NM705 EXAM 2 QUESTIONS AND ANSWERS WITH COMPLETE
SOLUTIONS VERIFIED LATEST UPDATE
What are the 5 Apgar criteria and how do you score them?
Tone
Pulse
Reflex
Color
RR (vigorous cry)
What is the purpose of the Apgar score?
Purpose is to predict possible issues and an indicator of resuscitation effort success
obtain q 5 minutes up to 20 minutes if efforts are ongoing or score < 7
What is a common misconception about Apgar?
It is not used to diagnose specific complications
Not a reliable measure of perinatal asphyxia although it can help with determining
the need for cord blood gases
What are the normal ranges for a newborn who is less than 12 hours old: Heart
rate, Respiratory rate, Blood pressure, and Temperature?
HR 100-160
RR 40-60
BP 63 systolic
,Axillary Temp 36.5-37.5.
Abdominal Temp 36 - 36.5C
Why is axillary temp higher than abdominal temp?
Axilla is closer to the heart and faster in circulation. The probe also rests in between
skin
Abdomen temp measurements are exposed to air and further from the circulatory
system and heart, making temps slightly lower
What are the normal variations and unacceptable abnormal characteristics in vital
signs?
Normal:
elevated HR when crying
lower RR or HR when sleeping
Abnormal:
Grunting with breaths
What are some newborn vital signs criteria that would help you know you needed
to consult on this baby?
Respiratory depression (<30) or elevation (>60 that does not stabilize
Grunting/Nasal Flaring
Suprasternal or subcostal retractions
,O2 <95%
Low axillary temperature that rises or falls over time
Elevated HR that doesn't ↓ w/ STS
Describe the 3 fetal shunts and where are they located? What function do they
serve the fetus? What causes each to close?
Foramen ovale (hOle between right & left atria)
Helps oxygenated blood to bypass the lungs; keeps lung blood flow minimal →
oxygenated blood to critical organs
as blood returns to the left side of the heart from the systemic circulation the pressure
in the left atria is greater than the right atria “pushes the FO door closed”
Occurs after birth from pressure changes → Anatomic by 30 months
Ductus arteriousus (right ventricle to Ductus arteriosus to descending aorta)
located between aorta and pulmonary artery) {Air in the lungs) AWAY from
LUNGS
Shunts blood from RV through the DA to the descending aorta to bypass the lungs
Starts to close as the pulmonary arteries dilate, the PVR drops, and placental
prostaglandin levels plummet
Smooth muscle Constriction of the DA (functional closure w/in 48-72 hours)
following birth max 96hrs → Anatomic closure is typically complete between 2-3
months
, Ductus venosus (umbilical vein to IVC to bypass the liVer) Connects the umbilical
vein to the IVC allowing fetal blood to bypass the liver → O2 rich blood to RA then to
critical organs
Intracardiac pressure changes cause the DV to close
Closure ~37 days
Where is the Foramen Ovale lcoated?
between right & left atria
Where is the ductus arteriosis located?
RV to the ductus arteriosus to descending aorta
Where is the ductus venosus located?
umbilical vein to IVC to bypass the liver
What function do fetal shunts serve in the fetus?
Three fetal shunts send the highly oxygenated blood from the placenta more directly to
the left side of the fetal heart where it will go directly to the fetal heart muscle, brain, and
then lastly the body
What causes each fetal shunt to close?
Pressure changes at birth lead to fetal duct closure
What is the pressure change that helps close the foramen ovale?
Increased pressure in the LEFT atrium
What role does a decrease in placental prostaglandins play in the closure of one
of the fetal shunts?
Once the placenta is removed then the placental prostaglandin levels fall
SOLUTIONS VERIFIED LATEST UPDATE
What are the 5 Apgar criteria and how do you score them?
Tone
Pulse
Reflex
Color
RR (vigorous cry)
What is the purpose of the Apgar score?
Purpose is to predict possible issues and an indicator of resuscitation effort success
obtain q 5 minutes up to 20 minutes if efforts are ongoing or score < 7
What is a common misconception about Apgar?
It is not used to diagnose specific complications
Not a reliable measure of perinatal asphyxia although it can help with determining
the need for cord blood gases
What are the normal ranges for a newborn who is less than 12 hours old: Heart
rate, Respiratory rate, Blood pressure, and Temperature?
HR 100-160
RR 40-60
BP 63 systolic
,Axillary Temp 36.5-37.5.
Abdominal Temp 36 - 36.5C
Why is axillary temp higher than abdominal temp?
Axilla is closer to the heart and faster in circulation. The probe also rests in between
skin
Abdomen temp measurements are exposed to air and further from the circulatory
system and heart, making temps slightly lower
What are the normal variations and unacceptable abnormal characteristics in vital
signs?
Normal:
elevated HR when crying
lower RR or HR when sleeping
Abnormal:
Grunting with breaths
What are some newborn vital signs criteria that would help you know you needed
to consult on this baby?
Respiratory depression (<30) or elevation (>60 that does not stabilize
Grunting/Nasal Flaring
Suprasternal or subcostal retractions
,O2 <95%
Low axillary temperature that rises or falls over time
Elevated HR that doesn't ↓ w/ STS
Describe the 3 fetal shunts and where are they located? What function do they
serve the fetus? What causes each to close?
Foramen ovale (hOle between right & left atria)
Helps oxygenated blood to bypass the lungs; keeps lung blood flow minimal →
oxygenated blood to critical organs
as blood returns to the left side of the heart from the systemic circulation the pressure
in the left atria is greater than the right atria “pushes the FO door closed”
Occurs after birth from pressure changes → Anatomic by 30 months
Ductus arteriousus (right ventricle to Ductus arteriosus to descending aorta)
located between aorta and pulmonary artery) {Air in the lungs) AWAY from
LUNGS
Shunts blood from RV through the DA to the descending aorta to bypass the lungs
Starts to close as the pulmonary arteries dilate, the PVR drops, and placental
prostaglandin levels plummet
Smooth muscle Constriction of the DA (functional closure w/in 48-72 hours)
following birth max 96hrs → Anatomic closure is typically complete between 2-3
months
, Ductus venosus (umbilical vein to IVC to bypass the liVer) Connects the umbilical
vein to the IVC allowing fetal blood to bypass the liver → O2 rich blood to RA then to
critical organs
Intracardiac pressure changes cause the DV to close
Closure ~37 days
Where is the Foramen Ovale lcoated?
between right & left atria
Where is the ductus arteriosis located?
RV to the ductus arteriosus to descending aorta
Where is the ductus venosus located?
umbilical vein to IVC to bypass the liver
What function do fetal shunts serve in the fetus?
Three fetal shunts send the highly oxygenated blood from the placenta more directly to
the left side of the fetal heart where it will go directly to the fetal heart muscle, brain, and
then lastly the body
What causes each fetal shunt to close?
Pressure changes at birth lead to fetal duct closure
What is the pressure change that helps close the foramen ovale?
Increased pressure in the LEFT atrium
What role does a decrease in placental prostaglandins play in the closure of one
of the fetal shunts?
Once the placenta is removed then the placental prostaglandin levels fall
