Question

Create a chart explaining the importance of the APGAR score for a diabetic newborn.

1. Make sure to recognize a normal and abnormal APGAR scores with the diabetic newborn.

2. What type of complications the nurse or medical team can foresee to assess.

3. Are the assessment findings different from an average normal newborn? Briefly explain.

Answer 1

1.Apgar score assess heart rate,respiratory rate,muscle tone,reflex irritability and colour.Apgar score 0-3 severely distressed ,4-6 indicate moderate difficulty,7 -10 indicate adjusting well to extrauterine life. Apgar score less than 4 indicate immediate resuscitation.Apgar assessments are done at 1 minute and 5 minutes.For a baby with a score of less than 6 we would do a 1,2,5 and 10 minute APGAR assessments.Risk factors for neonatal hypoglycaemia are when the APGAR score is less than 5 ,because low Apgar score ,tends the baby to go through glucose stores faster.

2 Prevention is best.So the health care providers assess for risk factors .Although of infants of diabetic mothers (IDM)are large ,they have immature physiologic function and exhibit many problems of preterm infant.Complications most often seen are hypoglycaemia,IDM continues to produce high levels of insulin,they have less ability to release glucagon and catecholamines which normally stimulate glucagon breakdown and glucose release.Diabetic women have serum magnesium and increased urinary calcium secretion ,which causes hypoparathyroidism in their infants.Other factors may include vitamin D antagonism ,from elevated cortisol levels,hypophosphataemia from tissue catabolism and decreased serum magnesium.Hyperbilirubinaemia maybe seen 48-72 after birth maybe caused by slightly decreased ECV ,which increases hematocrit level,which facilitates and increase in RBC breakdown and increasing bilirubin levels.

3 There have been several studies on the neonatal outcomes associated with pregestational diabetes mellitus and GDM and APGAR scores.newborns of diabetic mother showed lower 1-minute and 5-minute Apgar score. Apgar scores are not associated with maternal GDM when compared to normal glucose tolerance in pregnancy.