Nclex Review on Maternity: The Apgar Score

The Apgar Score

The Apgar test is usually given to your baby twice: once at 1 minute after birth, and again at 5 minutes after birth. Rarely, if there are concerns about the baby’s condition and the first two scores are low, the test may be scored for a third time at 10 minutes after birth.

Five factors are used to evaluate the baby’s condition and each factor is scored on a scale of 0 to 2, with 2 being the best score:

activity and muscle tone
pulse (heart rate)
grimace response (medically known as “reflex irritability”)
appearance (skin coloration)
respiration (breathing rate and effort)

You add these five factors together to calculate the Apgar score.

Scores obtainable are between 10 and 0, with 10 being the highest possible score.

Apgar Scoring
Apgar Sign	2	1	0
Heart Rate (pulse)	Normal (above 100 beats per minute)	Below 100 beats per minute	Absent (no pulse)
Breathing (rate and effort)	Normal rate and effort, good cry	Slow or irregular breathing, weak cry	Absent (no breathing)
Grimace(responsiveness or “reflex irritability”)	Pulls away, sneezes, or coughs with stimulation	Facial movement only (grimace) with stimulation	Absent (no response to stimulation)
Activity (muscle tone)	Active, spontaneous movement	Arms and legs flexed with little movement	No movement, “floppy” tone
Appearance (skin coloration)	Normal color all over (hands and feet are pink)	Normal color (but hands and feet are bluish)	Bluish-gray or pale all over

Basal Body Temperature Method
A type of contraception in which it is based on the basal and thermal shift in the menstrual cycle.

Remember:

The heart begins to beat at 22-25 days after fertilization.
FETAL HEART TONES (Fetal Heart Rate)
Is assesed by a fetoscope or an ultrasonic doppler device between 8-16 weeks.

Gravida and Para are the terms used to describe the childbearing history
Gravida– number of times the woman had been pregnant.
Para– number of infants that have been delivered after the 20 weeks gestation

TPAL
T- Number of TERM infants born after 37 weeks.
P- number of PREMATURE infants born between 20 and 37 weeks.
A- number of pregnancies that end up in abortion propor tp 20 weeks.
L- number of children that is currently alive.

NCLEX Review & Nursing School