NM705 EXAM 2 QUESTIONS AND ANSWERS WITH COMPLETE
SOLUTIONS VERIFIED LATEST UPDATE
Apgar Criteria
(A) Appearance (or color. 0 is blue or pale, 1 is acrocyanotic, and 2 is completely pink)
(P) Pulse (0 is no pulse, 1 is <100 BPM, and 2 is >100 BPM)
(G) Grimace (or reflex irritability. 0 is no response, 1 is a grimace, and 2 is a cry or
active withdrawal)
(A) Activity (or muscle tone. 0 is limp, 1 is some flexion, and 2 is active motion)
(R) Respirations (0 is absent, 1 is weak cry and/or hypoventilation, and 2 is good
respirations, crying).
<12H HR + Normal Variations
100-160
Normal Variations:
- Initial murmur on the left sternal border until the ductus arteriosus closes
,- May increase to greater than or equal to 170 when crying or with activity
- May decrease to 70 - 90 when in deep sleep or with vagal stimulation that can occur
with yawning, stooling, or suctioning
<12H RR + Normal Variations
40 - 60
Normal Variations:
- Diphragmatic and abdominal breathing
- Obligate nasal breathing
- IF ALL OTHER FINDINGS ARE NORMAL, occasional rales in the first few hours,
apnea for less than 15 seconds, irregular breathing, "brief" tachypnea up to 6 hours post
birth, and occasional rales in the first 24 hours can be normal.
<12H Respiratory Abnormal Characteristics
<30 or >60 breaths per minute, grunting with every expiration, nasal flaring with every
breath, and visible retractions (whether suprasternal or subcostal)
<12H BP + Normal Variations
Average systolic is 63mm/Hg and should be equal in all four extremities
Normal Variations:
, - Values in newborns depend on weight, postnatal age, type of delivery, birth asphyxia,
and placental transfusion. The AAP does not recommend universal BP screening in a
health neonate for this reason.
<12H Temperature + Normal Variations
Axillary should be 36.5/97.7 - 37.5/99.0 and abdominal should be 36/96.8 - 36.5/97.7
Normal Variations:
- When using an abdominal skin sensor, be sure it's in good contact with the skin and
covered with a reflective shield.
- Skin temperatures are slightly lower than core temperatures. Skin temp is not as good
as core temp.
<12H Abnormal Temperature Characteristics
Axillary temperature of <36.5/97.7 or >37.5/99.0
Fetal Shunts
Foramen Ovale, Ductus Arteriosus, Ductus Venosus
Foramen Ovale
Connects the two atria in the fetal heart
Ductus Arteriosus
Connects the pulmonary artery to the aorta, bypassing the lungs
Ductus Venosus
SOLUTIONS VERIFIED LATEST UPDATE
Apgar Criteria
(A) Appearance (or color. 0 is blue or pale, 1 is acrocyanotic, and 2 is completely pink)
(P) Pulse (0 is no pulse, 1 is <100 BPM, and 2 is >100 BPM)
(G) Grimace (or reflex irritability. 0 is no response, 1 is a grimace, and 2 is a cry or
active withdrawal)
(A) Activity (or muscle tone. 0 is limp, 1 is some flexion, and 2 is active motion)
(R) Respirations (0 is absent, 1 is weak cry and/or hypoventilation, and 2 is good
respirations, crying).
<12H HR + Normal Variations
100-160
Normal Variations:
- Initial murmur on the left sternal border until the ductus arteriosus closes
,- May increase to greater than or equal to 170 when crying or with activity
- May decrease to 70 - 90 when in deep sleep or with vagal stimulation that can occur
with yawning, stooling, or suctioning
<12H RR + Normal Variations
40 - 60
Normal Variations:
- Diphragmatic and abdominal breathing
- Obligate nasal breathing
- IF ALL OTHER FINDINGS ARE NORMAL, occasional rales in the first few hours,
apnea for less than 15 seconds, irregular breathing, "brief" tachypnea up to 6 hours post
birth, and occasional rales in the first 24 hours can be normal.
<12H Respiratory Abnormal Characteristics
<30 or >60 breaths per minute, grunting with every expiration, nasal flaring with every
breath, and visible retractions (whether suprasternal or subcostal)
<12H BP + Normal Variations
Average systolic is 63mm/Hg and should be equal in all four extremities
Normal Variations:
, - Values in newborns depend on weight, postnatal age, type of delivery, birth asphyxia,
and placental transfusion. The AAP does not recommend universal BP screening in a
health neonate for this reason.
<12H Temperature + Normal Variations
Axillary should be 36.5/97.7 - 37.5/99.0 and abdominal should be 36/96.8 - 36.5/97.7
Normal Variations:
- When using an abdominal skin sensor, be sure it's in good contact with the skin and
covered with a reflective shield.
- Skin temperatures are slightly lower than core temperatures. Skin temp is not as good
as core temp.
<12H Abnormal Temperature Characteristics
Axillary temperature of <36.5/97.7 or >37.5/99.0
Fetal Shunts
Foramen Ovale, Ductus Arteriosus, Ductus Venosus
Foramen Ovale
Connects the two atria in the fetal heart
Ductus Arteriosus
Connects the pulmonary artery to the aorta, bypassing the lungs
Ductus Venosus
