Newborn Assessment Normal Findings Review Questions and Correct Answers

when assessing the posture, what information should the nurse refer to? Refer to maternal chart for fetal presentation, position, and type of birth, since newborn readily assumes in the utero position. When assessing the posture what are average findings for the vertex? Arms, legs in moderate flexion; fist clench Do newborns readily extend their extremities? No, resistance to having extremities extended for examination or measurement, crying possible when attempted. Describe movement of the newborn? Normal spontaneous movement bilateral asynchronous (legs flex and extend an alternating fashion) but equal extension in all extremities. Where will you be able to see visible pulsations in a newborn? Visible pulsations in left mid clavicular line, fifth intercostal space. what is the average apical pulse rate in a newborn? 120-140 bpm, apical pulse located in the fourth intercostal space How do you measure quality of the pulse in the newborn? the first sound will be the closure of the mitral and tricuspid valves in the second sound will be the closure of the aortic of pulmonic valves. They should be sharp and clear. What is a normal variation of heart sounds in a newborn? Murmur, especially over base or at the left sternal border in interspace 3-4 (Foreman ovale anatomically closing at about one year) should there be any differentiation between peripheral pulses? No peripheral pulses should be equal and strong. What is the normal temperature range and what route should you take it newborn? Temperature should be taken axillary 36.5-37.2°C is normal for newborns. Temperature should stabilize by 8 to 10 hours of age. Why is it important to count for full minute when assessing the respiratory rate of newborn? Newborns respirations have a tendency to be shallow and irregular in rate, rhythm, and depth when the infant is awake.