A nurse is completing a newborn gestational age assessment. Which of the following findings should be recorded as part of this assessment on the newborn?
A.
Plantar creases cover 2/3 of sole
B.
Acrocyanosis of hands and feet
C.
Anterior fontanel soft and level
D.
Vernix caseosa in inguinal creases
The correct answer and Explanation is :
The correct answer is A. Plantar creases cover 2/3 of sole.
Explanation:
The newborn gestational age assessment, often performed using tools like the Ballard Score or Dubowitz Score, evaluates various physical and neurological criteria to estimate the gestational age of a newborn. This helps determine if a baby is preterm, full-term, or post-term.
Plantar creases (option A) are a significant part of the physical assessment used to estimate gestational age. At birth, the extent of plantar creases on the soles of the feet correlates with the maturity of the fetus. For a full-term newborn (approximately 37 to 42 weeks gestational age), plantar creases are usually present over the entire sole of the foot, with the more mature the baby, the more extensive the creases. By 34 to 36 weeks gestational age, plantar creases typically cover 2/3 of the sole, indicating a moderate level of fetal maturity. Thus, this finding helps estimate the baby’s gestational age.
Acrocyanosis of hands and feet (option B) is a common finding in newborns and is generally due to the immature circulatory system. It is not specifically used to estimate gestational age, as it can be seen in both preterm and full-term infants.
Anterior fontanel soft and level (option C) is a normal finding in a newborn and is not used for estimating gestational age. The anterior fontanel (the soft spot on the top of the baby’s head) is typically soft and level, which is a normal anatomical feature and does not provide information about the newborn’s gestational age.
Vernix caseosa (option D) is a white, cheesy substance found on the skin of newborns, particularly in the inguinal creases and other skin folds. While its presence can indicate the maturity of the skin, it is not used directly to estimate gestational age. Vernix decreases in amount with increasing gestational age, but its presence in inguinal creases alone is not a reliable indicator of gestational age.
In summary, the presence of plantar creases covering 2/3 of the sole is a reliable indicator used in the gestational age assessment of a newborn.