PHYSICALEXAMINATIONOFTHENEWBORN VitalSigns: Countrespirationsfor1fullminute Listentoheartratefor1fullminute Demonstratetakingaccurateaxillarytemp(afterauscultationbelow) Voiceaccuraterangesforall HR110160 RR3060 T97.698.6F Auscultatewhilebabyisquiet: Heartsounds:PMI,rhythm,rate(tachycardia,bradycardia),murmur? Lungs:Shouldbeclearandequalbilaterally.

rally.Auscultateforrales,rhonchi,wheezes Bowelsoundsshouldbeactive Duringentireassessment,shouldnote: Skin:lanugo,vernix,meconiumstaining,milia,Mongolianspots,jaundice,hemangioma,nevi, rash,excoriation,petechiae,bruises. General:Describerestingposture,activity,grossabnormality,color(pink,cyanotic/acrocyanotic, palemottled) Behavior:Isbabyalert,wakeseasily,irritable,consolable,quietawake,sleeping Neurologic:Tone,posture,activity,normalcry(orhighpitched?) Reflexes:Suck,Root,Grasp(palmer/plantar),Moro,Babinski Head:molding,caput,cephalohematoma(beabletotellushowyoucantellthedifference),sagittal suture(overriding,separated,approximatedallarenormalfindings),anteriorfontanel(palpateto checkifsoft,firm,bulging,flat,etc),followthesagittalsuturebacktotheposteriorfontanelbutifthere issignificantcaputmaynotbeabletofeel.Inspectscalpforhairdistribution,lesions,excoriations, eccymosis Eyes:Edema,discharge,scleracolor,Redreflexpresent? Nose:Narespatent?nasalflaring?Septummidline?Drainagepresent? Ears:Notepositionofears(lowset?)skintags?pits?Malformationoftheear? Mouth:Palate(hardandsoftpalateintact),Epstein'spearls,teeth,tongue(size,position),gums,mucous membranesmoist/pink,frenulumshort? Neck:Tracheamidline,anymassespalpable,claviclesintact? Chest:ObserveforSymmetry,retractions,flaring,grunting,tachypnea,notebreastbuds. Peripheralperfusion(capillaryfillingtimecancheckthisonthesternumwhencheckingforjaundice) andcheckthefollowingperipheralpulsesfemoral,brachial,radial Abdomen:Shape,muscletone,diastasisrecti.Palpatetheabdomenshouldbesoftwithoutmasses.

Umbilicus:Numberofvessels(ifabletoseeonlyifrecentlydelivered),signsofinfection,isthe identificationtaginplaceanddothenumbersmatchthearmandlegbands? Genitourinary: Femalesizeofclitorisandlabia,doeslabiamajoracompletelycoverlabiaminora,hymenaltags, dischargeorpseudomenstruation,doesthegenitaliaappearnormalforafemaleinfant Maleurethralmeatuspatencyandposition,testiculardescentandscrotaldevelopment(i.e., rugaeonlyoninferioraspect,orsurfacecompletelycoveredwithrugaeandpendulousin appearance),doesthegenitaliaappearnormalforamaleinfant Anus:Patency(rectaltempforfirsttemperatureatdelivery,passageofstool) Extremities:Symmetry,ROM,OrtolaniandBarlowmaneuvertocheckhips(forcongenitaldysplasia), positionofhandsandfeet,numberdigits,shape&lengthofdigits,lengthofnails,arePalmarcreases normal(simiancrease)?Subcutaneoustissuenormal? Spine:straight,midline,intact,sacraldimple/tuftofhair?