Newborn Care Flashcards
Apgar scoring is done ___ and ___ minutes after the birth of an infant
1; 5
What is the point of apgar scoring?
To assess how baby is adapting to extra-uterine life
Apgar score between 0-3
Infant is in severe distress
Apgar score between 4-6
Moderate distress
Apgar score between 7-10
Minimal difficulty adapting to extra-uterine life
Categories of Apgar scoring
Activity/muscle tone, pulse, grimace/reflex irritability, appearance/color, respirations
Activity/muscle tone Apgar scoring
0-2 points
Flaccid, no muscle tone = 0 points
Some flexion = 1 point
Well-flexed active motion = 2 points
Pulse Apgar scoring
Absent = 0 points
Less than 100 bpm = 1 point
Above 160 bpm = 2 points
Grimace Apgar scoring
No grimace = 0 points
Grimace, but no cry = 1 point
Crying = 2 points
Appearance/color Apgar scoring
If whole body is pale/blue = 0 points
Acrocyanosis (trunk is pink, extremities blue) = 1 point
Whole body is pink = 2 points
Respirations Apgar scoring
Not breathing = 0 points
Slow, weak cry = 1 point
Good cry = 2 points
Expected temperature of newborns
97.4-99.6
Expected newborn HR
100-160 bpm
Expected RR for newborns
30-60 breaths/min
Expect BP for newborns
Systolic 65-90
Diastolic 45-65
Scale that helps to determine if baby is premature or fully mature
New Ballard scale
New Ballard scale neuromuscular assessment
- Posture: flaccid and extended indicated prematurity. Well-flexed with arms pulled inward and resistance indicate mature baby
- square window (bending of wrist down to arm): this can be done in a mature infant. A 90 degree window indicates prematurity
- arm recoil indicates a mature infant whereas recoil is delayed or absent in premature baby’s
- popliteal angle (extension of baby’s knee): bending of less than 90 degrees indicates mature infant; if able to bend up to head (180 degrees) then that indicates prematurity
- scarf sign (pull arm over neck): resistance indicates maturity. If arm is able to go all the way across with no resistance then that indicates prematurity
- heal to ear: if it can go all the way up, this indicate prematurity. Resistance indicates maturity
New Ballard scale physical maturity assessment
Mature: leathery and wrinkled skin, little to no lanugo, wrinkles or creases of plantar surface that go all the way across, eyes open spontaneously, hingilus testicals with rugae (wrinkle), labia fully developed
Premature: sticky and transparent skin, lanugo, smooth plantar surface with no creases, eyes fused shut, smooth wrinkle-free scrotum, prominent clitoris with flatter labia
Heat loss from direct contact to cooler surface (ex: placing infant on metal scale without anything in between)
Conduction
Heat loss from cooler air (ex: fan circulating air past the newborn)
Convection
Heat loss when surface liquid is converted vapor (ex: baby’s are delivered covered with fluid; bath)
Evaporation
Heat loss from proximity to a closer surface (ex: crib next to cold window)
Radiation
Thermoregulation nursing care
Dry newborn thoroughly after birth, place cap on bed, wrap tightly in in blanket, skin to skin care with mom or another parent, avoid contact with colder surfaces
Normal weight for newborns
2500-4000 g
Normal length for newborns
48-53 cm (19-21 inches)
Normal head circumference for baby
13-15 in
Normal chest circumference in newborn
12-14 in (NOTE: at birth, the head circumference is 2-3 cm larger than the chest circumference. It is not until 1 year of age that the head and chest circumference approximate one another)
