Study Guide: MIDTERM NUR 211/091 – Maternal/Child Nursing
(50 items- 3 Multiple Response – 1 Math)
Chapter 22- The Normal Newborn: Nursing Care – 25 items
A. Assessments:
1. Initial Assessment – APGAR Scoring
What is APGAR?
An easy and quick assessment tool used to assess the status of a newborn baby after birth.
APGAR is a mnemonic that stands for:
• Appearance (skin color)
• Pulse (heart rate)
• Grimace (reflex irritability)
• Activity (muscle tone)
• Respiration (effort)
*APGAR scoring is performed at 1 minute and 5 minutes after birth and may be reassessed at 10 minutes
(5 minutes later) after birth, if the score is 6 or less.
*Each category is scored 0-2 and added up for a score 0-10. The higher the score the better the baby is
doing. It is rare to have a perfect 10 because most babies have acrocyanosis after birth where the feet and
hands will be blue.
Interventions based on the APGAR Score:
Score 7-10: no interventions, baby doing good just needs routine post-delivery care
Score 4-6: some resuscitation assistance required. Oxygen, suction…. stimulate the baby, rub baby’s back
Score 0-3: need full resuscitation
,2. Clinical Assessment of gestational Age:
• The gestational age assessment is an examination of the newborn’s physical and neurologic
characteristics to determine the number of weeks from conception to birth. It is important
because neonates born before or after term and those whose size is not appropriate for gestational
age are at increased risk for complications. Although the gestational age may be calculated from
the mother’s last menstrual period and by ultrasonography during the pregnancy, the date of the
last menstrual period is not always accurate, and ultrasonography is not always performed.
Because the times of development for various fetal characteristics are known, the presence or
absence of these characteristics can help estimate gestational age. The estimated age then can be
compared with the newborn’s weight, length, and head circumference to determine whether the
neonate is large, appropriate (average), or small in size for gestational age.
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