The Apgar score is a scoring system doctors and nurses use to assess newborns one minute and five minutes after they’re born. Show
Dr. Virginia Apgar created the system in 1952, and used her name as a mnemonic for each of the five categories that a person will score. Since that time, medical professionals across the world have used the scoring system to assess newborns in their first moments of life. Medical professionals use this assessment to quickly relay the status of a newborn’s overall condition. Low Apgar scores may indicate the baby needs special care, such as extra help with their breathing. Usually after birth, a nurse or doctor may announce the Apgar scores to the labor room. This lets all present medical personnel know how a baby is doing, even if some of the medical personnel are tending to the mom. When a parent hears these numbers, they should know they’re one of many different assessments medical providers will use. Other examples include heart rate monitoring and umbilical artery blood gases. However, assigning an Apgar score is a quick way to help others understand the baby’s condition immediately after birth.
Assessments for Newborn BabiesEach newborn baby is carefully checked at birth for signs of problems or complications. The healthcare provider will do a complete physical exam that includes every body system. Throughout the hospital stay, doctors, nurses, and other healthcare providers continually look at the health of the baby. They are watching for signs of problems or illness. Assessments may include the below.
Apgar scoringThe Apgar score helps find breathing problems and other health issues. It is part of the special attention given to a baby in the first few minutes after birth. The baby is checked at 1 minute and 5 minutes after birth for heart and respiratory rates, muscle tone, reflexes, and color. A baby who needs help with any of these issues is getting constant attention during those first 5 to 10 minutes. In this case, the actual Apgar score is given after the immediate issues have been taken care of. Each area can have a score of 0, 1, or 2, with 10 points as the maximum. Most babies score 8 or 9, with 1 or 2 points taken off for blue hands and feet because of immature circulation. If a baby has a difficult time during delivery and needs extra help after birth, this will be shown in a lower Apgar score. Apgar scores of 6 or less usually mean a baby needed immediate attention and care.
Birth weightA baby's birth weight is an important marker of health. Full-term babies are born between 37 and 41 weeks of pregnancy. The average weight for full-term babies is about 7 pounds (3.2 kg). In general, very small babies and very large babies are at greater risk for problems. Babies are weighed every day in the nursery to look at growth, and the baby’s need for fluids and nutrition. Newborn babies may often lose 5% to 7% of their birth weight. This means that a baby weighing 7 pounds 3 ounces at birth might lose as much as 8 ounces in the first few days. Babies will usually gain this weight back within the first 2 weeks after birth. Premature and sick babies may not begin to gain weight right away. Most hospitals use the metric system for weighing babies. This chart will help you convert grams to pounds. Converting grams to pounds and ounces:1 lb. = 453.59237 grams; 1 oz. = 28.349523 grams; 1000 grams = 1 Kg.
MeasurementsThe hospital staff takes other measurements of each baby. These include:
The staff also checks these vital signs:
Physical examA complete physical exam is an important part of newborn care. The healthcare provider carefully checks each body system for health and normal function. The provider also looks for any signs of illness or birth defects. Physical exam of a newborn often includes:
Gestational assessmentThe healthcare provider will check how mature the baby is. This is an important part of care. This check helps figure out the best care for the baby if the dates of a pregnancy are uncertain. For example, a very small baby may actually be more mature than he or she appears by size, and may need different care than a premature baby needs. Healthcare providers often use an exam called the Dubowitz/Ballard Examination for Gestational Age. This exam can closely estimate a baby's gestational age. The exam looks at a baby's skin and other physical features, plus the baby’s movement and reflexes. The physical maturity part of the exam is done in the first 2 hours of birth. The movement and reflexes part of the exam is done within 24 hours after birth. The provider often uses the information from this exam to help with other maturity estimates. Physical maturityThe physical maturity part of the Dubowitz/Ballard exam looks at physical features that look different at different stages of a baby's gestational age. Babies who are physically mature usually have higher scores than premature babies. Points are given for each area of assessment. A low of -1 or -2 means that the baby is very immature. A score of 4 or 5 means that the baby is very mature (postmature). These are the areas looked at:
Maturity of nerves and musclesThe healthcare provider does 6 checks of the baby's nerves and muscles. A score is given to each area looked at. Typically, the more mature the baby is, the higher the score. These are the areas checked:
When the physical assessment score and the nerves and muscles score are added together, the healthcare provider can estimate the baby’s gestational age. Scores range from very low for immature babies to very high scores for mature and postmature babies. All of these exams are important ways to learn about your baby's well-being at birth. By finding any problems, your baby's doctor can plan the best possible care. What does the Apgar score measure?Apgar is a quick test performed on a baby at 1 and 5 minutes after birth. The 1-minute score determines how well the baby tolerated the birthing process. The 5-minute score tells the health care provider how well the baby is doing outside the mother's womb.
How do you assess an Apgar score?The Apgar score is a test given to newborns soon after birth. This test checks a baby's heart rate, muscle tone, and other signs to see if extra medical care or emergency care is needed. Babies usually get the test twice: 1 minute after birth, and again 5 minutes after they're born.
Which assessment factors are included in a 5 minute Apgar score Select all that apply?The five areas that are assessed when the Apgar score is calculated are heart rate, respiratory effort, muscle tone, reflex irritability, and color.
Which of the following is evaluated by the Apgar scale?The Apgar Score, a tool used to assess well being in the minutes after birth, incorporates 5 elements: respiratory effort, heart rate, reflex irritability, muscle tone, and color. The Apgar Score has been used to predict neonatal mortality and morbidity in term infants.
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