NM705 EXAM 2 QUESTIONS AND ANSWERS WITH COMPLETE
SOLUTIONS VERIFIED LATEST UPDATE
NRP O2 sat in newborns
The Neonatal Resuscitation Program targets O2Sat at 60-65% at 1 min, 80-85% at 5
mins
5 APGAR criteria
How the newborn is adapting to extrauterine life
Apgar scores are done at 1 and 5 minutes for healthy newborns.
Infant score <7 at 5min intervals 🡪scoring continues at 5-minute intervals thereafter up
to 20 minutes
Score of 7-10= vigorous neonate (generally normal)
Score of 4-6= requires focused resuscitation efforts (fairly low)
Score of 3 or less=requires intensive resuscitation procedures (critically low)
5 components:
Appearance/Color
Pulse
Grimace
Activity
Respirations
Appearance Scoring
,0=cyanotic/pale all over/blue
1=peripheral cyanosis only (acrocyanotic)
2=pink (pink all over)
Pulse Scoring
0= absent
1= <100
2= 100-140 or >100
Grimace Scoring
0= no response to stimulation
1= Grimace or weak cry when stimulated
2= cry when stimulated or active withdrawal
Activity Scoring
0=floppy or limp
1=some flexion
2= well flexed and resisting extension
Respiration Scoring
0= apneic
1= slow, irregular breathing (weak cry)
2= strong cry
Purpose of APGAR score and what does it mean?
Score is an indicator of resuscitation success not to detect perinatal asphyxia!
Does not predict individual adverse outcomes. APGAR score is used to convey
information about NB status response to resuscitation efforts. Resuscitation efforts start
,before 1st APGAR score, does not determine need for resuscitation
7+ = vigorous neonate (generally normal)
4-6 = requires focused resuscitation efforts (fairly low)
3 or less = requires intensive resuscitation procedures (critically low)
Does the umbilical arteries or vein bring O2 blood to fetus from placenta
Umbilical vein brings O2 blood to fetus from placenta
When to discontinue resuscitation efforts on a newborn
If you can confirm that there is no heartrate for at least 10 minutes, dc of resuscitation
efforts may be appropriate. Very few infants with an APGAR score of 0 at 10 minutes
survive with normal neurologic outcomes
Normal RR for a newborn
RR: 30-60
May decrease if sleeping and raise when crying
Some transient tachypnea, rales, grunting, and nasal flaring can be normal at first, but
should be monitored if it persists
Brief periods of apnea <15-20 sec may occur
Normal to have diaphragmatic or abdominal breathing and nasal breathing, no
retractions
<30 or >60 is abnormal
, Abnormal: grunting with every expiration, nasal flaring with every breath, visible
retractions (subcostal or suprasternal)
Normal HR in newborn
HR: 100 - 160 beats per minute
Initial murmur left sternal border until ductus arteriosus closes
May increase to above 170 with crying or activity
May decrease to 70-90 during deep sleep or with vagal stimulation (yawn, stool,
suction)
Lower when sleeping
Higher when crying
Settles back to within normal range in 30 mins after settling back down
Normal temperature in a newborn
Axillary temp 36.5-37.5 C (97.7-99 F)
Abdominal skin temp (36-36.5 C = colder)
abdominal temperature is slightly lower than the axillary temperature
Abnormal <36.5 and >37.5
Normal BP in newborn
Average systolic rate at full term = 63mmHg
BP >2kg = systolic 25-75 mmHg; Diastolic 20-50 mmHg; Equal in all four extremities
Ductus Venosis (DV)
SOLUTIONS VERIFIED LATEST UPDATE
NRP O2 sat in newborns
The Neonatal Resuscitation Program targets O2Sat at 60-65% at 1 min, 80-85% at 5
mins
5 APGAR criteria
How the newborn is adapting to extrauterine life
Apgar scores are done at 1 and 5 minutes for healthy newborns.
Infant score <7 at 5min intervals 🡪scoring continues at 5-minute intervals thereafter up
to 20 minutes
Score of 7-10= vigorous neonate (generally normal)
Score of 4-6= requires focused resuscitation efforts (fairly low)
Score of 3 or less=requires intensive resuscitation procedures (critically low)
5 components:
Appearance/Color
Pulse
Grimace
Activity
Respirations
Appearance Scoring
,0=cyanotic/pale all over/blue
1=peripheral cyanosis only (acrocyanotic)
2=pink (pink all over)
Pulse Scoring
0= absent
1= <100
2= 100-140 or >100
Grimace Scoring
0= no response to stimulation
1= Grimace or weak cry when stimulated
2= cry when stimulated or active withdrawal
Activity Scoring
0=floppy or limp
1=some flexion
2= well flexed and resisting extension
Respiration Scoring
0= apneic
1= slow, irregular breathing (weak cry)
2= strong cry
Purpose of APGAR score and what does it mean?
Score is an indicator of resuscitation success not to detect perinatal asphyxia!
Does not predict individual adverse outcomes. APGAR score is used to convey
information about NB status response to resuscitation efforts. Resuscitation efforts start
,before 1st APGAR score, does not determine need for resuscitation
7+ = vigorous neonate (generally normal)
4-6 = requires focused resuscitation efforts (fairly low)
3 or less = requires intensive resuscitation procedures (critically low)
Does the umbilical arteries or vein bring O2 blood to fetus from placenta
Umbilical vein brings O2 blood to fetus from placenta
When to discontinue resuscitation efforts on a newborn
If you can confirm that there is no heartrate for at least 10 minutes, dc of resuscitation
efforts may be appropriate. Very few infants with an APGAR score of 0 at 10 minutes
survive with normal neurologic outcomes
Normal RR for a newborn
RR: 30-60
May decrease if sleeping and raise when crying
Some transient tachypnea, rales, grunting, and nasal flaring can be normal at first, but
should be monitored if it persists
Brief periods of apnea <15-20 sec may occur
Normal to have diaphragmatic or abdominal breathing and nasal breathing, no
retractions
<30 or >60 is abnormal
, Abnormal: grunting with every expiration, nasal flaring with every breath, visible
retractions (subcostal or suprasternal)
Normal HR in newborn
HR: 100 - 160 beats per minute
Initial murmur left sternal border until ductus arteriosus closes
May increase to above 170 with crying or activity
May decrease to 70-90 during deep sleep or with vagal stimulation (yawn, stool,
suction)
Lower when sleeping
Higher when crying
Settles back to within normal range in 30 mins after settling back down
Normal temperature in a newborn
Axillary temp 36.5-37.5 C (97.7-99 F)
Abdominal skin temp (36-36.5 C = colder)
abdominal temperature is slightly lower than the axillary temperature
Abnormal <36.5 and >37.5
Normal BP in newborn
Average systolic rate at full term = 63mmHg
BP >2kg = systolic 25-75 mmHg; Diastolic 20-50 mmHg; Equal in all four extremities
Ductus Venosis (DV)
