USMAN DANFODIO

UNIVERSITY SOKOTO
FACULTY OF ALLIED HEALTH SCIENCES
DEPARTMENT OF NURSING SCIENCE
NUR 409
MATERNA AND CHILD HEALTH NURSING
ASSIGNMENT
TOPIC: APGAR SCORE
APGAR score is a simple method of quickly assessing
the health and vital signs of a newborn. It is an easy
and quick assessment tool.
It can also be described as a standardised
assessment performed 1 and 5minutes 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
• It may be performed at 10minutes If the APGAR
SCORE IS </=6
• It was discovered by Dr. Virginia Apgar in 1952.
COMPONENTS OF APGAR
• Appearance/colour
• Pulse/ heart rate
• Grimace/ reflexes
• Activity/ muscle tone
• Respiration
APGAR SCORING METHOD
How does the Apgar score work?
The Apgar scoring system is divided into five
categories. Each category receives a score of 0 to 2
points. At most, a child will receive an overall score of
10. However, a baby rarely scores a 10 in the first few
moments of life. This is because most babies have
blue hands or feet immediately after birth.
 A: Appearance (color)
0 points: blue, bluish-gray, or pale all over
1 point: body pink but extremities blue
2 points: pink all over

P: Pulse/heart rate
0 points: absent
1 point: less than 100 beats per minute
2 points: greater than 100 beats per minute
 G: Grimace (response to stimulation, such as suctioning
the baby’s nose)
0 points: absent
1 point: facial movement/grimace with stimulation
2 points: cough or sneeze, cry and withdrawal of foot with
stimulation
A: Activity/muscle tone
0 points: limp or floppy
1 point: limbs flexed
2 points: active movemen
R: Respiration/breathing
0 points: absent
1 point: irregular, weak crying
2 points: good, strong cry.
Most of the time a low Apgar score is caused by:
Difficult birth
C-section
Fluid in the baby's airway
 SCORE INTEPRETATION
NORMAL/ ASSURING: 7-10
MODERATE ABNORMAL : 4-6
ABNORMAL : 0-3
INTERVENTIONS BASED ON SCORE
7-10 = Routine post delivery care
4-6 = Some resuscitation (oxygen, suctioning,stimulation
of baby by rubbing back e.t.c)
0-3 = Full resuscitation
 Nurse interventions to improve
the APGAR score include:
• Stimulating the baby to breathe or providing positive
pressure ventilation (PPV) via the bag valve mask.
• Possible bulb suctioning the airway as needed, though
this is being phased out unless absolutely critical due to
risk for bradycardia and aspiration.
• Normalizing temperature (usually involves keeping baby
warm, but hyperthermia can occur in febrile mothers).
• Performing chest compressions as needed.
• If heart rate is less than 100 bpm, apneic or gasping, it’s a
common policy to start PPV until heart rate and respiratory
status improves.
CASE SCENARIOS...
• 1. You’re assessing the one minute APGAR score of
a newborn baby. On assessment, you note the
following about your newborn patient: heart rate
130, pink body and hands with cyanotic feet, weak
cry, flexion of the arms and legs, active movement
and crying when stimulated. What is your patient’s
APGAR score?
2. A newborn’s five minute APGAR score is 5. 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.
3. Regarding the scenario in the question above,
when would you reassess the APGAR score?
• A. 2 minutes after the previous APGAR assessment
• B. 15 minutes after the previous APGAR assessment
• C. 5 minutes after the previous APGAR assessment
• D. No reassessment of the APGAR score is needed
4. 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