Ch18

Question 1

First assessment

Answer 1

Performed in the birthing area immediately after delivery. Vital signs, APGAR score, length, weight, and “eyes & thighs” included

Question 2

Second assessment

Answer 2

A complete head-to-toe assessment including vital signs, gestational age assessment, anthropometric measurements, and reflex testing. This assessment must be completed within the first 24 hours of life

Question 3

Problem signs during newborn assessment

Answer 3

Flaccid body posture
Abnormal respiratory rates
Abnormal breath sounds
Abnormal heart rates 
Abnormal newborn size
Nasal flaring
Chest retractions
Grunting on exhalation, labored breathing
Generalized cyanosis

Question 4

APGAR

Answer 4

A = appearance (color)
P = pulse (heart rate)
G = grimace (reflex irritability)
A = activity (muscle tone)
R = respiratory (respiratory effort)

Question 5

Perfect APGAR score = 10 pts

Answer 5

Pink trunk and extremeties
>100 bpm
Sneeze/cough/cry
Right flexion, good resistance to extension
Breaths 30-60/min

Question 6

V/S: temp

Answer 6

97.7–99.5 degrees F axillary
Axilla is preferred site over rectal temperature
Adhesive probes should be placed over liver

Question 7

V/S: Heart rate

Answer 7

120–160 bpm; regular rhythm

Question 8

V/S: respiration

Answer 8

30-60 bpm
Respirations irregular, shallow, unlabored
Symmetrical chest movements

Question 9

V/S: BP

Answer 9

50-75mm Hg systolic & 30-45mm Hg diastolic

Not part of the normal assessment

Question 10

V/S: pulse ox

Answer 10

96-100% on room air (R hand & either foot. After 24h of age)

Question 11

Eye prophylaxis

Answer 11

• help prevent neonatorum blindness if mom had gonorrhea or chlamydia when baby comes through birth canal. erythromycin ointment put in conjunctiva tract
  Installation is to be done as soon as possible after birth & no longer than 1-2 hours after

Question 12

Vitamin k

Answer 12

prevent clotting: Fat-soluble vitamin which promotes blood clotting by the synthesis of prothrombin by the liver

Question 13

Measuring newborn lenght

Answer 13

Length is measured from the head of the newborn to the heel, while the newborn is in a supine position with one leg extended completely
Expected length, full term = 19-21 inches

Question 14

Newborn weight

Answer 14

Weight is measured in grams, on a digital scale
Newborns may lose up to 10% of their birth weight
Typical weight, full term = 2,700-4,000g (6-9 lbs)

Low Birthweight (

Question 15

Head and chest circumference

Answer 15

Average Head Circumference is 13-15 inches (32-38cm)

Average Chest Circumference is 12-14 inches (30-36cm)

Question 16

Vernix caseosa

Answer 16

Thick white cheesy-looking substance that protects the fetus’ skin
Often found in body creases, ears, etc.

Question 17

Lanugo

Answer 17

Hair
Grows on fetuses as a part of normal gestation
Typically found on shoulders, back, cheeks,
Begins to appear at 24 weeks gestation & is shed by 40 weeks
Its presence is typically a sign of prematurity

Question 18

Milia

Answer 18

Unopened sebaceous glands
Most often on nose, chin, forehead
Disappear on their own, within 1-2 weeks

Question 19

Erythema toxicum

Answer 19

Known as “Newborn Rash”
Benign, idiopathic, generalized, transient rash
70% of newborns develop
Resolves on its own within days

Question 20

Nevus simplex

Answer 20

Also known as stork bites or salmon patches
Frequently on eyelids, forehead, upper lip & nape of the neck
Concentration of immature blood vessels
Most visible when infant cries or is upset
Usually fade within the first year

Question 21

Nevus Flammeus

Answer 21

Also known as “Port Wine Stain”
Most often on the face

Below the dermis
Permanent
May be associated with structural malformations and certain cancers

Question 22

Nevous vasculosus

Answer 22

Known as Strawberry Hemangioma
Benign capillary hemangioma 
Raised, rough, sharp demarcation
Often on scalp, neck, or face
No treatment
Usually resolves within 3 years

Question 23

Mongolian spots

Answer 23

Concentrated area of pigmented cells
Appear as blue or purple splotches 
Most often on buttocks
Frequently on dark-skinned newborns
Usually disappear within first 4 years

Question 24

Seborrhoeic dermatitis

Answer 24

cradle cap

Question 25

Caput succedaneium

Answer 25

Localized edema on the scalp
Common with prolonged labor & vacuum extraction
Crosses suture lines
Resolves within days

Question 26

cephalhematoma

Answer 26

Localized effusion of blood below the periosteum of the skull
Does NOT cross suture lines
Often occurs with forceps/vacuum extractions
takes several weeks to resolve
increases chance for jaundice

Question 27

Strabismus

Answer 27

the eyes aren’t moving together

normal findings up to 3-4 months of age

Question 28

Umbilical cord assessment

Answer 28

Inspect umbilical cord for 3 vessels

2 arteries and 1 vein

Question 29

Locate urethral meatus of boy

Answer 29

Hypospadius (ventral side)

Epispadias (dorsal side)

Question 30

Screening for genetic & inborn errors of metabolism typically include:

Answer 30

PKU (after 24 hours of age)
Congenital Hypothyroidism
Galactosemia
Sickle Cell Anemia

Question 31

Hypoglycemia S/S

Answer 31

Jitteriness, Tremors
High-pitched/Weak cry
Respiratory Distress/Apnea
Stupor, Lethargy
Refusal to feed
Seizures