Which of the following components are used to calculate the Apgar score for a newborn?
(Select All that Apply.)

A. Respiratory rate: Respiratory effort is a key Apgar component, assessing the newborn’s ability to breathe effectively. A strong cry (2 score) indicates good respiratory effort and scores higher, while absent (0 score) or weak (1 score) respiration reflects respiratory compromise.

B. Body temperature: Body temperature is not part of the Apgar score. While important for overall newborn assessment and thermoregulation, it does not directly reflect the infant's immediate adaptation to extrauterine life in the first minute.

C. Muscle tone: Muscle tone evaluates the infant's level of flexion and spontaneous movement. A newborn with active motion and flexed extremities receives a 2 score, indicating healthy neuromuscular function and oxygenation, some flexion receives a 1 score while zero reflects a zero score.

D. Reflexes: Reflex irritability is measured by the newborn’s response to stimuli, such as suctioning or a mild slap on the sole. A prompt cry or withdrawal indicates intact neurologic responsiveness and earns a higher Apgar score.

E. Blood pressure: Blood pressure is not evaluated in the Apgar scoring system. It requires equipment and time that are not practical in the rapid assessment immediately after birth, unlike observable and quickly assessed criteria.

F. Heart rate: Heart rate is the most critical element of the Apgar score. It reflects cardiovascular stability, with scores ranging from 0 for absent to 2 for rates over 100 beats per minute, indicating effective circulatory function.

A. 22/min: A respiratory rate of 22 breaths per minute is well below the normal range for a newborn. This could indicate respiratory depression or central nervous system suppression, both of which are concerning in a neonate and require immediate evaluation.

B. 110/min:. A respiratory rate of 110/min suggests tachypnea, which may be due to transient tachypnea, respiratory distress, or sepsis and warrants further assessment.

C. 48/min: The normal respiratory rate for a newborn is between 30 to 60 breaths per minute. A rate of 48/min falls comfortably within this expected range, indicating adequate respiratory function. Breathing should also be assessed for regularity, absence of grunting, and use of accessory muscles.

D. 100/min: This respiratory rate is much too high for a newborn and indicates marked tachypnea, which could be associated with respiratory compromise such as hyaline membrane disease, meconium aspiration, or pneumonia. Immediate evaluation would be needed in such cases.