Newborn Care: Transition, Assessment, and Common Problems
Core concepts
Newborn questions test transition to extrauterine life, assessment, and common complications. Know Apgar components (appearance, pulse, grimace, activity, respiration) and that Apgar scores guide resuscitation response, not long-term prognosis. Understand thermoregulation, hypoglycemia risk, jaundice, and feeding.
Know normal newborn findings: heart rate, respiratory rate, temperature, weight loss, and stool transition (meconium to transitional to milk stools). Recognize signs of respiratory distress (grunting, retractions, nasal flaring, tachypnea) and the need for intervention.
Jaundice assessment includes timing, location, and risk factors; pathologic jaundice appears early or rises quickly. Hypoglycemia risk is higher in infants of diabetic mothers, preterm, and small-for-gestational-age infants. Understand newborn screening, vitamin K, and eye prophylaxis.
Traps in questions
A frequent trap is treating a normal finding as abnormal (for example, mild acrocyanosis or molding). Another is choosing an intervention before assessing airway, breathing, and temperature. Questions may ask about jaundice timing; early jaundice is more concerning than physiologic jaundice appearing after 24 hours.
Rule of thumb
Newborn distress: assess airway and breathing first, then warmth and glucose. A newborn who is grunting or retracting needs immediate evaluation, not feeding.
Worked example: A term newborn at 2 hours has a blood glucose of 40 mg/dL and is asymptomatic. Provide feeding and recheck per protocol; treat per unit policy if symptomatic or below threshold.