What sign should the nurse look for to assess potential congenital abnormalities in the newborn during the first examination?

Assessing potential congenital abnormalities in a newborn during the first examination involves looking for various physical signs that may indicate underlying issues. Abnormal skin markings can be significant indicators of congenital abnormalities. Conditions such as cutaneous lesions, vascular markings, or pigmented lesions may suggest chromosomal abnormalities or syndromes. For instance, certain skin markings, like café-au-lait spots, may be associated with neurofibromatosis, while congenital dermal melanocytosis can indicate conditions like spina bifida.

While symmetrical features are generally a sign of normal development and can indicate overall health, they do not specifically indicate abnormalities. Similarly, missing reflexes may suggest neurological issues but are not as directly associated with congenital structural defects. Translucent skin typically relates to prematurity rather than congenital abnormalities and does not provide a clear indication of structural malformations that can be assessed during the initial examination. Hence, looking for abnormal skin markings is crucial in evaluating the possibility of congenital conditions in newborns.