Newborn Assessment & Adaptation Exam: Circulatory Changes, APGAR Scores, External Assessment, Chest & Abdomen Assessment, Neurologic Assessment, New Ballard Scale, Gestational Age Classification, Vital Signs, Vernix Caseosa, Lanugo, Milia, Mongolian Spots

Newborn Assessment & Adaptation Exam: Circulatory Changes, APGAR Scores, External Assessment, Chest & Abdomen Assessment, Neurologic Assessment, New Ballard Scale, Gestational Age Classification, Vital Signs, Vernix Caseosa, Lanugo, Milia, Mongolian Spots, Telangiectatic Nevi, Nevus Flammeus, Erythema Toxicum, Head Circumference, Fontanels, Sutures, Caput Succedaneum, Cephalohematoma, Reflexes (Moro, Rooting, Grasp, Babinski, Stepping, Tonic Neck), Sensory Responses (Vision, Hearing, Touch, Taste, Smell), Habituation, Laboratory Values, Airway & Hypothermia Management, Oxygenation, Complications Exam Questions Verified and Complete with A+ Graded Rationales Latest Updated 2026 Circulatory Changes After Birth With expulsion of placenta and cutting of umbilical cord, a newborn begins breathing independently. 3 shunts - ductus arteriosus, ductus venosus, and foramen ovale functionally close with the flow of oxygenated blood in the lungs and readjustment of atrial BP of the heart. APGAR Scores Completed at 1 and 5 minutes after birth. 0 - 3 indicates severe distress 4 - 6 indicates moderate distress 7 - 10 indicates no distress APGAR Scoring Heart Rate: 0 - absent, 1 - less than 100, 2 - greater than 100 Respiratory Rate: 0 - absent, 1 - slow, weak cry, 2 - good cry Muscle Tone: 0 - absent, 1 - some flexion, 2 - well-flexed Reflex Irritability: 0 - none, 1 - grimace, 2 - cry Color: 0 - blue, pale, 1 - pink body, cyanotic hands and feet (acrocyanosis). External Assessment Skin color, peeling, birthmarks, foot creases, breast tissue, nasal patency, and meconium staining (may indicate fetal hypoxia) Chest Assessment Point of maximal impulse location, ease of breathing, auscultation for HR and quality of tones and respirations for crackles, wheezes, and equality of (B) breath sounds. Abdomen Assessment Rounded abdomen and umbilical cord for one vein and two arteries. Neurologic Assessment Muscle tone and reflex reaction (Moro reflex); palpation for the presence and size of fontanels and sutures; assessment of fontanels for fullness or bulge. Other Observations Inspection for gross structural malformations. New Ballard Scale Newborn maturity rating scale that assesses neuromuscular and physical maturity. Provides an estimation of gestational age and a baseline to assess growth and development. Expected Reference Ranges of Physical Measurements Weight - g Length - 45 - 55 cm (18 - 22 in) Head Circumference - 32 - 36.8 cm (12.6 -14.5 in) Chest Circumference - 30 - 33 cm (12 - 13 in) Classification by Gestational Age and Birth Weight Appropriate for gestational age (AGA) - weight is between 10th and 90th percentile. SGA - weight below 10th percentile. LGA - weight above 90th percentile. Low Birth Weight (LBW) - 2500g or less at birth. Intrauterine growth restriction (IUGR) - growth rate does not meet expected norms. Term - 38 - 42 weeks Preterm or Premature - born prior to 37 weeks. Postterm - born after 42 weeks. Postmature - born after 42 weeks with evidence of placental insufficiency. Newborn Vital Signs In the following sequence: Respiratory: 30 - 60/min with short periods of apnea. Heart Rate: 100-160 BPM with brief fluctuations dependent on infant activity. BP: 60 - 80 mm Hg systolic; 40 - 50 mm Hg diastolic. Temp: 36.5 - 37.2 C (97.7 - 98.9 F) axillary. Vernix Caseosa Protective, thick, cheesy covering. Lanugo Fine, downy hair; varies regarding the amount present, usually found on the pinnas, forehead, and shoulders. Milia Small raised white spots on the nose, chin, and forehead; should disappear spontaneously and should not be squeezed. Mongolian Spots Bluish, purple spots of pigmentation commonly noted on shoulders, back, and buttocks. Freq present on newborns with dark skin. Make sure parents are aware and document location and presence. Telangiectatic Nevi ("Stork Bites") Flat, pink or red marks that easily blanch and are found on the back of the neck, nose, upper eyelids, and middle of the forehead. Usually fade by age 2. Nevus Flammeus ("port wine stain") Capillary angioma below the surface of the skin that is purple or red, varies in size and shape, is commonly seen on the face, and does not blanch or disappear. Erythema Toxicum (erythema neonatorum) Pink rash that appears suddenly anywhere on the body of a term newborn during the first 3 weeks. "Newborn rash". No treatment is required. Head Size 2 - 3 cm larger than chest circumference. If greater than or equal to 4cm larger, may be indication of hydrocephalus (excessive cerebral fluid within the brain cavity surrounding the brain). if less than or equal to 32cm, indication of microcephaly (abnormally small head). Fontanels Anterior Fontanel - palpated and ap