NEONATAL
ASSESSMENT
EQUIPMENTS:
• warmer or another heat source
• digital rectal thermometer
• stethoscope
• clock with second hand,
• identification equipment (Vitam pad for footprints),
• tape measure
• Scale
• Terramycin eye ointment
• Vitamin K and syringe
• antisepic swab (e.g, povidone-iodine)
• small bandage, 2 x 2 gauze pad
• gestational assesment form
• drying agent or prescribed antibiotic ointment for
umbilical cord
• neonate's layette
• towels and blankets
• sterile gloves
Indication:
Routinely performed for all neonates
in the healthcare facility setting.
Objectives:
• To identify the neonate and obtain comprehensive
baseline data effectively.
• To provide care for the neonate safely and
aseptically.
Procedure:
1. Wash hands.
2. Put on sterile gloves.
3. Place the neonate into the warmer.
4. Assess respirations, apical pulse, and rectal temperature.
5. Perform proper identification of neonate:
Procedure:
6. With the use of stamping pad, obtain footprints or
fingerprinting (discharge fingerprinting is also performed,
if necessary). Foot or fingerprinting are difficult to take and
difficulty to distinguish.
7. Attaching an identification device to the newborn with a
matching device for the mother (i.e., electronically readable
identification wrist or ankle bands or bracelets), and father.
In another variation, the mother wears a wrist band,
but the infant has an umbilical clamp.
The infant is actually marked with a semipermanent
ink.
• Genotyping (the only fail-safe method of identification).
8. Perform a thorough physical assessment.
9. Weight and measure the neonate. Hold forceps and cord
while weighing.
10. Apply prescribed eye ointment within one hour
of life.
A few drops of silver nitrate solution or an antibiotic is usually
placed into the eyes to prevent infection from any harmful
organisms that the baby may have had contact with during delivery
(e.g., maternal sexually transmitted diseases [STDs]).
11. Inject prescribed dosage of vitamin K within 2
hours of life to prevent hemorrhagic disease.
12. Complete gestational age assessment.
13. Bathe the neonate.
14. Apply a drying agent or prescribed antibiotic
ointment to the umbilical cord (or follow health
agency policy).
15. Dress neonate in warm linen or clothes.
16. Wrap neonate in blanket.
15. Observe for unusual signs and symptoms
(neonate distress).
16. Place back into warmer or have mother hold
baby if able.
17. Ensure infant's safety and comfort. Return for
needed assessments, evaluation or follow-up.
17. Remove and dispose gloves.
18. Wash hands.
19. Chart: Document date, time, tasks completed,
assessment results, any abnormalities, and
resulting nursing actions.
APGAR SCORING
The Apgar score is one of the first checks of your new
baby's health. The Apgar score is assigned in the first
few minutes after birth to help identify babies that have
difficulty breathing or have a problem that needs further
care. The baby is checked at one minute and five
minutes after birth for heart and respiratory rates,
muscle tone, reflexes, and color.
Each area can have a score of zero, one, or two, with 10
points as the maximum. A total score of 10 means a baby is
in the best possible condition. Nearly all babies score
between eight and 10, with one or two points taken off for
blue hands and feet because of immature circulation. If a
baby has a difficult time during delivery, this can lower the
oxygen levels in the blood, which can lower the Apgar
score. Apgar scores of three or less often mean a baby
needs immediate attention and care.