Nurs 133 final exam Questions and Correct Answers the Latest Update and Recommended Version
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What is the apgar scale?
-Assessment tool used to assess the newborn at 1 min interval and then again at 5 mins. If
less than 7 then continue to assess every 5 mins until newborn is stable
APGAR components
Respiratory rate, HR, muscle tone, reflex irritability and colour
how to calculate an...
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Nurs 133 final exam Questions and
Correct Answers the Latest Update and
Recommended Version
What is the apgar scale?
✓ -Assessment tool used to assess the newborn at 1 min interval and then again at 5 mins. If
less than 7 then continue to assess every 5 mins until newborn is stable
APGAR components
✓ Respiratory rate, HR, muscle tone, reflex irritability and colour
how to calculate an APGAR score
✓ Each component is evaluated out of 2
✓ No pulse: 0, less than 100bpm: 1, steady and more than 100bpm: 2
when and why an RN uses APGAR
✓ After 1 minute of life
✓ Assesses transition to extrauterine life
what are the initial physiological needs of a newborn as they transition to extrauterine life
and what nursing assessments/interventions would you expect?
✓ -Thermoregulation, providing warmth and drying the newborn -Assess and position
airway
✓ -Palpating suture lines and fontanels in order to assess degree of moulding and any head
trauma
✓ -Reflexes (rooting-touch side of cheek they will turn their head toward that touch, sucking,
grasping etc)
✓ -Vitamin K
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Palmar grasp reflex and when does it disappear
✓ When stroking a finger inside of baby palm, baby grips finger
✓ Disappears around 4-6 months
Plantar grasp reflex and when does it disappear
✓ when placing a finger under toes, they curl
✓ Disappears around 9 months to 1 year of age
Moro or startle reflex and when does it disappear
✓ When laying infant down or they hear a loud noise, they will extend their arms with palms
facing up
✓ Disappears around 6 months of age
Rooting reflex and when does it disappear
✓ When infants cheek or side of mouth is stroked, the head will turn towards it and open
their mouth in attempt to suck
✓ Disappears around 4 months
Sucking reflex and when does it disappear
✓ When something touches the top of the infant's mouth, they will begin to suck
✓ Disappears around 4 months
Babinski reflex and when does it disappear
✓ When the bottom of the foot is stroked from heel upwards, the big toe dorsiflexes (bends
back) and the other toes fan or spread out
✓ Disappear around 1 year of age
Crawling reflex or bauer crawling reflex and when does it disappear
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✓ When infant is placed on their stomach and pressure (such as a hand) is applied to the
sole of the foot, the infant will attempt to push against the hand and move the arms and
legs in a crawling like motion
✓ Disappears a few weeks or months after birth
Step reflex and when does it disappear
✓ When holding the infant upright with legs and feet touching a surface, the infant will
move the legs like taking steps or walking.
✓ Disappears about 3-4 months of age
Tonic neck reflex or fencing reflex and when does it disappear
✓ When infant's head is turned to a particular side, the leg and arm on that side will extend
while the leg and arm on the opposite side will flex.
✓ Disappears around 4 months of age
Reflexes a baby has transitions into
✓ more deliberate movements
Why are newborns administered Vitamin K?
✓ To prevent hemorrhagic disease
Breastmilk vs formula? Frequency?
✓ -Breast milk is best if possible
✓ -Antibodies
✓ Breast milk 8-12 times a day
✓ Formula every 3-4hrs
How would a new parent know that their baby is getting enough breastmilk or formula?
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