Newborn Infant Assessment and Care

Immediate Post-Delivery Responsibilities

• Assess the newborn's condition systematically.
• Use eye protection and gloves to avoid contamination from maternal and fetal fluids.
• Place the infant in a warmer and dry them quickly to prevent heat loss.
• Remove wet linens and keep the infant uncovered for warming and observation.

APGAR Score

• Timing: Assessed at 1 and 5 minutes post-birth.
• Components:
  • Heart Rate:
    • 2 for >100 bpm
    • 1 for <100 bpm
    • 0 for no heart rate
  • Respiratory Effort:
    • 2 for vigorous crying
    • 1 for weak, irregular effort
    • 0 for no effort
  • Muscle Tone:
    • 2 for well-flexed
    • 1 for some flexion
    • 0 for flaccid
  • Reflex Irritability:
    • 2 for crying
    • 1 for grimace
    • 0 for no response
  • Skin Color:
    • 2 for completely pink
    • 1 for peripheral cyanosis
    • 0 for central cyanosis or pallor
• Scores:
  • 8-10: Satisfactory
  • 5-7: Needs stimulation/oxygen
  • Below 4: Requires resuscitation

Initial Physical Examination

• Head-to-Toe Scan for anomalies (e.g. cleft palate, polydactyly).
• Umbilical Cord Check: Ensure 2 arteries and 1 vein.
• Identification: Bands and possibly foot/hand printing.

Post-Delivery Care

• Weigh and measure the newborn.
• Maintain infant temperature.
• Check initial vital signs.
• Temperature: Preferably via axillary method.
• Heart Rate: 110-160 bpm, pediatric stethoscope recommended.
• Respiratory Rate: 30-40 breaths per minute.
• Blood Pressure: Check policy; normal ranges are provided.

Head and Neck Assessment

• Fontanelles: Check size, shape for dehydration or pressure.
• Caput Succedaneum/Cephalohematoma: Identify and reassure parents.
• Eye Examination: Check color, reflexes, and any signs of trauma.
• Ear Position and Structure: Low-set ears may indicate abnormalities.
• Nasal Patency and Inspection: Ensure airway is clear.

Oral and Facial Assessment

• Mouth and Lip: Check for palatal integrity, Epstein's pearls.
• Reflexes: Rooting and sucking; ensure feeding ability.

Body and Extremities

• Skin: Check for variations like Mongolian spots.
• Neck/Clavicle: Palpate for fractures or anomalies.
• Chest and Abdomen: Measure circumference, check for hernias.
• Hip and Leg: Check for dysplasia, equal length and movements.

Reflexes and Neurological Assessment

• Reflexes: Moro, tonic neck, plantar grasp, Babinski.
• Monitor for any asymmetries or abnormalities.

Genital and Anal Examination

• Female Genitals: Check for edema or discharge.
• Male Genitals: Position of the urinary meatus, check for hydrocele.
• Anus: Ensure patency, note first stool passage.

Screening and Medications

• Blood Samples: Check for various disorders and glucose levels.
• Eye Medication: Prevent ophthalmia neonatorum.
• Vitamin K Injection: Prevent bleeding due to vitamin K deficiency.

Documentation and Reporting

• Document all findings and report abnormalities.
• Early problem identification is crucial for effective intervention.