NSG 3500 - EXAM 4 QUESTIONS AND VERIFIED
ANSWERS
When is the APGAR score assigned? - Answers - At 1 and 5 minutes after birth
What are the five categories of the APGAR score? - Answers - 1. HR
2. RR
3. muscle tone
4. reflex irritability (cry)
5. generalized skin color (coloring)
When the APGAR score is <9 at 5 minutes, it is more important to stabilize the infant
than keep them with mom. T/F? - Answers - True
What does each APGAR score mean? - Answers - >7 = normal
4-6 = low
<3 = critical
What are the 4 factors that influence initiation of the first breath? - Answers - Chemical
factors: hypercarbia, acidosis, and hypoxia
Sensory factors: overwhelming stimuli aids in transition
Thermal factors: drastic change in temp aids in transition
Mechanical factors: thoracic squeeze through birth causes fluid release and
replacement with air
Why does hypoxia, hypercarbia, and acidosis trigger respirations? - Answers - - hypoxia
causes blood oxygen (PO2) levels to rise and pH to drop
- carbon dioxide levels (PCO2) begin to rise and prompt the resp center within the
medulla to initiate breathing
Periodic breathing in a newborn is not usually associated with any change in skin color
or HR. How long are these pauses? - Answers - 5-15 seconds (approx 3 seconds is
norm? P. 298)
What are indicators of respiratory difficulties in the newborn? - Answers - - apnea (no
breathing for more than 20 seconds)
- expiratory grunting
- wheezing
- nasal flaring
- retractions
- use of accessory muscles to breathe when at rest
- high RR
, What are the five changes for successful cardiopulmonary adaptation? - Answers - -
increased aortic pressure
- decreased venous pressure
- increased systemic pressure
- decreased pulmonary pressure
- closure of foramen ovale, DA, and DV
What is the HR when baby is first born? - Answers - 160-180 and then 30 min later it
goes to 120-160
The baby cannot become hypoglycemic from heat loss. T/F? - Answers - False.
How do newborns respond to cold? - Answers - They burn brown adipose tissue since
they cannot shiver to maintain warmth
What can the nurse do to regulate temperature in the newborn? - Answers - - skin-to-
skin contact with mom and warm blankets
- dry head and place cap on baby
- warp baby in two warm blankets
- place unwrapped baby under radiator and monitor temp
- monitor axillary temp
- keep newborn away from drafts
babies can regulate their temp better in 24-48hrs
Blood volume is determined in large part by the timing of the umbilical cord clamping.
T/F? - Answers - True
_____________________ is seen in most newborns as oxygenated blood is shunted to
central area of the body and vital organs first. - Answers - Acrocyanosis
What are factors that affect blood glucose on newborns? - Answers - - small for
gestational age (SGA)
- large for gestational age (LGA)
- infants of diabetic mothers
- post-term or intrauterine growth restriction
What is vitamin K used for? - Answers - Coagulation; neonates are at risk of blood
clotting deficiency in the first few days of life
What are nursing considerations with the Hep B vax? - Answers - •Requires consent
from mother
•First vaccination can be given after birth
•Second vaccination given at one month
•Third dose given after 5 months
ANSWERS
When is the APGAR score assigned? - Answers - At 1 and 5 minutes after birth
What are the five categories of the APGAR score? - Answers - 1. HR
2. RR
3. muscle tone
4. reflex irritability (cry)
5. generalized skin color (coloring)
When the APGAR score is <9 at 5 minutes, it is more important to stabilize the infant
than keep them with mom. T/F? - Answers - True
What does each APGAR score mean? - Answers - >7 = normal
4-6 = low
<3 = critical
What are the 4 factors that influence initiation of the first breath? - Answers - Chemical
factors: hypercarbia, acidosis, and hypoxia
Sensory factors: overwhelming stimuli aids in transition
Thermal factors: drastic change in temp aids in transition
Mechanical factors: thoracic squeeze through birth causes fluid release and
replacement with air
Why does hypoxia, hypercarbia, and acidosis trigger respirations? - Answers - - hypoxia
causes blood oxygen (PO2) levels to rise and pH to drop
- carbon dioxide levels (PCO2) begin to rise and prompt the resp center within the
medulla to initiate breathing
Periodic breathing in a newborn is not usually associated with any change in skin color
or HR. How long are these pauses? - Answers - 5-15 seconds (approx 3 seconds is
norm? P. 298)
What are indicators of respiratory difficulties in the newborn? - Answers - - apnea (no
breathing for more than 20 seconds)
- expiratory grunting
- wheezing
- nasal flaring
- retractions
- use of accessory muscles to breathe when at rest
- high RR
, What are the five changes for successful cardiopulmonary adaptation? - Answers - -
increased aortic pressure
- decreased venous pressure
- increased systemic pressure
- decreased pulmonary pressure
- closure of foramen ovale, DA, and DV
What is the HR when baby is first born? - Answers - 160-180 and then 30 min later it
goes to 120-160
The baby cannot become hypoglycemic from heat loss. T/F? - Answers - False.
How do newborns respond to cold? - Answers - They burn brown adipose tissue since
they cannot shiver to maintain warmth
What can the nurse do to regulate temperature in the newborn? - Answers - - skin-to-
skin contact with mom and warm blankets
- dry head and place cap on baby
- warp baby in two warm blankets
- place unwrapped baby under radiator and monitor temp
- monitor axillary temp
- keep newborn away from drafts
babies can regulate their temp better in 24-48hrs
Blood volume is determined in large part by the timing of the umbilical cord clamping.
T/F? - Answers - True
_____________________ is seen in most newborns as oxygenated blood is shunted to
central area of the body and vital organs first. - Answers - Acrocyanosis
What are factors that affect blood glucose on newborns? - Answers - - small for
gestational age (SGA)
- large for gestational age (LGA)
- infants of diabetic mothers
- post-term or intrauterine growth restriction
What is vitamin K used for? - Answers - Coagulation; neonates are at risk of blood
clotting deficiency in the first few days of life
What are nursing considerations with the Hep B vax? - Answers - •Requires consent
from mother
•First vaccination can be given after birth
•Second vaccination given at one month
•Third dose given after 5 months
