Apgar Score and Neonatal Resuscitation

Question 1

What five parameters does the Apgar scoring system measure?

Answer 1

Heart rate
Respiratory effort
Muscle tone
Reflex irritability
Color

Question 2

When is the Apgar assessment performed?

Answer 2

1 minute and 5 minutes after delivery

Question 3

What is the normal range for Apgar?

Answer 3

8-10

Question 4

What Apgar score indicates moderate distress?

Answer 4

4-7

Question 5

What Apgar score indicates impending demise?

Answer 5

0-3

Question 6

Assign points according to the Apgar scoring system:
Absent HR

Answer 6

0

Question 7

Assign points according to the Apgar scoring system:
HR <100

Answer 7

1

Question 8

Assign points according to the Apgar scoring system:
HR >100

Answer 8

2

Question 9

Assign points according to the Apgar scoring system:
Absent respiratory effort

Answer 9

0

Question 10

Assign points according to the Apgar scoring system:
Slow, irregular respirations

Answer 10

1

Question 11

Assign points according to the Apgar scoring system:
Normal respirations, crying

Answer 11

2

Question 12

Assign points according to the Apgar scoring system:
Limp

Answer 12

0

Question 13

Assign points according to the Apgar scoring system:
Some flexion of extremities

Answer 13

1

Question 14

Assign points according to the Apgar scoring system:
Active motion

Answer 14

2

Question 15

Assign points according to the Apgar scoring system:
Absent reflex irritability

Answer 15

0

Question 16

Assign points according to the Apgar scoring system:
Grimacing

Answer 16

1

Question 17

Assign points according to the Apgar scoring system:
Cough, sneeze, or cry

Answer 17

2

Question 18

Assign points according to the Apgar scoring system:
Pale, blue

Answer 18

0

Question 19

Assign points according to the Apgar scoring system:
Body pink, blue extremities

Answer 19

1

Question 20

Assign points according to the Apgar scoring system:
Completely pink

Answer 20

2

Question 21

When should breathing begin for the neonate?

Answer 21

30 seconds after delivery

Question 22

When should a normal respiratory pattern be established in the neonate?

Answer 22

90 seconds after delivery

Question 23

What SpO2 is normal immediately following delivery?

Answer 23

60%

Question 24

How long after delivery should the SpO2 rise to 90%?

Answer 24

After 10 minutes

Question 25

How should hypothermia be avoided in the neonate?

Answer 25

Radiant heat

Question 26

What are considerations for supplemental oxygen in the neonate?

Answer 26

Use room air/ avoid FiO2 100%- supplemental O2 increases the risk of an inflammatory response

If bradycardia or inadequate oxygen is persistent, supplemental O2 level may need to be increased despite risk

Question 27

What is the best indicator of adequate ventilation in a previously distressed neonate?

Answer 27

Resolution of bradycardia

Question 28

What is the proper finger placement and depth when providing chest compression to the neonate?

Answer 28

Over the lower third of the sternum with a depth of one-third of the AP of the chest

Question 29

What are common routes of administration of emergency drugs for the neonate?

Answer 29

Umbilical vein
ETT
Intraosseous

Question 30

What is the concentration of epinephrine for neonatal resuscitation?

Answer 30

1:10,000

Question 31

What is the dosage for epinephrine for neonatal resuscitation?

Answer 31

10-30 mcg/kg (IV)

0.05- 0.2 mg/kg (intratracheal)

Question 32

What is the dosage for volume expanders when resuscitating the neonate?

Answer 32

10 mL/kg over 5-10 minutes