Case Scenario: Baby Girl "A"
Patient History:
A 24-year-old G1P0 mother at 39 weeks gestation arrives in active labor. After two hours of
pushing, Baby Girl "A" is delivered via spontaneous vaginal delivery. The amniotic fluid was
clear, and no maternal medications were administered during the second stage of labor.
Immediate Delivery Findings (1 Minute):
The newborn is handed to the nurse for initial assessment. You observe the following:
Heart Rate: 110 beats per minute (bpm).
Respiratory Effort: The baby is letting out a weak, irregular cry.
Muscle Tone: There is minimal flexion of the extremities.
Reflex Irritability: The baby grimaces when the soles of the feet are flicked.
Color: The body is pink, but the hands and feet appear bluish (acrocyanosis).
Follow-up Findings (5 Minutes):
The nurse provides routine care, including drying, stimulating, and clearing the airway. At 5
minutes:
Heart Rate: 140 bpm.
Respiratory Effort: The baby has a vigorous, strong cry.
Muscle Tone: The baby is moving all extremities actively.
Reflex Irritability: The baby cries and pulls away when stimulated.
Color: The body and extremities are now completely pink.
Student Worksheet: Assessment & Analysis
1. Calculate the Apgar Scores
Using the Apgar Scoring System, assign a value (0, 1, or 2) for each category.
Category 1-Minute Score 5-Minute Score
Appearance (Color) ? ?
Pulse (Heart Rate) ? ?
Grimace (Reflex) ? ?
Activity (Muscle Tone) ? ?
Respiration (Effort) ? ?
Total Score /10 /10
2. Prioritize Nursing Actions
Based on the 1-minute score, which of the following is the priority action for the nurse?
A) Initiate full neonatal resuscitation (CPR).
B) Provide routine care: dry, stimulate, and place skin-to-skin.
C) Immediately transfer to the NICU for observation.
