APGAR

-Maria Teresa P. Villanueva

• Appearance
• Pulse
• Grimace
• Activity
• Respiration
 Slide Title

• What is APGAR
– 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
 APPEARANCE

Pale; Blue Acrocyanosis Pink

Skin color

• .
 PULSE
No Pulse <100/min >100/min

A newborn's pulse is normally 120 to 160 beats per minute

.
 GRIMACE
No Response Baby Grimace Vigorous Cry
Cough/ Sneeze

Reflex Irritability describing response to stimulation

 ACTIVITY
Floppy Some Flexion Full Flexion

Muscle Tone Active, spontaneous movement. Arms and legs

flexed with little movement
 Respiration
Absent Slow/Irregular/Weak Good/Strong Cry
Cry

A normal RR is 40-60 bpm

Should be observe the RR in one full minute
APGAR SCORE CLASSIFICATION
SCORE Interpretation
7-10 Normal

4-6 Needed to clear the airway & Oxygen

Supplementary

0-3 Need Resuscitation

QUESTIONAIRE
• 1.) A mother had long labor and when she deliver the newborn
it appears blue, absent crying & no response. Which of the
following nursing interventions will you provide to this
newborn?
a) Routine post-delivery care
b) Continue to monitor and reassess the APGAR score in 10 minutes.
c) Some resuscitation assistance such as oxygen and rubbing baby’s
back and reassess APGAR score.
d) Full resuscitation assistance is needed and reassess APGAR score
• Answer
– D) Full resuscitation assistance is needed and
reassess APGAR score
• The possible APGAR of a newborn is 0-3 and it is
needed resuscitation. There are also possibility that the
baby is in distress and meconium stain inside the
uterine life.
• 1.) The primary critical observation for Apgar scoring
is the
a) Heart Rate
b) Respiratory Rate
c) Presence of stain
d) Evaluation of Moro Reflex
• Answer
– A) Heart Rate
• The heart rate is vital for life and is the most critical
observation in Apgar scoring. Respiratory effect rather
than rate is included in the Apgar score; the rate is very
erratic.
• 3.)A nurse in a newborn nursery receives a phone call to
prepare for the admission of a 43-week-gestation
newborn with Apgar scores of 1 and 4. In planning for the
admission of this infant, the nurse’s highest priority
should be to:
a) Turn on the apnea and cardiorespiratory monitors
b) Connect the resuscitation bag to the oxygen outlet
c) Set up the intravenous line with 5% dextrose in water
d) Set the radiant warmer control temperature at 36.5* C
• Answer
– B) Connect the resuscitation bag to the oxygen
outlet
• The highest priority on admission to the nursery for a
newborn with low Apgar scores is airway, which would
involve preparing respiratory resuscitation equipment. The
other options are also important, although they are of
lower priority.
• 4.) When performing a newborn assessment. the
nurse should measure the vital signs in the following
sequence:
a) Pulse, respirations, temperature
b) Respirations, temperature, pulse
c) Respirations, pulse, temperature
d) Temperature, pulse, respirations
• Answer
– C.)Respirations, pulse, temperature
• This sequence is least disturbing. Touching with the
stethoscope and inserting the thermometer increase
anxiety and elevate vital signs.
• 5.) A nurse tells the parents of a newborn, “Your baby’s
Apgar scores were 9 and 10.”  The parents ask what this
means for their baby’s health. How should the nurse
respond?
a.) APGAR 5
b.) APGAR 9
c.) APGAR 12
d.) APGAR 6
• Answer
– D. “The Apgar score tells us your baby adjusted
well to life outside the womb.”
• Apgar score is a useful tool to document a newborn’s
adjustment to the extrauterine environment as fetal
circulation changes over to postnatal circulation.
• 6.) A newborn's one minute APGAR score is 8. Which of the
following nursing interventions will you provide to this newborn?
a) Routine post-delivery care
b) Full resuscitation assistance is needed and reassess APGAR
score
c) Continue to monitor and reassess the APGAR score in 10
minutes
d) Some resuscitation assistance such as oxygen
• Answer
– A.) Routine post-delivery care
• The newborn has a normal APGAR score that range 10-
7
• 7.) A newborn has a pink torso but blue hands and feet. Her pulse
rate of 60 and does not respond to your attempts to stimulate her.
She also appears to be limp and taking slow, gasping breaths. What
is her APGAR score?
a) APGAR 5
b) APGAR 2
c) APGAR 3
d) APGAR 4
• Answer
– C.) APGAR 3
• Appearance: 1 + Pulse: 1 + Grimace: 0 + Activity: 0 +
Respiration: 1 = 3
• 8.) A newborn has central cyanosis and limp. He has no
respiratory effort and a pulse of 92. What is his APGAR score?
a) APGAR 0
b) APGAR 2
c) APGAR 3
d) APGAR 1
• Answer
– D.) APGAR 1
• Appearance: 0 + Pulse: 1 + Grimace: 0 + Activity: 0 +
Respirations: 0 = 1
• 9.) You are assessing the one-minute APGAR score for a
newborn. She is pink all over and has a pulse of 130. As you
dry her off she begins to cry vigorously and kick her legs. What
is her APGAR score?
a) APGAR 7
b) APGAR 10
c) APGAR 8
d) APGAR 9
• Answer
– B.)APGAR 10
• Appearance: 2 + Pulse: 2 + Grimace: 2 + Activity: 2 +
Respiration: 2 = 10
• 10.) Starting at which number on the APGAR score
should you need to start resuscitation efforts?
a) APGAR 5
b) APGAR 6
c) APGAR 3
d) APGAR 4
• Answer
–  D.) APGAR 3
• A newborn with an APGAR score less than 6 usually
requires resuscitation.  You should not use the APGAR score
alone to determine the need for resuscitation.
THANK YOU
&
GOD BLESS!!!