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Questions and Answers
What is the best way to determine a newborn's heart rate?
When should a newborn spontaneously cry after birth?
What is an indication of poor muscle tone in a newborn?
What is the age range of a newborn, according to the Newborn Screening Act?
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Why is it important to assess an infant under a prewarmed radiant heat warmer?
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What is true about newborns' color at birth?
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What is a cue used to evaluate reflex irritability in a newborn?
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Why is a 10-minute APGAR scoring performed?
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What is an indication of a newborn's respiratory status?
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What is an important aspect of continuing assessment of high-risk infants?
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A nursing diagnosis for a newborn may include?
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What is a crucial aspect of newborn assessment?
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What is assessed during the 1-minute APGAR scoring?
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Why is suctioning important in neonatal care?
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What is NOT one of the aspects involved in APGAR scoring?
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What is an important aspect of developmental care?
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What is a crucial aspect of respiratory care for newborns?
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What is essential for maintaining a stable body temperature in newborns?
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Study Notes
Assessment of the High Risk Newborn: APGAR Scoring
- APGAR scoring is a numerical expression of the newborn's adaptation to extra uterine life at 1 and 5 minutes after birth.
- APGAR scoring involves 5 aspects: heart rate, respiratory effort, muscle tone, reflex irritability, and color.
Heart Rate
- Heart rate is determined by auscultating the newborn's heart.
- It is the best way to determine heart rate.
Respiratory Effort
- Newborns usually cry spontaneously at about 30 seconds after birth.
- Respiratory effort is observed in the presence of breath sounds.
Muscle Tone
- Mature newborns hold their extremities tightly flexed, simulating their intrauterine position.
- They should resist any effort to extend their extremities.
- Poor muscle tone is observed when the infant shows no flexion of the arms and legs, and the extremities "flop" back to the mattress when manipulated or flexed.
Reflex Irritability
- One of two possible cues is used to evaluate this point: response to a suction catheter in the nostrils (cough or sneeze) or response to having the soles of the feet slapped (cry and withdrawal of foot).
Color
- All infants appear cyanotic at the moment of birth.
- They grow pink with or shortly after the first breath.
- The color of the newborn corresponds to how well they are breathing.
Newborn Care
- Newborns need to be assessed at birth for obvious congenital anomalies and gestational age.
- Assessments should be made with an infant under a prewarmed radiant heat warmer to guard against heat loss.
Nursing Diagnosis
- Ineffective airway clearance is related to the presence of mucus or amniotic fluid in the airway.
- Ineffective cardiovascular tissue perfusion is related to breathing difficulty.
- Nursing care involves initiation and maintenance of respirations, establishment of extrauterine circulation, and maintenance of fluid and electrolyte balance, among others.
Continuing Assessment
- Continuing assessment of high-risk infants involves the use of instrumentation such as cardiac, apnea, and blood pressure monitoring.
- Close observation is crucial and cannot be replaced by monitor equipment.
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Description
Assess the high-risk newborn with a poor APGAR score. Learn how to obtain the APGAR scoring, including heart rate, respiratory effort, and muscle tone. Apply your knowledge in this quiz.
