NSG 3500 - EXAM 4 QUESTIONS AND
ANSWERS (GRADED A+)
When is the APGAR score assigned? - ANSWER-At 1 and 5 minutes after birth
What are the five categories of the APGAR score? - ANSWER-1. HR
2. RR
3. muscle tone
4. reflex irritability (cry)
5. generalized skin color (coloring)
When the APGAR score is <9 at 5 minutes, it is more important to stabilize the infant
than keep them with mom. T/F? - ANSWER-True
What does each APGAR score mean? - ANSWER->7 = normal
4-6 = low
<3 = critical
What are the 4 factors that influence initiation of the first breath? - ANSWER-Chemical
factors: hypercarbia, acidosis, and hypoxia
Sensory factors: overwhelming stimuli aids in transition
Thermal factors: drastic change in temp aids in transition
Mechanical factors: thoracic squeeze through birth causes fluid release and
replacement with air
Why does hypoxia, hypercarbia, and acidosis trigger respirations? - ANSWER-- hypoxia
causes blood oxygen (PO2) levels to rise and pH to drop
- carbon dioxide levels (PCO2) begin to rise and prompt the resp center within the
medulla to initiate breathing
Periodic breathing in a newborn is not usually associated with any change in skin color
or HR. How long are these pauses? - ANSWER-5-15 seconds (approx 3 seconds is
norm? P. 298)
What are indicators of respiratory difficulties in the newborn? - ANSWER-- apnea (no
breathing for more than 20 seconds)
- expiratory grunting
- wheezing
- nasal flaring
- retractions
- use of accessory muscles to breathe when at rest
- high RR
, What are the five changes for successful cardiopulmonary adaptation? - ANSWER--
increased aortic pressure
- decreased venous pressure
- increased systemic pressure
- decreased pulmonary pressure
- closure of foramen ovale, DA, and DV
What is the HR when baby is first born? - ANSWER-160-180 and then 30 min later it
goes to 120-160
How do we measure chest circumference? - ANSWER-Place measurement tape on
nipple line and wrap around entire thoracic area
How do we measure abdominal circumference? - ANSWER-- place tape above
umbilicus and circle infants' body
- abdomen should be same size as chest
What is the Ballard score? - ANSWER-- simplified score for assessment of fetal
maturation of newborns
- measures neuromuscular and physical maturity
- done within first 12 hours of life
What is the vernix caseosa? - ANSWER-- thick, white creamy material found in term
infants
- covers large areas of skin in preterm infants
- skin protectant
I am a normal newborn transient rash, may start on face and spread to rest of body,
persists up to one month, no treatment needed. What am I? - ANSWER-Erythema
toxicum
The baby cannot become hypoglycemic from heat loss. T/F? - ANSWER-False.
How do newborns respond to cold? - ANSWER-They burn brown adipose tissue since
they cannot shiver to maintain warmth
What can the nurse do to regulate temperature in the newborn? - ANSWER-- skin-to-
skin contact with mom and warm blankets
- dry head and place cap on baby
- warp baby in two warm blankets
- place unwrapped baby under radiator and monitor temp
- monitor axillary temp
- keep newborn away from drafts
babies can regulate their temp better in 24-48hrs
ANSWERS (GRADED A+)
When is the APGAR score assigned? - ANSWER-At 1 and 5 minutes after birth
What are the five categories of the APGAR score? - ANSWER-1. HR
2. RR
3. muscle tone
4. reflex irritability (cry)
5. generalized skin color (coloring)
When the APGAR score is <9 at 5 minutes, it is more important to stabilize the infant
than keep them with mom. T/F? - ANSWER-True
What does each APGAR score mean? - ANSWER->7 = normal
4-6 = low
<3 = critical
What are the 4 factors that influence initiation of the first breath? - ANSWER-Chemical
factors: hypercarbia, acidosis, and hypoxia
Sensory factors: overwhelming stimuli aids in transition
Thermal factors: drastic change in temp aids in transition
Mechanical factors: thoracic squeeze through birth causes fluid release and
replacement with air
Why does hypoxia, hypercarbia, and acidosis trigger respirations? - ANSWER-- hypoxia
causes blood oxygen (PO2) levels to rise and pH to drop
- carbon dioxide levels (PCO2) begin to rise and prompt the resp center within the
medulla to initiate breathing
Periodic breathing in a newborn is not usually associated with any change in skin color
or HR. How long are these pauses? - ANSWER-5-15 seconds (approx 3 seconds is
norm? P. 298)
What are indicators of respiratory difficulties in the newborn? - ANSWER-- apnea (no
breathing for more than 20 seconds)
- expiratory grunting
- wheezing
- nasal flaring
- retractions
- use of accessory muscles to breathe when at rest
- high RR
, What are the five changes for successful cardiopulmonary adaptation? - ANSWER--
increased aortic pressure
- decreased venous pressure
- increased systemic pressure
- decreased pulmonary pressure
- closure of foramen ovale, DA, and DV
What is the HR when baby is first born? - ANSWER-160-180 and then 30 min later it
goes to 120-160
How do we measure chest circumference? - ANSWER-Place measurement tape on
nipple line and wrap around entire thoracic area
How do we measure abdominal circumference? - ANSWER-- place tape above
umbilicus and circle infants' body
- abdomen should be same size as chest
What is the Ballard score? - ANSWER-- simplified score for assessment of fetal
maturation of newborns
- measures neuromuscular and physical maturity
- done within first 12 hours of life
What is the vernix caseosa? - ANSWER-- thick, white creamy material found in term
infants
- covers large areas of skin in preterm infants
- skin protectant
I am a normal newborn transient rash, may start on face and spread to rest of body,
persists up to one month, no treatment needed. What am I? - ANSWER-Erythema
toxicum
The baby cannot become hypoglycemic from heat loss. T/F? - ANSWER-False.
How do newborns respond to cold? - ANSWER-They burn brown adipose tissue since
they cannot shiver to maintain warmth
What can the nurse do to regulate temperature in the newborn? - ANSWER-- skin-to-
skin contact with mom and warm blankets
- dry head and place cap on baby
- warp baby in two warm blankets
- place unwrapped baby under radiator and monitor temp
- monitor axillary temp
- keep newborn away from drafts
babies can regulate their temp better in 24-48hrs
