1.01 Immediate Post-partum Assessment Flashcards
Components of the immediate post-partum assessment
- General appearance
- APGAR score
- Essential intrapartum newborn care
- Vital signs
- Anthropometrics
- Gestational age
Classifies newborn’s neurologic recovery from stress of birth
APGAR score
Components of APGAR score
Appearance Pulse Grimace Activity Respiration
T/F. APGAR score indicates the NEED for resuscitation
F. It indicates EFFECTIVE neonatal resuscitation
A heart rate of <100 will have an APGAR score of
1
A good and strong respiration will have an APGAR score of
2
Muscle tone is scored 0 in APGAR score. How do you describe the muscle tone of the newborn.
Flaccid, limp
Muscle tone is scored 1 in APGAR score. How do you describe the muscle tone of the newborn.
Some flexion of the arms and legs
Muscle tone is scored 2 in APGAR score. How do you describe the muscle tone of the newborn.
There is active movement
Grimace on reflex irritability gets an APGAR score of
1
APGAR score of 2 on reflex irritability means
A vigorous cry, sneeze or cough
A blue, pale color will get an APGAR score of
0
A pink color all over will get an APGAR score of
2
APGAR score of 1 under color means
Body is pink but extremities are blue and pale
A 8-10 score on a 1-min APGAR score test means
Normal
A 5-7 score on a 1-min APGAR score test means
Some nervous system depression
A 0-5 score on a 1-min APGAR score test means
Severe depression, requires immediate resuscitation
A 8-10 score on a 5-min APGAR score test means
Normal
A 0-7 score on a 5-min APGAR score test means
High risk for subsequent central nervous system and other organ system dysfunction
4 Components of the essential intrapartum newborn cares (EINC)
- Immediate and thorough drying of the newborn
- Early skin-to-skin contact bet. mother and newborn
- Properly-timed cord clamping and cutting
- Non-separation of mother and NB for early breastfeeding initiation
Most accurate to measure temperature
Rectal temp.
Temperature abnormalities in a NB may indicate
Sepsis, metabolic abnormalit, etc.
Normal RR
40-60 breaths/min
Normal HR
120-160 bpm
Normal SLEEPING HR
100 bpm
Normal systolic BP
40-80 mmHg
Normal diastolic BP
20-55 mmHg
T/F. Periodic breathings (>/= 3 apneic episode lasting within a 20s period of otherwise normal respiration) is normal and common in newborns
True
Most reliable measurement of RR
Sleeping RR
Why is there a decreasing HR with increasing age
Decreased metabolic states
Increased adaptability to environment
Normal head circumference
32cm-37cm
Average head circumference
35 cm
Normal birth length
48-52cm
Normal chest circumference
30-35 cm
Normal birth wt
2500g - 4000g
Landmarks for taking the head circumference
Anterior: Supraorbital ridge
Posterior: Most prominent part of the occiput
Anthropometric measure that relates to intracranial volume and rate of brain growth
Head circumference
Inadequate weight gain for age:
Growth <5th percentile for age
Weight for length <5th percentile
Drop >2 quartiles in 6 mos
Wt to be considered AGA
> /= 2000g ; <4000g
Wt to be considered LGA
> 4000g
Methods to determine gestational age
- Mom’s menstrual history
- Early fetal ultrasound
- Ballard score
2 components of the Ballard score
- Neuromuscular maturity
2. Physical maturity
A gestational age of <34 wks is classified as
Preterm; short-term complications (respi and cardio)
To be classified late preterm, gestational age must be
34-36 wks
Gestational age for postterm is
> 42 weeks; perinatal mortality or morbidity
