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Questions and Answers
What is the purpose of the Apgar scoring?
What is the purpose of the Apgar scoring?
A score of 8 to 10 on the Apgar scale indicates a smooth transition to extrauterine life.
A score of 8 to 10 on the Apgar scale indicates a smooth transition to extrauterine life.
True
What does cyanosis that does not clear after birth indicate?
What does cyanosis that does not clear after birth indicate?
Congenital cardiopulmonary anomalies or central nervous system depression.
Normal values for length and weight are based on __________.
Normal values for length and weight are based on __________.
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What should be assessed during the physical examination of a newborn?
What should be assessed during the physical examination of a newborn?
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A newborn should still be assessed quickly to prevent exposure to chilling.
A newborn should still be assessed quickly to prevent exposure to chilling.
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What is the consequence of poor CNS control or respiratory difficulty in a newborn?
What is the consequence of poor CNS control or respiratory difficulty in a newborn?
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A newborn's skin and sclera may begin to appear yellowish due to the accumulation of __________.
A newborn's skin and sclera may begin to appear yellowish due to the accumulation of __________.
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Study Notes
APGAR Scoring
- Assessments occur immediately at delivery, then at 1 minute and 5 minutes post-birth.
- Components evaluated: Appearance (color), Pulse (heart rate), Grimace (cry), Activity (tone and reflex irritability), Respiration (effort).
- Scores between 8 and 10 indicate a stable transition to extrauterine life.
- Scores of 7 or lower at 5 minutes, especially if persistent after 10 minutes, correlate with increased neonatal morbidity and mortality.
- Cyanosis persisting beyond 1 minute and not resolving by 5 minutes may signal congenital cardiopulmonary anomalies or CNS depression.
Physical Examination of the Newborn
- A comprehensive physical examination should be conducted within 24 hours after birth.
- Conduct the exam in the presence of family to foster interaction and answer questions while discussing findings.
- Basic measurements include length (from crown to heel), weight, and head circumference.
- Normal measurement values vary based on gestational age.
- Accurate gestational age can be established using physical and neuromuscular characteristics, precise to ± 2 weeks in healthy infants, but less reliable in sick neonates.
Physiologic Adjustment
- Newborns undergo irregular adjustment phases in the first six hours of life before systems stabilize, initially described by Desmond as three periods of reactivity.
- Prompt assessments are essential to prevent chilling while ensuring important findings are not overlooked.
- Approximately 20 hours after birth, a detailed examination can be performed as infant systems stabilize.
Assessment of Neonate’s General Appearance
- Posture: Neonates exhibit flexion of the head and extremities close to the chest and abdomen, resembling fetal position.
- Skin inspection reveals color variations: increased red blood cell concentration can enhance the visibility of blood vessels.
- Poor CNS control or respiratory difficulties may lead to pallor and cyanosis, particularly marked by mottling.
- Cyanosis of the trunk requires immediate attention as it indicates possible respiratory obstruction or cardiac issues.
Mucus Obstruction and Airway Considerations
- Cyanosis can arise from mucus blockages affecting oxygenation; suction mouth before nose to avoid aspiration risks.
- Nose is the primary route for air; suctioning the nose first could trigger reflex gasps that complicate mucus removal.
Skin Condition Indicators
- Hydration status assessed through skin elasticity; hydrated skin is resilient, while dehydrated skin remains elevated upon release.
- Elevated bilirubin levels cause jaundice, becoming noticeable between the second and third day of life due to fetal RBC breakdown.
- Immature liver function in newborns can hinder bilirubin processing, leading to elevated indirect bilirubin levels.
Anemia in Newborns
- Anemia can result from various factors, affecting the newborn's overall health, including the mother's health during pregnancy.
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Description
Test your knowledge on the APGAR scoring system, which is crucial for assessing newborns immediately at delivery and again at one and five minutes after birth. This quiz covers the key components including Appearance, Pulse, Grimace, Activity, and Respiration.
