While performing a physical examination on a newborn, which assessment should be reported to the physician?
A. Head circumference of 40 cm.
B. Chest circumference of 32 cm.
C. Acrocyanosis and edema of the scalp.
D. Heart rate of 160 and respirations of 40.
Correct Answer: A. Head circumference of 40 cm
Average circumference of the head for a neonate ranges between 32 to 36 cm. An increase in size may indicate hydrocephalus or increased intracranial pressure. A newborn’s head is usually about 2 cm larger than the chest size. Between 6 months and 2 years, both measurements are about equal. After 2 years, the chest size becomes larger than the head.
Option B: The body of a normal newborn is essentially cylindrical; head circumference slightly exceeds that of the chest. For a term baby, the average circumference of the head is 33–35 cm (13–14 inches), and the average circumference of the chest is 30–33 cm (12–13 inches).
Option C: Peripheral cyanosis (acrocyanosis) involves the hands, feet, and circumoral area. It is evident in most infants at birth and for a short time thereafter. If limited to the extremities in an otherwise normal infant, it is due to venous stasis and is innocuous. Localized cyanosis may occur in presenting parts, particularly in association with abnormal presentations.
Option D: Heart rates normally fluctuate between 120 and 160 beats per minute. In agitated states, a rate of 200 beats per minute may occur transiently. The heart rate of premature infants is usually between 130 and 170 beats per minute, and during occasional episodes of bradycardia, it may slow to 70 beats per minute or less. Normal neonates breathe at rates that vary between 40 and 60 respirations per minute. Rapid rates are likely to be present for the first few hours after birth.