Determine the Apgar score for a baby which is limp, completely cyanotic, has a pulse of 70 beats/min, and slow respirations.

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To determine the Apgar score, each of the five criteria—Appearance, Pulse, Grimace response, Activity, and Respiration—is assessed on a scale from 0 to 2. The maximum possible score is 10.

In this case, the baby is limp, which indicates a score of 0 for Activity, as normal tone is needed for a score of 2. The baby is completely cyanotic, resulting in a score of 0 for Appearance, since a score of 1 would only be given for peripheral cyanosis (blue extremities only). The heart rate is 70 beats per minute, which scores 1 point, as a normal pulse is above 100 beats per minute. The respirations are slow and ineffective, so this would also score 0, as adequate effort is necessary for a score of 2. If the baby cries or has some response, it could score 1 in Grimace response, but it’s mentioned that the baby is limp, which generally doesn't suggest any reflexes.

Adding these scores together:

  • Appearance: 0

  • Pulse: 1

  • Grimace response: 0

  • Activity: 0

  • Respiration: 0

This totals up to

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