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
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)
1
,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
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 - in-
creased 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
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
2
, 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
_____________________ is seen in most newborns as oxygenated blood is shunted to cen-
tral area of the body and vital organs first. - ANSWER Acrocyanosis
Blood volume is determined in large part by the timing of the umbilical cord clamping. T/F? -
ANSWER True
What are factors that affect blood glucose on newborns? - ANSWER - small for gesta-
tional age (SGA)
- large for gestational age (LGA)
- infants of diabetic mothers
- post-term or intrauterine growth restriction
What is vitamin K used for? - ANSWER Coagulation; neonates are at risk of blood clotting
deficiency in the first few days of life
What are nursing considerations with the Hep B vax? - ANSWER •Requires consent from
mother
•First vaccination can be given after birth
•Second vaccination given at one month
3
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
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)
1
,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
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 - in-
creased 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
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
2
, 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
_____________________ is seen in most newborns as oxygenated blood is shunted to cen-
tral area of the body and vital organs first. - ANSWER Acrocyanosis
Blood volume is determined in large part by the timing of the umbilical cord clamping. T/F? -
ANSWER True
What are factors that affect blood glucose on newborns? - ANSWER - small for gesta-
tional age (SGA)
- large for gestational age (LGA)
- infants of diabetic mothers
- post-term or intrauterine growth restriction
What is vitamin K used for? - ANSWER Coagulation; neonates are at risk of blood clotting
deficiency in the first few days of life
What are nursing considerations with the Hep B vax? - ANSWER •Requires consent from
mother
•First vaccination can be given after birth
•Second vaccination given at one month
3
