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Difficulty: MediumAnte/Intra/Postpartum and Newborn Care

At exactly 11 minute following a spontaneous vaginal delivery, the attending nurse evaluates the newly born neonate. Assessment reveals an apical heart rate of 9696 beats per minute. The infant exhibits a slow and irregular breathing pattern. Musculoskeletal assessment demonstrates some flexion of the extremities. During the clearing of the airway with a bulb syringe, the neonate displays a grimace. Observation of the skin reveals a pink torso with distinct bluish discoloration of the hands and feet.

Calculate the newborn's 11-minute Apgar score.

Answer: 5 points

Answer

The newborn's Apgar score is 5.
The Apgar score is a standardized assessment tool used at 11 and 55 minutes post-delivery to evaluate newborn transition. It evaluates five parameters (Appearance, Pulse, Grimace, Activity, and Respiration), each scored from 00 to 22. In this scenario, all five parameters reflect a score of 11, resulting in a total score of 55, indicating moderate difficulty transitioning to extrauterine life.

Step-by-Step Solution

1
Evaluate Appearance (Skin Color)
11 point
A pink torso with bluish hands and feet indicates acrocyanosis, which scores 11 point. A completely pink body would score 22 points, and a pale or completely cyanotic body would score 00.
2
Evaluate Pulse (Heart Rate)
11 point
The heart rate is 9696 beats per minute. A rate below 100100 bpm scores 11 point. A rate above 100100 bpm scores 22 points, and an absent pulse scores 00.
3
Evaluate Grimace (Reflex Irritability)
11 point
The neonate displays only a grimace in response to bulb suctioning. This scores 11 point. A vigorous cry or pulling away would score 22 points, while no response scores 00.
4
Evaluate Activity (Muscle Tone)
11 point
The infant shows some flexion of the extremities, which scores 11 point. Active, vigorous motion scores 22 points, and a flaccid or limp presentation scores 00.
5
Evaluate Respiration (Breathing Effort)
11 point
The breathing pattern is slow and irregular, which scores 11 point. A good, strong cry scores 22 points, and absent respirations score 00.
6
Calculate total score
55 points
Summing the points for all five categories (1+1+1+1+11 + 1 + 1 + 1 + 1) yields a total Apgar score of 55.

Key Concept

Apgar Scoring System
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Topics

Ante/Intra/Postpartum and Newborn Care

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