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General Appearance
Flexed, with good muscle tone
Skin
Color/Perfu
sion
Respiratory
rate
Heart rate
Vital Signs
30-60 per minute; short periods of periodic breathing
Passing tachypnea
Breath sounds clear
Respirations shallow and irregular
Breathing is abdominal and movements are symmetric
Length
Head
Circumfere
nce
Chest
Circumfere
nce
31-38 cm
31-36 cm
HeadTo-Toe Assessment
Head
Face
Nose
Mouth
Eyes
Ear
Neck
Chest
Abdomen
Genitals
Extremities
Spine
Hips
Reflexes
Rooting
Sucking
Grasp
Moro/Startle
Babinski
Step, dance
Tonic neck
(Fencing)
Senses
Vision
Hearing
Taste
Smell
Touch
preferred
Can taste; prefers sweet over salty
Highly sensitive sense of smell; physiologic change when exposed to strong odors
Very sensitive to touch and pain