Page 813 - Saunders Comprehensive Review For NCLEX-RN

8. Eyelids often edematous as a result of pressure during
the birth process and the effects of eye medication
F. Ears
1. Symmetrical
2. Firm cartilage with recoil
3. Top of pinna on or above line drawn from outer
canthus of eye
4. Low-set ears associated with Down syndrome, renal
anomalies, or other genetic or chromosomal
syndromes
G. Nose
1. Flat, broad, in center of face
2. Obligatory nose breathing
3. Occasional sneezing to remove obstructions
4. Nares are patent and should not flare (flaring is an
indication of respiratory distress).
H. Mouth
1. Pink, moist gums
2. Soft and hard palates intact
3. Epstein’s pearls (small, white cysts) may be present on
hard palate.
4. Uvula in midline
5. Freely moving tongue, symmetrical, has short
frenulum
6. Sucking and crying movements symmetrical
7. Able to swallow
8. Root and gag reflexes present

When assessing the newborn’s mouth, look for the presence of

thrush (Candida albicans), which are white patchy areas on the tongue
or gums that cannot be removed with a washcloth; these may be
painful.
I. Neck
1. Short and thick
2. Head held in midline
3. Trachea midline
4. Good range of motion and ability to flex and extend
5. Assess for torticollis (head inclined to 1 side as a result
of contraction of muscles on that side of the neck)

J. Chest

1. Circular appearance because anteroposterior and
lateral diameters are about equal (approximately 30 to
33 cm [12 to 13.2 inches] at birth)
2. Diaphragmatic respirations—chest and abdomen
should rise and fall in synchrony, not in a seesaw
pattern

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