1. Gestational Age
   1. Over 38 weeks
   2. Established in the first 4 hours after birth
   3. Establishment of gestational age
      1. physical characteristics
         1. Resting posture
         2. Skin
         3. Lanugo
         4. Sole (plantar) creases
         5. Areola
         6. Ear form and cartilage distribution
         7. Appearance of male and female genitals
         8. Vernix
         9. Consistency of hair
         10. Skull firmness
         11. Nails
      2. Neurologic or neuromuscular development
         1. Dubowitz tool
         2. New Ballards score
2. Reflexes
   1. Blink
      1. lack indicates damage of cranial nerve, CNS injury
   2. Pupillary reflex
      1. lack indicates damage of cranial nerve CNS injury
   3. Moro
      1. Asymmetry of body response indicates fractured clavicle, injury to brachial plexus
   4. Rooting and sucking
      1. Poor response (preterm, breast fed of barbiturate-addicted mother, possible cardiac problem.
      2. Absence of response indicates preterm, neurologic involvement, depressed newborn
   5. Palmar grasp
      1. Asymmetry of response indicated neurologic problems
   6. Plantar grasp
      1. Absence indicates low spinal cord defects
   7. Stepping
      1. Asymmetry indicated neurologic abnormality
   8. Babinski
      1. absence indicated low spinal cord defects
   9. Tonic neck
      1. Absence after 1 month of age or persistent asymmetry indicates cerebral lesion
   10. Prone crawl
       1. absence indicates preterm, weak, or depressed newborn
   11. Trunk incurvation (Galant)
       1. failure to rotate to stimulated side indicates neurologic damage
3. Body Systems
   1. Cardiovascular
      1. Blood pressure
         1. At birth 80-60/ 45- 40 mm Hg
         2. Day 10- 100/50
      2. Pulse
         1. 120-160 bpm ( if asleep- as low as 80; if crying- upto 180
   2. Respiratory
      1. 30-60 breaths/min
      2. Crying- Strong and lusty. Moderate tone and pitch
   3. Integumentary
      1. Color
         1. Consistent with ethnic background
         2. Mottled when undressed
      2. texture
         1. Smooth, soft, flexible; may have dry, peeling hands and feet
      3. Turgor
         1. Elastic, returns to normal shape after pinching
      4. Pigmentation
         1. Clear, milla across bridge of nose, forehead, or chin will disappear within a few weeks
         2. Acrocyanosis
            1. Bluish of hands and feet
         3. Mottling
            1. lacy pattern of dilated blood vessels under the skin
         4. Harlequin sign
            1. (Clown) deep red develops over one side of the newborns body while other side remains pale
         5. Jaundice
            1. first detectable on face
         6. Erythema toxicum
            1. An eruption of lesions in the area surrounding a hair follicle .
            2. often called "newborn rash" or " flea bite"
         7. Milla
            1. Exposed sebaceous glands, appears as raised white spots on face
         8. Skin turgor
            1. Assessed to determine hydration status, need for early feeding, and presence of any infection processes
   4. Neurologic / Neuromuscular
      1. Motor functions
         1. Symmetrical movement and strength in all extremities
         2. Maybe jerky or have brief twitching
         3. head lag not over 45 degrees
         4. Neck control adequate to maintain erect briefly
      2. Reflexes