Neonatal Assessments

Question 1

Normal HR

Answer 1

120-160 BPM
(can be higher for premies )

Question 2

Normal RR

Answer 2

30-60/min

Question 3

Normal Temp

Answer 3

36.5- 37.5 C axillary

Question 4

Normal O2 Sat

Answer 4

89-95%

Question 5

modes of delivery

Answer 5

vaginal, cesarean, assisted

Question 6

when are Apgar’s taken

Answer 6

@ 1 and 5 minutes after birth

Question 7

immediate concerns after birth

Answer 7

resuscitation and congenital anomalies

Question 8

Maternal history that Is important

Answer 8

HIV, GBS status, prental care, medications, gestational diabetes, preeclampsia

Question 9

O2 goal

Answer 9

greater than 90 if more than a few minutes old

Question 10

tone expectation

Answer 10

flexed at rest, resistance with extension

Question 11

cry expectation

Answer 11

strong and lusty

Question 12

reflexes

Answer 12

rooting, suckling, Moro (startle), Palmar grasp, Plantar grasp, Babinski, Stepping

Question 13

head shape

Answer 13

molding, caput succedaaneum, cephalohematoma

Question 14

fontanelle assessment

Answer 14

anterior: soft, flat, diamond shape ( 2-3 cm)
posterior : smaller, triangular

Question 15

sutures

Answer 15

palpable, they may be overriding from vaginal exit

Question 16

eye assessment

Answer 16

clear, red reflex present, no discharge

Question 17

ear assessment

Answer 17

placement, recoil, tags/pits

Question 18

nose assessment

Answer 18

latency ( check for chooanal atresia), nasal flaring

Question 19

mouth assessment

Answer 19

Palate intact, suck reflex, Epstein pearls, natal teeth, tongue mobility (ankyloglossia)

Question 20

neck assessment

Answer 20

look for webbing, masses, range of motion,, clavicle intact

Question 21

respiration assessment

Answer 21

No grunting, retractions, nasal flaring

Question 24

Circulation Assessment

Answer 24

Pulses: Brachial, femoral palpable and equal
Cap refill: <3 seconds

Question 25

abdomen assessment

Answer 25

Shape: Round, soft, non-distended Bowel sounds: Present in all quadrants Liver/spleen: May be palpable 1–2 cm below costal margin Umbilical cord: 3 vessels (2 arteries, 1 vein) No masses, hernias, or organomegaly

Question 26

Genitalia Assessment

Answer 26

Female: Labia majora may cover minora in term babies Vaginal discharge or pseudomenses normal Male: Testes descended Rugae on scrotum Urethral meatus at tip (check for hypospadias or epispadias)

Question 27

GI

Answer 27

meconium passes within 24-48 hours. no fissures or signs of imperforate anus

Question 28

Musculoskeletal and Extremity Assessment

Answer 28

symmetry of movement, count fingers/toes and check for webbing Hips: Barlow/Ortolani maneuvers to check for dislocation Spine: Straight, no dimples, tufts of hair or masses

Question 29

skin assessment

Answer 29

pink, may have acrocyanosis Lesions:Vernix caseosa, Lanugo, Milia, Mongolian spots, Erythema toxicum

Question 30

Birthmarks

Answer 30

document size and location

Question 31

turgor assessment

Answer 31

reflects hydration status

Question 32

Screenings does in the first 24-48 hours

Answer 32

- Newborn metabolic screen (heel stick) - Hearing screen - Critical congenital heart disease screen (CCHD) – pulse oximetry in R hand and either foot - HIV, Hep B (vaccine and/or immunoglobulin if indicated) - Glucose: Especially in LGA/SGA, preterm, IDM

Question 33

signs of distress

Answer 33

Nasal flaring, retractions, grunting, desats, bradycardia

Question 34

acrocyanosis

Answer 34

a condition where the hands, feet, or sometimes the face appear bluish or purple due to decreased oxygen delivery to the skin in those areas. Usually benign in newborn. It's normal in the first 24–48 hours after birth and doesn’t indicate serious disease unless it persists or is accompanied by other signs

Question 35

central cyanosis

Answer 35

a bluish discoloration of the central parts of the body, such as the lips, tongue, and mucous membranes, and it indicates low oxygen levels in the arterial blood—unlike acrocyanosis, which is usually due to peripheral vasoconstriction