How To Perform a Neonatal Assessment in the NICU

Hi friends, in this video I am going to show you how to perform a neonatal assessment on a NICU patient. This is my routine assessment that I do every few hours when it’s time for my patient’s “cares”-their hands-on time. It’s important to work quickly and efficiently, especially the younger the gestational age, so here’s my flow as I work least to most invasive and from top to bottom. I’m hitting the highlights of a routine assessment in this video, but below you’ll find a detailed, normal NICU assessment.
00:00 Begin Here
01:05 Before You Start
03:44 Hands-On Assessment
🧠 Neurological
Equal and reactive pupils
No head abnormalities (no molding, caput, cephalhematoma, forcep marks)
Anterior fontanel open and soft
Posterior fontanel open
Sutures approximate
Moves all extremities equally
Moro, suck, rooting, and palmar grasp present
🫀 Cardiovascular
Regular rhythm/clear audible without murmur
Pulses present and equal in all extremities
Capillary refill upper and lower extremities less than 3 sec
Mucus membranes pink and moist
No edema
🫁 Respiratory
Chest expansion symmetrical
Non-labored respiratory effort
No retractions
Clear and equal breath sounds

💩 Gastrointestinal
Soft, rounded, pink, non-distended abdomen
Bowel sounds audible 4 quadrants
💦 Genitourinary
Voiding per diaper
Yellow urine

👶🏻 Skin
Warm, dry, intact
Normal skin turgor
Occiput, sacrum, and heels intact
No diaper dermatitis present
This content was peer-reviewed for accuracy by Christine McQuay, MHA, MSHI, BSN, RN, RNC-NIC.
What more NICU-specific content? Follow me on TikTok! / neostat
My favorite infant/neonatal stethoscope: amzn.to/3MEVpPg
I’m Anna and I am a critical care registered nurse. I have worked in the NICU, PICU, pediatric floor, and on my hospital’s critical care children’s transport service. I am also a nursing instructor and love teaching students and new nurses!
Disclaimer: This video is intended for educational purposes only and is not indented as medical advice. While I strive for 100% accuracy, errors may occur and practices may change over time.
The link provided includes an affiliate link that I receive a small kickback from.

[@user-dh6bk1nm5u]

So handy and clear!! Love your video❣️

[@chloefischer4143]

Love this!! Thank you!

[@annafinley7166]

What more NICU-specific content? Follow me on TikTok! www.tiktok.com/@neostat

[@lifewiththetaylors9386]

Nice🥰

[@kellywelch134]

I was just wondering how often your hospital requires apical heart rate? We are required a minimum of once per shift. We also rarely use our respiratory rate from the monitor, so we count each time. We honestly never do a neuro check on infants after initial check at delivery unless there is cause to do so. I was actually told by one of our neos not to check pupil reflex. I definitely think I will start introducing this into my assessment. Loved the video. Thank you!

[@eloteheartz3727]

very cool and informative!

[@ireenmuswemamusute498]

Love your videos and am registered nurse what's to do neonatal nursing in 2023 in take

[@JustMarianalynn]

I’m school they taught us do check placement in adults by checking the pH. They said injecting air has been proven to do more harm than good. Is it different with babies?

[@roxylalondes]

This is late, but checking with xray is the best

[@milaglabog1392]

Do not approach the child when in the incubator?