Newborn Physical Exam Flashcards
What are normal newborn measurements?
head circumference?
weight?
length?
Head Circumference ~ 12-15 inches ( 31-38 cm)
Weight~ 5lbs 8oz- 8lbs 13 oz ( 2500-4000 grams)
Length~18-22 inches (46-56 cm)
Normal newborn vital signs
Temperature (axillary/rectal) ~ 97.7-99.0 F
heart rate~ 80-180 bpm depending on infant state
respiratory rate~ 30-60 breaths per minute
Newborn respiratory exam
observe for accessary muscle use
chest excursion
Newborn Cardiac exam
ideally when infant is quiet
heart rate at PMI
Auscultate in all 5 areas~ aortic, pulmonic, erbs point, tricuspid and mitral areas
Observe for normal S1 and S2 and presence of S3 or S4
palpate for heaves, thrills and PMI
How to screen for congenital heart defects?
pre and post ductal pulse oximetry~ right hand (preductal) and right foot (postductal)
must be done after 24 hrs of age and before discharge
What are normal results for pre/postductal pulse ox?
both hand and foot > 95% and less than a 3% difference between hand and foot saturations
**discrepancies should receive urgent referral to cardiology **
Normal skin findings
should be pink and well perfused
capillary refill = less than 2 seconds
skin turgor = skin should be elastic
mucus membranes= should be pink and moist
Normal newborn chest findings
should be cylindrical
1:1 anterior /posterior
average chest circumference is 33 cm or 2 cm less than head circumference
“witches milk” or breast engorgement
normal in male and female newborns
from moms hormones
Assymmetry of chest should be investigated for ______
pathologic cause
Abdomen should be ____ and ____ shaped
rounded and domed
How many vessels in normal umbilical cord?
2 arteries and one vein
1% of babies have a single vessel cord
when does umbilical cord normally fall off?
between 7-10 days
Male gentalia normal findings
placement of urethral opening should be at tip of penis
both testes should be descended and palpable
Hydroceles
should transilluminate and will resolve spontaneously
What to assess in female gentalia?
assess size of labia majora and minora and clitoris
milky vaginal discharge is normal
blood tinged mucus / vaginal discharge is normal
Spine assessment newborn normal findings
should be straight and flexible
observe for pilonidial dimple ~ be sure base is visible
Upper extremities
full range of motion
symmetry
brachial pulses
lower extremities
femoral pulses
ortolani and Barlow maneuvers
symmetry of skin folds( gluteal and femoral areas)
size, shape and symmetry of feet
an increase of more than 2 percentiles or decrease of more than 2 percentiles is ____
concerning
