Card Set Information
Infant physical exam
Pulse, respirations, temperature.
Weight, length, head circumference - plot on growth curve.
Body symmetry, spontaneous position, flexion of head and extremeties, spontaneous movement.
Skin color and characteristics, any obvious deformities.
Symmetry and positioning of facial features.
Alert, responsive affect.
Strong, lusty cry.
Chest and Heart:
Skin condition over chest & abdomen, chest configuration, nipples, and breast tissue.
Note movement of abdomen with respirations, any chest retraction.
Palpate apical impulse and note location; chest wall for thrills, tactile fremitus if infant is crying.
Ausculatate breath sounds, heart sounds in all locations, bowel sounds in abdomen and in chest.
Inspect shape and skin condition.
Inspect umbilicus; count vessels (2 arteries, 1 vein), note condition of cord or stump, any hernia.
Palpate skin turgor.
Palpate lightly for muscle tone, liver, spleen tip, bladder.
Palpate deeply for kidneys, any mass.
Palpate femoral pulses, inguinal lymph nodes.
Percuss all quadrants.
Head and Face:
Note molding after delivery, any swelling on cranium, bulging of fontanel with crying or at rest.
Palpate fontanels, suture lines, any swellings.
Inspect positioning and symmetry of facial features at rest and while the infant is crying.
: To open eyes, support head and shoulders and gently lower the baby backward, OR ask parent to hold baby over his or her shoulder while you stand behind parent.
Inspect the lides (edematous in neonate), palpebral slant, conjunctivae, any nystagmus, any discharge.
Using penlight, elicit pupillary reflex, blink reflex, corneal light reflex, assess tracking of moving light.
Using an opthalmascope, elicit red reflex.
Inspect size, shape, alignment of auricle, patency of auditory canals, any extra skin tags or pits.
Note the startle reflex in response to loud noise.
Palpate flexible auricles.
: Defer otoscopic exam until end of complete exam.
Determine patency of nares.
Note nasal discharge, sneezing, any flaring with respirations.
Mouth and Throat:
Inspect lips and gums, high-arched intact palate, buccal mucosa, tongue size, frenulum, note absent or minimal salivation in neonate.
Note rooting reflex.
Insert a gloved little finger, note sucking reflex, and palpate palate.
Lift shoulders and let head lag to inspect neck; note midline trachea, any skinfolds, any lumps.
Palpate lymph nodes, thyroid, and any masses.
While infant is supine, elicit tonic neck reflex; not a supple neck with movement.
Inspect and manipulate, noting ROM, muscle tone, absence of scarf sign (elbow should not reach midline).
Count fingers, count palmer creases, note color of hands and nail beds.
Place your thumbs in the infant's palms to note grasp reflex, then wrap your hands around infant's hands to pull up and note head lag.
Inspect and manipulate the legs and feet, noting RM, muscle tone, and skin condition.
Note alignment of feet and toes, look for flat soles, count toes, note any syndactyly.
Test Ortanlani's sign for hip stability.
Inspect labia and clitoris (edematous in newborn), vernix caseosa between labia, patent vagina.
Inspect posiiton of urethral meatus (do not retract foreskin), strength of urine stream if possible, rugae on scrotum.
Palpate testes in scrotum.
Lift infant under axillae, hold infant facing you at eye level.
Note shoulder muscle tone, infant's ability to stay in your hands without slipping.
Rotate the neonate slowly side to side, note the doll's eye reflex.
Turn infant around so his/her back is to you; elicit the stepping reflex and the placing reflex against the edge of the exam table.
Spine and rectum:
Turn the infant over and hold him/her prone in your hands, or place prone on exam table.
Inspect length of spine, trunk incurvation reflex, symmetry of gluteal folds.
Inspect intact skin, any sinus openings, protrusions, or tufts of hair.
Note patent anal opening. Check for passage of meconium stool during 1st 24-48 hrs.
With an otoscope, inspect the auditory canal and tympanic membrane.
Elicit the Moro reflex by letting the infant's head and trunk drop back a short way, by jarring crib sides, or by making a loud noise.