NSG 3500 TEST QUESTIONSAND ANSWERS A+
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When is the APGAR score assigned?
At 1 and 5 minutes after birth
What are the five categories of the APGAR score?
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?
True
What does each APGAR score mean?
>7 = normal
4-6 = low
<3 = critical
What are the 4 factors that influence initiation of the first breath?
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?
- 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?
5-15 seconds (approx 3 seconds is norm? P. 298)
What are indicators of respiratory difficulties in the newborn?
- 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?
- 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?
160-180 and then 30 min later it goes to 120-160
The baby cannot become hypoglycemic from heat loss. T/F?
False.
How do newborns respond to cold?
They burn brown adipose tissue since they cannot shiver to maintain warmth
What can the nurse do to regulate temperature in the newborn?
- 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?
True
_____________________ is seen in most newborns as oxygenated blood is
shunted to central area of the body and vital organs first.
Acrocyanosis
What are factors that affect blood glucose on newborns?
- 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?
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?
•Requires consent from mother
•First vaccination can be given after birth
•Second vaccination given at one month
•Third dose given after 5 months
What is included in the newborn assessment?
- head circumference, chest circumference, length, weight
- Ballard scoring
- Dubowitz exam
- newborn screen
How do we measure head circumference?
- place tape measure immediately above eyebrows and pinna of the ear and wrap
around the occipital prominence at the back of the head
- measure 3x and record the largest finding
The head and chest measurements may be equal during the first few days of life.
T/F?
True
GRADED.Buy Quality Materials!
When is the APGAR score assigned?
At 1 and 5 minutes after birth
What are the five categories of the APGAR score?
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?
True
What does each APGAR score mean?
>7 = normal
4-6 = low
<3 = critical
What are the 4 factors that influence initiation of the first breath?
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?
- 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?
5-15 seconds (approx 3 seconds is norm? P. 298)
What are indicators of respiratory difficulties in the newborn?
- 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?
- 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?
160-180 and then 30 min later it goes to 120-160
The baby cannot become hypoglycemic from heat loss. T/F?
False.
How do newborns respond to cold?
They burn brown adipose tissue since they cannot shiver to maintain warmth
What can the nurse do to regulate temperature in the newborn?
- 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?
True
_____________________ is seen in most newborns as oxygenated blood is
shunted to central area of the body and vital organs first.
Acrocyanosis
What are factors that affect blood glucose on newborns?
- 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?
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?
•Requires consent from mother
•First vaccination can be given after birth
•Second vaccination given at one month
•Third dose given after 5 months
What is included in the newborn assessment?
- head circumference, chest circumference, length, weight
- Ballard scoring
- Dubowitz exam
- newborn screen
How do we measure head circumference?
- place tape measure immediately above eyebrows and pinna of the ear and wrap
around the occipital prominence at the back of the head
- measure 3x and record the largest finding
The head and chest measurements may be equal during the first few days of life.
T/F?
True
