Newborn Assessment Third Examination
- After 6-8 weeks of neonatal life
- in the postpartum period, once the
mother gives birth, the newborn
experiences complex biophysiologic
and behavioral changes.
- Changes resulting from the
transition from the intrauterine
life now to extrauterine life.
- Nursing care of the newborn
based on knowledge of these
particular changes.
- The few hours after birth
represents a critical adjustment
period for a newborn.
*kaya siya critical baka
kasi hindi kayanin ni baby
yung changes sa outside
world.
**also immediate nursing
care is needed.
- Comprehensive knowledge of
the mother is essential
INDICATIONS
First Examination
- Monitoring the baby inside the
womb of the mother before the
delivery and 2 hours after birth.
*A systematic approach
helps the pertinent data are not
overlooked (like APGAR’s
scoring)
Second Examination
- Before discharge
(follow-up consultation)
**dito sinasabe yung scheduling
of vaccines
PHASES OF ASSESSMENT
Initial
- Our goal is primarily to able to
establish and maintain a patient
airway and support respiration
- Maintain warmth
*** not too high, not too low
*** 25℃ to 28℃ - temp. of the DR
and NICU
- Ensure safety and prevent injury
or friction
- Be able to identify actual
(nakita) and potential (baby is at
risk for a complication) problem.
Transitional
- Continuation of care
- Continues to protect and ensure
the safety of the infant
- Provide the parents some
information regarding newborn
care (most esp. If 1st child nila
ito)
**primary goal is magkaroon ng
bonding yung infant with
mother (and pwede rin with
father)

1st Stage
2nd Stage
Notes:
10 - highest
9 - acceptable
- Remember! Whenever you
check for presence of cyanosis,
always check for:
- Nail Beds
- palms/ talampakan
- lips
- In APGAR scoring, there is a
1-5-10 minutes ruling
- If in the 1st to 5th minutes after
delivery assessment was scored
as an excellent there is no need
to go further to the 10th minute.
***The reason in this assessment
is to see how well the baby
accepts life outside the uterus.
*** there is a research that shows
an evidence that if an infant that
has an APGAR’s score remain
low at the 5th minute to 10
minutes or even more are likely
to suffer long term neurological
damage
Transitional assessment
- Lasts for 6-8 hours, first
30 minutes awake and
remaining hours the
newborn will be sleeping
- 6-12 hours observation
should be made until the
vital signs are established
- Hyper-responsive to
stimuli
- Skin color changed
** the newborn normally
becomes quiet, relaxed
and falls asleep.
** slight cyanosis -needs
guidance and heart rate
increases rapidly. This
usually happens due to
the surroundings like
room temperature,
something noisy was
heard by the infant, light
system, or due to the
change of environment
from intrauterine to
extrauterine.
** transitory asphyxia
- Low oxygenated
level, high carbon
dioxide level
 ASSESSMENT OF GESTATIONAL
AGE
Ballard Scoring Criteria
Dubowitz Maturity Scale
- A systematic assessment of
physical signs and neurological
tasks helps establish or estimate
the newborn’s gestational age.
- Physical and Neuromuscular
maturity may be estimated
using such as Ballard Scoring
Criteria and Dubowitz (is not
usually used)
***pag mataas score sa Ballard
and Dubowitz it shows lang na
nakakapagsurvive or mataas
chances ng survival rate ni baby
sa outside world (doctor
gumagawa nito)
Ballard Scoring Criteria
- Commonly used to determine
the gestational age of our
newborn
- Physical: 6 nerve muscular
- Maturity
Small for gestational age (SGA)
- The newborn is less than 10% of
the ideal weight at the time of
birth. (usually mothers who are
alcoholic and/or smoker.
- > 2,500 grams
Large for gestational age (LGA)
- The newborn is more than 90%
of the ideal weight at the time
of birth.
- More than 4,000 grams
**Macrosomia
- mga pinanganak ng may
gestational diabetes
- The dr. usually orders
blood sugar test or serum
glucose test
- Nanginginig yung bata
- hypoglycemia
Appropriate for gestational age
- The newborn is within the ideal
range of birth weight
- 2,500 - 4,000 grams
**** disproportion in the range is
suspected to have gigantism/
dwarfism.
FULL TERM
- Pregnancy that reached 37 to 42
weeks age of gestation or
beyond post-term
 PRETERM
- Pregnancy that reached 28 to 36
weeks of gestation
POST TERM
- Pregnancy that has extended to
or beyond 42 weeks of gestation
GENERAL PHYSICAL
EXAMINATION
Vital signs
Temperature: can be taken through
rectal (also to check for the patency of
the anus) or axilla
Normal temp.: 36.5℃ to 37.4℃
Hypothermia: less than 36℃
Hyperthermia: more than 40℃
Respiration: count by observing the
abdominal movements and count in
one full minute for accuracy.
Normal: 30 to 60 cpm
Tachypnea: more than 60 cpm
Bradypnea: less than 20 cpm
**complications dahil sa change in
pressure gradient
** pre-warm muna lahat ng gamit for the
newborn
** 24℃ - 28℃ temp. ng room pag nalabas
na yung baby dapat walang air drop
**poikilothermic - mabilis magreact sa
temp.
**diretso si baby sa regent warmer tas
after 30 sec. sa chest naman siya ni
mother
** yung gestational diabetes nawawala
after delivery,
**CBQ: obligatory nasal breather
- Takes 3 weeks for the baby to
realize they can breathe
through their mouth
Pulse: you may use the apical pulse
which is located on the left mid-clavicular
between 4th and 5th intercostal space.
Count in one full minute for accuracy
Normal pulse rate - 120 - 160 bpm
Bradycardia - less than 120 bpm
Tachycardia - more than 160 bpm
Blood Pressure: blood pressure
monitoring is not routinely done. The
average systolic and diastolic pressure is
60 - 80 mmHg or 40 -50 mmHg at 1-3
days of age.
ANTHROPOMETRIC MEASUREMENT
- To assess the body size, shape,
and the composition of the
newborn’s body
- To compare the size with
estimated period of gestation
- To identify if there are
abnormalities in newborn