APGAR, Vital Signs, New Ballard Scale, Thermoregulation, Height/Weight - Maternity | @LevelUpRN

Summary

In this educational video, Meris from Level Up RN covers essential newborn assessment topics, including the Apgar scoring system, which evaluates an infant's adaptation to extra-uterine life at one and five minutes post-birth. She explains the scoring criteria for activity, pulse, reflex irritability, appearance, and respiration. Meris also discusses newborn vital signs, the New Ballard scale for assessing maturity, thermoregulation challenges, and anthropometric measurements. The video concludes with quiz questions to test viewers' understanding.

Takeaways

• 📝 The Apgar score is a system used to assess the condition of a newborn baby immediately after birth.
• 🕒 Apgar scoring is performed at one and five minutes after birth to evaluate the baby's adaptation to life outside the womb.
• 🔢 The score ranges from 0 to 10, with 10 being the best and 0 the worst, indicating the level of distress.
• 🏥 A score of 7 to 10 indicates minimal difficulty adapting to extra-uterine life, which is the desired outcome.
• 👶 The Apgar score assesses five categories: activity or muscle tone, pulse, grimace or reflex irritability, appearance or color, and respiration.
• 🌡️ Newborn vital signs include temperature (97.4 to 99.6°F), pulse (100 to 160 beats per minute), respirations (30 to 60 breaths per minute), and blood pressure (systolic 65 to 90 and diastolic 45 to 65).
• 📏 The New Ballard scale is used to determine if a baby is premature or fully mature, including neuromuscular and physical maturity assessments.
• 👶🏻 Physical maturity assessment in the New Ballard scale includes evaluating skin texture, lanugo, plantar surface creases, and the development of eyes, ears, and genitals.
• 🌡️ Newborns struggle with thermoregulation due to their different body composition and lack of adipose tissue.
• ❄️ Heat loss in newborns can occur through conduction, convection, evaporation, and radiation, emphasizing the need for proper保暖措施.
• 📏 Anthropometric measurements for newborns include weight (2,500 to 4,000 grams), length (48 to 53 cm), head circumference (13 to 15 inches), and chest circumference (12 to 14 inches).

Q & A

What is the purpose of Apgar scoring?

Apgar scoring is done one and five minutes after the birth of an infant to assess how well the baby is adapting to extra-uterine life, meaning outside of the uterus.

What is the range of Apgar scores and what do they indicate?

Apgar scores range from 0 to 10, with 10 being the best and 0 being the worst. A score of 0 to 3 indicates severe distress, 4 to 6 indicates moderate distress, and 7 to 10 indicates minimal difficulty adapting to extra-uterine life.

What are the five categories assessed in the Apgar score?

The five categories assessed in the Apgar score are activity or muscle tone, pulse, grimace or reflex irritability, appearance or color, and respiration.

How is the Apgar score determined for activity or muscle tone?

For activity or muscle tone, a baby gets 0 points if flaccid, 1 point for some flexion, and 2 points for well-flexed active motion.

What pulse rate corresponds to the different point values in the Apgar score?

In the Apgar score, a pulse rate of absent corresponds to 0 points, less than 100 beats a minute gets 1 point, and above 100 beats a minute gets 2 points.

How is the Apgar score assessed for grimace or reflex irritability?

For grimace or reflex irritability, 0 points are given if there is no grimace, 1 point if the baby is grimacing but not crying, and 2 points if the baby is crying.

What are the point values for appearance or color in the Apgar score?

For appearance or color, 0 points are given if the whole body is blue or pale, 1 point if there is acrocyanosis (trunk is pink, but extremities are blue), and 2 points if the whole body is pink.

How is the Apgar score determined for respiration?

For respiration, 0 points are given if the baby is not breathing, 1 point if they have a slow or weak cry, and 2 points if they have a good cry.

What is the expected range for a newborn's temperature, pulse, and respirations?

The expected ranges for a newborn are temperature 97.4 to 99.6 degrees Fahrenheit, pulse 100 to 160 beats per minute, and respirations 30 to 60 breaths a minute.

What is the New Ballard scale and why is it used?

The New Ballard scale is used to determine if a baby is premature or fully mature. It is important in cases where prenatal care was not done, or the mother was unaware of her pregnancy, or in cases of trauma where the mother cannot provide information about gestational age.

What are the two parts of the New Ballard scale?

The two parts of the New Ballard scale are the neuromuscular assessment and the physical maturity assessment.

How does the New Ballard scale assess for maturity in terms of posture?

For posture, a premature baby will have an extended posture with no tone, while a mature baby will be well-flexed with resistance against pulling.

What does a zero-degree square window on the New Ballard scale indicate?

A zero-degree square window on the New Ballard scale indicates a mature infant, as the wrist can be bent all the way down to the arm.

What does the presence of creases covering the entire plantar sole on the New Ballard scale suggest about the infant's maturity?

Creases covering the entire plantar sole on the New Ballard scale suggest a mature infant.

How does thermoregulation differ in newborns compared to adults?

Newborns have a harder time regulating their own temperature due to their different body makeup, lacking adipose tissue like adults and having brown fat instead. They are at risk for heat loss through conduction, convection, evaporation, and radiation.

What are the common anthropometric measurements for newborns?

Common anthropometric measurements for newborns include weight (2,500 to 4,000 grams), length (48 to 53 centimeters or 19 to 21 inches), head circumference (13 to 15 inches), and chest circumference (12 to 14 inches).

What is the significance of the head circumference being larger than the chest circumference at birth?

At birth, the head circumference is 2 to 3 centimeters larger than the chest circumference, which is significant because it indicates the baby's head is proportionally larger compared to the body, resembling a 'pumpkin on a broomstick'.