Newborn Assessment

Question 1

Describe newborn assessment of General Constitution.

Answer 1

General constitution:

• Weight – appropriate for gestational age (~2500-4500 grams//5.5-10lbs)
• Length (normal range is 18-22 inches)
• Head circumference – measured at largest circumference above the ears)

Posture:

• Flexion, muscle tone
• Moves extremities equally

Question 2

Normal newborn vital signs?

Answer 2

• Temp – 97.5-98.6
• Resp rate – 30-60
• Heart rate – 110-160
• B/P not routine

Question 3

Describe newborn assessment of the Head.

Answer 3

• Shape
• Size
• Suture lines
• Fontanels
• Molding
• Caput succedaneum (lasts 3-4 days) vs. cephalohematoma (lasts up to 8 weeks)

Question 4

Describe newborn assessment of the Face.

Answer 4

• Eyes (Sclera should be white)
• Ears (Low set? Small?)
• Nose (nares patent?)
• Mouth (palate, lips intact?)

Question 5

Describe newborn assessment of the Chest.

Answer 5

• Shape, size, symmetrical movement of chest with breathing
• Assess clavicles for crepitus
• Breast tissue
  
  • Placement
  • Development
  • Nipples
• Breath sounds equal bilaterally
• Respiratory effort (no grunting, flaring, retractions)
• Heart sounds
  
  • S1 and S2
  • Murmurs common in first few hours

Question 6

Describe newborn assessment of the Abdomen.

Answer 6

• Umbilical cord
  
  • 3 vessels
  • Color
  • Condition of cord
  • Hernia
• Abdomen soft, non-distended
• Bowel sounds may be heard in chest

Question 7

Describe newborn assessment of Genitalia.

Answer 7

• General appearance
• Edematous
• Gestational age
• Void within 24 hours of birth
• Vaginal discharge/bleeding
• Ambiguous genitalia
• Inguinal hernia
• Male-Undescended testes, hydrocele
• Male-Hypospadias, epispadias (delay circumcision)

Question 8

Describe newborn assessment of Extremities.

Answer 8

• Symmetry
• Asymmetrical or limited movement
• Creases on soles of feet / Palmer creases
• Ten fingers/toes
• Clubfoot
• Webbing fingers/toes – syndactyly
• Hip clicks
• Movement
• Tone
• Reflexes

Question 9

Describe newborn assessment of Reflexes

Answer 9

Sucking:

• Strong sucking movements of mouth

Swallowing:

• Follows sucking, usually at pause, can be seen in the neck

Rooting:

• When cheek is touched or stroked, infant turns head and opens mouth

Moro - startle:

• General body response to sudden stimulus – extension & abduction of limbs

Babinski:

• Upward stroking of sole and across ball of foot – great toes to hyperextend and foot to dorsiflex

Palmer:

• Touching palms of hands and feet cause flexion of fingers or toes

Question 10

Describe newborn assessment of the Skin.

Answer 10

• Color (dark red/purple, transitions to pinkish hues)
• Acrocyanosis
• Skin may flake/peel
• Vernix and lanugo
• Congenital dermal melanocytosis
• Mottling

Question 11

Examples of skin conditions that can be found?

Answer 11

• Milia
• Petechiae on presenting part
• Jaundice (prior to 24 hours significant)
• Hemangiomas
• Nevus simplex/flammeus
• Skin tags
• Erythema toxicum