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Apgar Scale -A method of evaluating a newborn’s physical condition.A. Pulse/Heart RateB. Breathing C. Muscle tone/ActivityD. Reflex/Response to stimulation (rooting,
grasp, startle)E. Skin color/Appearance
Can score 0-2 in each areaNormal 6-10 (any lower and may need
medical assistance
Postnatal Period
What is it? A test of the baby’s reflexes over several areas
given one and five minutes after birth.
APGAR Test
Color/Appearance:
a. Pale or blue = 0b. Normal color body, but blue extremities =
1c. Normal color = 2
2 points for completely pink body 1 point if body is pink, but arms and legs
are blue 0 points if the baby is blue or pale all
over
Respiration:
a. Not breathing = 0b. Weak cry, irregular breathing = 1c. Strong cry = 2
2 points for a strong cry1 point for a slow or weak cry0 points for no cry at all
Heart Rate/Pulse:
a. Absent heartbeat = 0b. Slow heartbeat (less than 100
beats/minute) = 1c. Adequate heartbeat (more than 100
beats/minute) = 2
2 = good strong heartbeat1 = slow but steady heartbeat0 = little or no heartbeat
Muscle Tone/Actvity:a. Limp, flaccid = 0b. Some flexing or bending = 1c. Active motion = 2
2 points for vigorous motion1 point for small flexing0 points for no movement
Response to Stimulation (also called Reflex Irritability or Grimace):
a. No response = 0b. Grimace (facial expression) = 1c. Vigorous cry or withdrawal = 2
2 points if the baby cries1 point if the baby grimaces (facial expression)0 points for no movement or sound
Results10 out of 10 is a perfect scoreThe higher the score, the better the conditionA score over 7 indicates good conditionA score of 10 is unusualA score less than 7 may indicate some
medical assistance
Silver nitrate (For umbilical cord), Eye drops/ antiseptic ointment , Vitamin K injection (aids in clotting of blood)
Baby weighed, measured, cleaned
Blood taken from umbilical cord to check blood type.
Foot printed
Baby and mother are banded with same number
Postnatal Period Cont…
Head ¼ the baby’s body
Head is molded- may appear pointed or lopsided
2 fontanels- located on head where bones are not yet joined.
Eyes are nearly adult size
How does a newborn look?
Dryness and peeling of the scalp.Extremely common
Apply baby oil, gently wipe out, shampooBegins in first 3 months
Last 6-12 months
May be caused by hormones
Cradle Cap
Puffy Face
-Due to pressure of the cervix and the birth canal, and the bloating from amniotic fluid.
-Diminishes in the first day
-Baby’s ears and face may be slightly squashed from pressure in birth canal.
Cephalohematoma
(Bruising)
-Pooling of blood between the skull and the periosteum. -Result of pressure on the pelvis, vacuum extraction, or forceps.-Happens if the 2nd stage of labor is prolonged.
“Stork Bites” Birth Mark (Nevus Simplex)-Pink spots found on the neck, nose upper eyelids, or upper lip.-Disappear within a year or two.-A stork bite is due to a stretching (dilation) of certain blood vessels. It may become darker when the child cries or the temperature changes. It may fade when you push on it.
Lanugo Hair-Fine, soft hair found on the face, shoulders, back or upper arm.
-Hair will rub off.
-Sometimes a sign of premature birth.
Dry, Peeling Skin
-Due to being exposed to water.
-Most common around ankles and wrists
-The later your due date, the more like your baby will have dry skin.
Milia aka "Baby Acne"
-Tiny white, pimple-lime spots found on baby’s face. -Clogged glands or hair follicles.-Leave alone, disappears in weeks.
General Rash
-Occurring in 30-70% of newborns.-No treatment, last for days.-Cause is sometimes unknown, or caused from exposure to womb, change in baby’s environment, or the many physical changes occurring in the baby.
Skin color - Jaundice• Common- caused by excess levels of bilirubin, which is
found in red blood cells. Bilirubin is usually excreted in functions that the liver performs.
• Jaundice occurs when bilirubin builds up faster than a newborn's liver can break it down and pass it from the body.
• Takes time for his liver to develop and take over the task.
• Phototherapy (ultraviolet light) sometimes given to help liver remove the jaundice causing bilirubin.
Swollen Scrotum/Labia- Babies received build up of hormones from mom.-Female babies may have vaginal discharge , with blood.-Resolves within a week.
Removing of foreskin Usually done within the first 24 hours after
being born up to the first week.Personal decision. (talk to spouse, family, Dr.)Reasons- cosmetic, health reasons
Circumcision
Plamer Grasp- stroking the palm of the hand causes baby to grasp. Close fingers around yours or object.
Plantar Grasp -(Babinski reflex) - When sole of foot is stroked baby will spread toes and turn inward. (like clutching something with toes)
Rooting- baby will turn toward touching of cheek. This helps baby find breast or bottle for feeding.
Tonic/ Neck- When baby’s head is turned to its side the arm on that side extends. (fencing position)
First Hour After BirthApgar Test & What it
MeansOther Tests after
birthCesarean births &
when necessary
Newborn’s appearance
Silver NitrateEye drops/OinmentFootprintIdentifying the babyMolded Head
The list below shows topics from the notes of a doctor who was scheduled to speak to a class on “The Hospitals Role After Birth. He can’t make it and you have been called in to give the talk & assembling the topics below in an organized sequence.