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Initial Newborn Care and Assessment

ABCs and Temperature
■ Baby should be pink and have a loud, vigorous cry.
■ Suction the nose and mouth to clear excess secretions, mucus.
■ Stimulate breathing with vigorous rubbing and drying.
■ Dry baby and maintain warmth (wrap in blankets, warmer, etc.).

APGAR and Vital Signs (see APGAR Score)
■ Assess and document APGAR at 1 and 5 minutes after delivery. Note: Some hospitals also require a 10-minute APGAR score.
■ Assess and record vital signs (see normal ranges below).

Preterm
RR: 50–70
HR: 140–180
SBP: 40–60
T: 36.8_–37.5 C
Newborn
RR: 30–60
HR: 120–160
SBP: 60–90
T: 36.8_–37.5 C

Identification
■ Place ID bands on baby and mother.
■ Record baby’s footprints in chart.

Measurements
■ Weight: Normal is 6–10 lb.
■ Length: Normal is 18–22 inches.
■ Head circumference: Normal is 33–35 cm.
■ Chest circumference: Normal is 30–33 cm.

Physical Assessment
Note: Perform a regular, head-to-toe assessment, similar to an adult, but note the following areas specific to newborn assessment.
■ Appearance: Baby should be pink, have a loud, vigorous cry, and be well-flexed with full ROM and spontaneous movements.
■ Fontanels: Anterior is diamond-shaped about 4 cm at widest point; posterior is triangular 1 cm or less at widest point.
■ Molding: Skull may be odd-shaped with overlapping cranial bones.
■ Mouth: Inspect the mouth for cleft lip and/or cleft palate.
■ Heart Murmur: Soft murmur considered normal in first few days.
■ Breathing: Abdominal breathing is normal in newborns.
■ Umbilical Cord: Should have 1 vein and 2 arteries. It should be clamped, may or may not be pulsating, and no sign of bleeding.
■ Extremities: Legs and arms equal length to each other and all fingers and toes accounted for.
■ Male Genitalia: Testes palpable in scrotum or inguinal canal.
■ Female Genitalia: Large labia minora and vaginal discharge of blood or mucus is considered normal.

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