newborn assessment competency

step 1

review maternal and newborn history

step 1 details

• blood type

• labs

• medications

• social history

• L&D summary

  • mode of delivery

  • complications

  • FHR patterns

  • meds in labor

  • APGAR score

  • resuscitation

• prenatal history

step 2

review newborn measurements → length, weight, head circumference

step 3

introduction to the patient

step 3 details

• introduce yourself

• confirm patient and newborn ID

• explain purpose of your interaction

• hand hygiene

step 4

appearance of newborn

step 4 details

• state (awake, alert, sleeping)

• tone (flexed, flaccid)

• color (appropriate, pale, jaundice)

step 5

vital signs → pulse, respirations, temperature

step 6

head

step 6 details

• size and shape

• sutures'

• fontanels'

• birth injuries

  • cephalohematoma

  • caput succedaneum

  • bruising

step 7

face

step 7 details

• nose

  • patency of nares

  • drainage

• mouth

  • intact soft and hard palates

  • epstein pearls

  • tongue tie

• eyes

  • symmetric

  • in line with ears

  • sclera

step 7 reflexes

rooting and sucking

step 8

ears

step 8 details

• size

• in line with the eyes

step 9

neck

step 9 details

• moves freely

• midline

• palpate clavicle for crepitus

step 9 reflex

tonic neck

step 10

skin

step 10 details

• temperature

• turgor

• capillary refill

• acrocyanosis

• jaundice

• milia

• erythema toxicum

• stork bite

• hyperpigmented macules

step 11

chest

step 11 details

• shape and symmetry

• retractions

• nipples in line

• lung sounds

• heart sounds

step 12

abdomen

step 12 details

• soft, nontender

• bowel sounds

• umbilicus

  • 3-vessel cord

  • cord stump status

step 13

genitals

step 13 details

• male

  • meatus at tip of penis

  • status of testes

  • edematous scrotum

• female

  • swollen labia

  • vaginal discharge

step 14

extremities and spine

step 14 details

• symmetric, free movement

• 20 digits

• clubbed feet

step 14 reflexes

palmar grasp, plantar grasp, babinski

step 15

buttocks

step 15 details

• dimple or hair tuft at the sacrum

• skin folds symmetry

• tests for hip dysplasia