for any abnormalities
  • Open baby’s eyes gently with the thumb and index finger and examine the eyes
  • Test for reflexes (at least one)
  • Examine the:
  • Nose, mouth and ears
  • Neck for enlarged lymph nodes
  • Armpit, upper limbs and nails
  • Skin for any rashes and muscle tone
  • Trunk and abdomen
  • Groins for swelling, vulva for discharges, scrotum for cleanliness and undescended testes
  • Lower limbs and nails

Precautions

  • Maintain infection prevention and control measures throughout.
  • Respect client privacy and confidentiality.
  • Ensure cultural sensitivity and dignity.
  • Refer or escalate when complications arise.

Aftercare

  • Evaluate client response to interventions.
  • Schedule follow-up as needed.
  • Ensure client understands care plan.

Nursing considerations

  • Adapt care to client's unique circumstances.
  • Involve family members as appropriate.
  • Consider social determinants of health.

Patient education

  • Provide condition-specific health education.
  • Teach self-care strategies where applicable.
  • Reinforce importance of follow-up.

Documentation

  • Record all assessments and findings.
  • Document interventions provided.
  • Note client education given.
  • Report any referrals made.

References and further reading

Educational resource only. Follow current Nursing and Midwifery Council guidance, local institutional protocols, scope of practice, and clinical supervision.

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