Each newborn baby is carefully checked at birth for signs of problems or complications. A complete physical assessment will be performed that includes every body system. Throughout the hospital stay, doctors, nurses, and other healthcare providers continually assess the health of the baby, observing for signs of problems or illness. Assessment may include: Show
The Apgar score is one of the first checks of your new baby's health. The Apgar score is assigned in the first few minutes after birth to help identify babies that have difficulty breathing or have a problem that needs further care. The baby is checked at one minute and five minutes after birth for heart and respiratory rates, muscle tone, reflexes, and color. Each area can have a score of zero, one, or two, with 10 points as the maximum. A total score of 10 means a baby is in the best possible condition. Nearly all babies score between eight and 10, with one or two points taken off for blue hands and feet because of immature circulation. If a baby has a difficult time during delivery, this can lower the oxygen levels in the blood, which can lower the Apgar score. Apgar scores of three or less often mean a baby needs immediate attention and care.
A baby's birthweight is an important indicator of health. The average weight for term babies (born between 37 and 41 weeks gestation) is about 7 lbs. (3.2 kg). In general, small babies and very large babies are at greater risk for problems. Babies are weighed daily in the nursery to assess growth, fluid, and nutrition needs. Newborn babies may often lose 5 to 7 percent of their birthweight. This means that a baby weighing 7 pounds 3 ounces at birth might lose as much as 8 ounces in the first few days. Babies will usually gain this weight back by 2 weeks of age. Premature and sick babies may not begin to gain weight right away. Most hospitals use the metric system for weighing babies. This chart will help you convert grams to pounds. Converting grams to pounds and ounces:1 lb. = 453.59237 grams; 1 oz. = 28.349523 grams; 1000 grams = 1 Kg. Other measurements are also taken of each baby. These include the following:
A complete physical examination is an important part of newborn care. Each body system is carefully examined for signs of health and normal function. The doctor also looks for any signs of illness or birth defects. Physical examination of a newborn often includes the assessment of the following: Gestational assessmentAssessing a baby's physical maturity is an important part of care. Maturity assessment is helpful in meeting a baby's needs if the dates of a pregnancy are uncertain. For example, a very small baby may actually be more mature than it appears by size, and may need different care than a premature baby. An examination called The Dubowitz/Ballard Examination for Gestational Age is often used. A baby's gestational age often can be closely estimated using this examination. The Dubowitz/Ballard Examination evaluates a baby's appearance, skin texture, motor function, and reflexes. The physical maturity part of the examination is done in the first two hours of birth. The neuromuscular maturity examination is completed within 24 hours after delivery. Information often used to help estimate babies' physical and neuromuscular maturity are shown below. Physical maturityThe physical assessment part of the Dubowitz/Ballard Examination looks at physical characteristics that look different at different stages of a baby's gestational maturity. Babies who are physically mature usually have higher scores than premature babies. Points are given for each area of assessment, with a low of -1 or -2 for extreme immaturity to as much as 4 or 5 for postmaturity. Areas of assessment include the following:
Neuromuscular maturitySix evaluations of the baby's neuromuscular system are performed. A score is assigned to each assessment area. Typically, the more neurologically mature the baby, the higher the score. The areas of assessment include:
When the physical assessment score and the neuromuscular score are added together, the gestational age can be estimated. Scores range from very low for immature babies (less than 26 to 28 weeks) to very high scores for mature and postmature babies. All of these examinations are important ways to learn about your baby's well-being at birth. By identifying any problems, your baby's doctor can plan the best possible care. How do you assess the heart rate of a newborn?Pulse. A newborn's pulse is normally 120 to 160 beats per minute. Breathing rate. A newborn's breathing rate is normally 40 to 60 breaths per minute.
What is the most accurate method to assess a heart rate in an infant?Pulse oximetry and electrocardiography are superior in accuracy compared to auscultation/palpation, however they require a longer time to assess the initial heart rate.
What assessment should the nurse do for a newborn?A full newborn nursing assessment should include measurements such as weight, length, head circumference, and vital signs. The assessment should start by generalizing the infant's appearance, including position, movement, color, and breathing (Overview, 2020).
Which pulse should the nurse use to obtain a heart rate on an infant?Count the apical pulse by auscultating for 1 full minute
the heart rate speeds up and down with respirations. The apical pulse on an infant is found at the 4th intercostal space (ICS), lateral to the midclavicular line…. remember in the adult it was the 5th ICS.
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