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Medical 2-29-Assessment Newborn


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Normal blood pressure
at birth?
80-60/45-40 mmHg
Normal blood pressure on day 10?
100/50 mmHg
Low blood pressure may indicate?
decreased cardiac output
Normal pulse when awake?
120-160 bpm
Normal pulse when asleep?
100 bpm
Normal pulse when crying?
180 bpm
Normal respirations?
30-60 breaths/minute
synchronization of chest and abdominal movements
diaphragmatic and abdominal breathing
transient tachypnea
Normal crying?
strong and lusty
moderate tone and pitch
cries vary in length from 3 to 7 minutes after consoling measures are used
Normal temperature?
axilla 97.5-99F
rectal 97.8-99F
98.8F desired
heavier newborns tend to have higher body temperatures
Normal weight?
2500 - 4000 g
5lb,8oz to 8lb,13oz
What is the normal weight loss in first 3 to 4 days?
5% to 10%
Why do large babies tend to lose more weight?
due to greater fluid loss in proportion to birth weight except infants of diabetic mother
What is normal length?
18-22 inches
grows 3 inches during first 3 months
Normal posture?
body usually flexed, hands may be tightly clenched, neck appears short as chin rests on chest
in breech births, feet are usually dorsiflexed
Normal skin?
color consistent with genetic background

newborns of European descent are pink-tinged or ruddy color over face, trunk, extremities

Newborns of African or Native American descent are pale pink with yellow or red tinge

Newborns of Asian descent: pink or rosy red to yellow tinge

Common variations: acrocyanosis, circumoral cyanosis, or harlequin color change

mottled when undressed

minor bruisingn over buttocks in breech presentation and over eyes and forehead in facial presentations
Normal texture?
smooth, soft, flexible, may have dry, peeling hands and feet
elastic, returns to normal shape after pinching
clear; milia across bridge of nose, forehead, or chin will disappear within a few weeks
cafe-au-lait spots (one or two)

mongolian spots common over dorsal area and buttocks in dark-skinned infants

erythema toxicum
telangiectatic nevi
petechiae of head or neck (breech presentation, cord around neck)
general appearance, size, movement
Round, symmetric, and moves easily from left to right and up and down; soft and pliable
circumference 32-37 cm (12.5-14.5 in);
2 cm greater than chest circumference
head one fourth of body size
one inch equals
2.5 centimeters
Common variations of head?
breech and cesarean newborns' heads are round and well shaped
palpation of juncture of cranial bones
anterior fontanelle: 3-4 cm long by 2-3 cm wide, diamond shaped
posterior fontanelle: 1-2 cm at birth, triangle shaped

slight pulsation

moderate bulging noted with crying, stooling, or pulsations with heartbeat
Hair texture?
smooth with fine texture variations (Note: Variations depend on ethnic background)
Hair distribution?
scalp hair high over eyebrows (Spanish-Mexican hairline begins mid-forehead and extends down back of neck)
Symmetric movement of all facial features, normal hairline, eyebrows and eyelashes present
Facial spacing of features?
eyes at same level, nostrils equal size, cheeks full, and sucking pads present
lips equal on both sides of midline
chin recedes when compared to other bones of face
Facial movement?
makes facial grimaces
symmetric when resting and
Eyes - general appearance andn placement?
bright and clear
even placement
slight nystagmus
(involuntary cyclical eye
concomitant strabismus
move in all directions
blue or slate blue-gray
brown color at birth in
dark-skinned infants
position; above pupils but within iris, no drooping; eyes on parallel plane;
epicanthal folds in Asians and 20% of newborns of northern European descent
Eye movement?
blink relfex in response to light stimulus
eyes open wide in dimly lighted room
Eye inspection?
edematous for first few days of life, resulting from birth and instillation of silver nitrate (chemical conjunctivitis); no lumps or redness
Cornea of eyes?
clear and corneal reflex present
Sclera of eyes?
may appear bluish in newborn, then white; slightly brownish color frequent in newborns of African descent
Pupils of eyes?
pupils equal in size, round, and react to light by accommodation

slight nystagmus in newborn who has not learned to focus
pupil light reflex

demonstrated at birth or by 3 weeks of age
Conjunctive of eyes?
chemical conjunctivitis
subconjunctival hemorrhage
palpebral conjunctiva (red
but not hyperemic
tracks moving object to midline
fixed focus on objects at a distance of about 10-20 in; may be difficult to evaluate in newborn
prefers faces, geometric designs, and black and white to colors
Lashes and lacrimal glands?
presence of lashes (lashes may be absent in preterm newborns)
cry commonly tearless

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