OBSERVATION OF NEWBORN INFANT MOTHER Initials Age I.
Para
Other Related Information
Length of Labor Hour and Date of Delivery Blood Type Presentation of Fetus
Gravida
INFANT AT BIRTH Initials Sex Birth Weight Length
Other Related Information
Gestational Age Blood Type RH Factor
1 minute
5 minute
Normal Newborn and your Observation of newborn 1. Posture
Sleeping Waking Crying
2. Respirations
Rate Type
3. Eyes
Open or Closed Color Movement Tears
4. Cry
Frequency and Cause Character Duration
5. Head
Size cm in relation to body Shape Fontanelles-sizes & shape Specific Characteristics Swelling
Abrasions Ect.
6. Blood
RBC _____ WBC_____
Hgb _____ Blood Type____
7. Skin
Color Lanugo Milia Irriation Jaundice Severity Cause Bilirubin Treatment Temperature
8. General Observation
Activity Level Chest Extremities Genitalia Breast Stool Frequency Consistency Urine
Weight-(today) Muscle Tone Other
9. Evidence that the newborn
can or cannot: Hear See Feel Taste Smell
10. Food Type
Amount How well tolerated
11. Reflexes
(list normal reflexes) (Observe reflexes of newborn infant)
12. Infants Mothers reaction to her infant
a.
Ability to hold, position and feed infant
b.
Assistance given and teaching program initiated
c. Other related information
13. Additional Information and Observations
14. Nursing Care:
General Care:
Special Care: