1. Read the Overview and Course Objectives.
2. Study the Terminology.
3. Read the course material.
4. Complete the Learning Activity.
5. Complete the Post Test with a score of 80% or more.

The most critical time in a person's life is the first few hours after birth. During this time, the newborn must make adaptations that will ensure his or her adjustment to life outside the womb. Immediately following delivery, complex physiological changes are occurring. It's important for nurses to observe infants carefully during this period to be able to identify those infants who are at risk, so the nurse must be familiar with the physical characteristics of a normal, healthy baby.

This program describes a comprehensive physical examination of the newborn. Upon completion, you will be able to differentiate between normal and abnormal physical findings in the appearance and activity of an infant.

To begin your assessment, it is important to obtain the mother's prenatal and interpartal history. Numerous maternity issues can affect the infant's status, these include insufficient weight gain, diabetes, preeclampsia, episodic bleeding, or infection. In addition, note the length of the mother's labor, the use of analgesics or anesthetics, the type of delivery, the Apgar scores, and whether or not the infant needed resuscitation.

Newborn infants may be assessed by a variety of parameters, each specifically designed to yield pertinent information. For example, the Apgar scoring technique, Dubowitz assessment of gestational age, and Brazelton behavioral assessment are all tools which provide a database for nursing care.

This program presents a basic, thorough physical examination. Optimally, the physical assessment should be performed within the first 24 hours of life. (Video Note: Even though the infant in the accompanying video presentation is ten days old, he is still considered a newborn and is appropriate for this demonstration).

From this exam we'll be able to compile a comprehensive database for subsequent assessment and care. Remember, the continuous assessments are crucial because of the rapid changes the infant undergoes in the first few days of life.

Unless a maternal history or the infant's physical appearance indicates reason for concern, do not complete your physical assessment until the infant reaches normal body temperature. This is usually considered to be about 98 degrees Fahrenheit or 36.7 degrees centigrade by the axillary method.

You may want to ask the parents to be present during the exam. It enables them to discuss any concerns they may have, and gives you a chance to teach them about their newborn. It also provides a wonderful opportunity to observe the parent-infant relationship and to identify any early problems.

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