The nurse practitioner examines a term newborn infant at 36…
The nurse practitioner examines a term newborn infant at 36 hours of life. The exam findings include Temp 98.6, HR 140, Resp 32, head normocephalic, anterior and posterior fontanelles patent and flat, symmetric movement of extremities, with good tone, pink skin tone with acrocyanosis present, PERRL intact, red reflex present symmetric bilaterally, scleral icterus present, ears well formed, alignment equal with outer canthus of eyes, canals patent, nose patent, soft and hard palate intact, easy respirations, clear throughout, grade I murmur heard with S1 and normal S2 present, PMI located at 4th intercostal space, midclavicular line, protuberant abdomen, soft, BS present, clamped cord stump with 2 arteries, 1 vein, liver edge palpated at 1.5cm below costal margin, spleen nonpalpable, brachial pulses +2, femoral pulses +1, spine straight and easily flexed, 3mm sacral dimple present within gluteal cleft, less than 2cm from anus, no hair tufts present, anus patent. Strong palmar grasp bilaterally, rooting reflex intact, when startled infant’s arms are extended and abducted, hands open, followed by inward movement and flexion towards body, with closed fists. Plantar reflex intact. Based on this assessment, what is your clinical impression(s) with supportive rationale?
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