Answer to Question 1
ANS:
8
0 1 2
Heart rate Absent Slow, <100 beats>100 beats/min
Respiratory effort Absent Irregular, slow, weak cry Good, strong cry
Muscle tone Limp Some flexion of extremities Well flexed
Reflex irritability No response Grimace Cry, sneeze
Color Blue, pale Body pink, extremities blue Completely pink
The newborn gets 2 for heart rate, 2 for respiratory effort, 1 for muscle tone, 2 for reflex irritability and 1 for color = 8
Answer to Question 2
ANS: C, D, E
Parents preparing infant formula must wash their hands well and then wash all of the equipment used to prepare the formula (including the cans of formula) with soap and water. Sterilizing bottles and nipples 5 minutes in boiling water may be required when a hot-water dishwasher is not available. Similar to breastfed infants, bottle-fed infants need to be held on alternate sides of the lap to expose them to different stimuli. Bottled water should not be considered sterile unless otherwise indicated; bottled water without fluoride should be avoided for mixing infant formula. Propping the bottle during infant feedings at night time could cause the infant to aspirate. The feeding should not be hurried. Even though they may suck vigorously for the first 5 minutes and seem to be satisfied, infants should be allowed to continue sucking. Infants need at least 2 hours of sucking a day. If there are six feedings per day, then about 20 minutes of sucking at each feeding provide for oral gratification.