Newborn Assessment Following Delivery

Initial Preparations

• Utilize eye protection and gloves to mitigate contact with maternal blood or fluids.
• Place the infant in a warmer.
• Quickly dry the infant to prevent heat loss from evaporation.
• Remove wet linen and leave the infant uncovered for warming and observation.

Apgar Score

• Conducted at 1 and 5 minutes post-birth.
• Five Components: Heart rate, respiratory effort, muscle tone, reflex irritability, and skin color.
• Scoring: 0 to 2 for each category.
  • Heart Rate: >100 bpm = 2, <100 bpm = 1, No heart rate = 0.
  • Respiratory Effort: Crying/spontaneous = 2, Weak/irregular = 1, No effort = 0.
  • Muscle Tone: Well-flexed = 2, Some flexion = 1, Flaccid = 0.
  • Reflex Irritability: Cry = 2, Grimace = 1, No response = 0.
  • Skin Color: Completely pink = 2, Cyanosis = 1, Pale/blue = 0.

Post-Apgar Evaluation

• Score 8-10: No specific intervention.
• Score 5-7: Stimulation and oxygen administration.
• Score <4: Resuscitation required.

Physical Examination

• Check infant’s head, back, and extremities for anomalies.
• Assess umbilical cord (2 arteries, 1 vein).
• Place identification bands on infant and parents.
• Weigh and measure the infant.
• Maintain infant temperature through swaddling or skin-to-skin contact.

Vital Signs and Measurements

• Normal heart rate: 110-160 bpm.
• Respiratory rate: 30-40 breaths per minute.
• Temperature: 36.5 - 37.5°C (97.7 - 99.5°F) when measured axillary.
• Blood pressure: If taken, use an appropriate size cuff.
• Head circumference: 33 to 35.5 cm.

Detailed Physical Examination

• Head: Palpate for size, shape, molding, fontanelles.
• Eyes: Check color, pupillary response, and for subconjunctival bleeding.
• Ears: Inspect for position, formation, and skin tags.
• Nose: Check for patency and flaring.
• Mouth: Check for symmetry, Epstein pearls, and feeding reflexes.
• Neck and Clavicle: Check for webbing, movements, and fractures.
• Chest: Measure circumference, check nipples, and auscultate heart.
• Abdomen: Palpate, auscultate bowel sounds, and measure circumference.
• Extremities: Inspect for length, symmetry, and reflexes.
• Back: Check for alignment and signs of spina bifida.

Genital and Anus Examination

• Female infants: Inspect labia, vaginal discharge.
• Male infants: Inspect penis, record voiding.
• Check scrotum for testicular descent.
• Verify anal patency and record first stool (meconium).

Newborn Screening Tests

• Blood samples for hemoglobin, glucose, and various disorders.
• Administer vitamin K and eye prophylaxis to prevent infections.

Documentation and Reporting

• Document findings and report abnormalities to healthcare providers.
• Ensure thorough assessment and collaboration for optimal newborn care.