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Foundational (NURS 399) Newborn Assessment Checklist (Q VI 2020)

John Marsh
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University of Nevada, Las Vegas

Assessment Of Foundational Knowledge In Maternal/Child Nursing And Psychiatric Nursing (NURS 399)

Newborn Assessment Checklist (Q VI 2020)

The initial post-delivery assessment aims to exclude obvious
abnormalities and includes:
 Assessment of colour to exclude pallor or cyanosis
 Muscle tone, posture and responsiveness
 Heart and respiratory rate
 Normality of facial features including eyes and mouth
 Normal alignment spine and exclusion of spina bifida
 Genitalia to exclude ambiguity
 Trunk and limbs to exclude obvious abnormality
 Check anus for patency
 Evidence of birth trauma such as bruises or scalpel marks
Birthweight, head circumference, temperature and the number of cord
vessels are also recorded at this stage, and any concerns or
abnormalities are reported to the pediatrician.
The Newborn and Infant Physical Examination (NIPE)
Recent standards for newborn and infant physical examination
(NIPE) set a timeline of 72 hours after birth for full newborn
examination (RCM 2012).
The aim of this more thorough examination is to:
 Screen for abnormalities
 Make referrals for further tests or treatment if needed
 Provide reassurance to the parents.
(Nottingham Neonatal Service, 2017)
This examination is more thorough than the initial assessment at birth
and includes the key components of the NIPE screening test. These are
the examination of the heart, eyes, hips, and in male infants,
examination of the testes (Royal Cornwall Hospitals NHS Trust 2017).
Gathering relevant information prior to examination
 Anticipated problems based on the maternal and family history
 Factors affecting wellbeing during pregnancy and birth such as
poor fetal growth
 Date, time, type of delivery and birth weight
 Whether the baby has passed urine and meconium
Prior to examination, maternal consent should be obtained, the
procedure explained and where possible the examination should take
place at the bedside with the mother present. Including the mother, or
if possible both parents, gives the midwife a valuable opportunity to
observe the parent’s interaction with their baby and to address any
general concerns they may have.
Who should conduct the examination?
Examination of the newborn is usually performed by a Midwife
who is qualified in the Newborn and Infant Physical
Examination Screening Programme (NIPE). However, regional
variations may occur depending on the availability and qualifications of
the staff available.
Examination prior to discharge may also be performed by a
Paediatrician or General Practitioner.
Wolke (2002) notes that mothers were more likely to be satisfied when
the newborn examination was conducted by a midwife rather than a
doctor. This was because midwives were more likely to discuss
healthcare issues during the examination and were able to provide
continuity of care.
Exclusion criteria for midwife examinations
 Prematurity, under 36+6 weeks gestation
 Admission to intensive care, or paediatric referral
 Family history of significant genetic, or congenital abnormalities
 Suspected, or confirmed abnormality at antenatal screening



Foundational (NURS 399) Newborn Assessment Checklist (Q VI 2020)

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