28. A neonate is delivered by cesarean section at 39 weeks' gestation. The neonate has an Apgar score of 9 at 5 minutes. A nurse should be aware that the most likely cause for subtraction of one point is:
28. A neonate is delivered by cesarean section at 39 weeks' gestation. The neonate has an Apgar score of 9 at 5 minutes. A nurse should be aware that the most likely cause for subtraction of one point is:
. The neonate has low blood glucose.
. The neonate has bradycardia.
. The neonate has acrocyanosis.
. The neonate has decreased tone.
Test-Taking Tip
Even though 10 is the highest Apgar score, the acrocyanosis effectively makes 9 the best score for a neonate. Note that three of the options are ↓ : blood glucose (low), heart rate ( brady ), tone (decreased). Choose the option that is different, that is, not "low."
Content Area: Child Health, Newborn; Integrated Process: Nursing Process, Assessment; Cognitive Level: Application; Client Need/Subneed: Health Promotion and Maintenance/Ante/Intra/Postpartum and Newborn Care
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Answer 1 is incorrect because low blood glucose is not one of the parameters for Apgar scoring. Answer 2 is incorrect because bradycardia would be a one-or two-point deduction in the Apgar scoring, in addition to the subtraction of a point for the acrocyanosis, leaving a 7 or 8 Apgar score. Answer 3 is correct because acrocyanosis (blue color of hands and feet in most infants usually for the first few hours after birth) is a normal finding for a neonate at 5 minutes of age. The acrocyanosis would lead to subtracting a point from the Apgar score. An Apgar score of 9 at 5 minutes is normal in a healthy neonate. Answer 4 is incorrect because decreased tone would subtract a point in addition to the presence of acrocyanosis, giving an 8 Apgar score at 5 minutes.