Terms Associated with the Normal Newborn

The following terms are associated with normal newborns. You should be familiar with these terms for the exam:

• Acrocyanosis—This is a bluish discoloration of the hands and feet of the newborn.

• APGAR scoring—This permits a rapid assessment of the need for resuscitation based on five signs. This survey is done at 1 and 5 minutes. Table 16.2 demonstrates the measures for APGAR scoring.

  Table 16.2. APGAR Scoring

  Heart Rate	Respirations	Reflexes	Cry-Reflex Irritability	Color
  0 = Absent	0 = Absent	0 = Absent, flaccid	0 = Absent	0 = Blue
  1 = Slow <100	1 = Slow, weak cry	1 = Some flexion of extremities	1 = Grimace	1 = Pink body, blue extremities
  2 = Over 100	2 = Good cry	2 = Good reflexes, active movement	2 = Cry	2 = Pink

  
  

• Caput succedaneum—This is an edema that crosses the suture line on the baby’s scalp.

• Cephalohematoma—This is blood that does not cross the suture line on the baby’s scalp.

• Hyperbilirubinemia—An elevation in the infant’s bilirubin level caused by an immature liver. The bilirubin level is checked by obtaining a blood sample via heel stick or by use of a bilirubinometer. This device uses a handheld battery-powered instrument to detect jaundice. Levels of 12mg/dl may require phototherapy. Preparation of the infant for phototherapy include covering the eyes and genitals. Increasing fluids and feedings is encouraged to facilitate the excretion of bilirubin through the gastrointestinal tract and urinary system.

• Milia—These are tiny, white bumps that occur across the newborn’s nose.

• Mongolian spots—These are darkened discolorations that occur on the sacral area of dark-skinned infants.