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OB chapter 9
physiologic adaptation of the newborn to birth
| Question | Answer |
|---|---|
| What happens when an infant lacks surfactant? | atelectasis |
| What stimulates the brain to begin respirations? | decreased Po2, increased Pco2, and decreased pH resulting in acidosis |
| Why are c-section babies more at risk for respiratory complications? | these babies do not experience chest compression followed by chest recoil |
| What are normal changes in pulmonary circulation after birth? | the three fetal shunts are closed to allow the neonate’s blood to circulate to the lungs for oxygenation and the liver for filtration |
| Most common cause of heat loss in newborns | large body surface area in relation to weight, thin skin and very little subcutaneous fat for insulation |
| What does cold stress in the newborn lead to? | increased BMR, oxygen consumption, depletion of glycogen stores and resulting acidosis |
| Brown fat | develops at 28 weeks gestation and is found around the neck; in the axillae; around the kidneys, adrenals, and sternum; between the scapula; and along the abdominal aorta. Typically disappears by 3 months of age; is used for nonshivering thermogenesis |
| Examples of Convection | air conditioning or people moving around |
| Examples of Radiation | crib near a cold window, walls of the incubator are cold |
| Examples of Evaporation | amniotic fluid on the skin of the newborn |
| Examples of Conduction | chilled hands, cold scales, cool examining tables, and a cold stethoscope |
| symptoms that show a newborn isn’t warm enough. | hypoglycemia, acidosis, jaundice, and respiratory distress |
| normal vitals for newborn | respirations:30-60 bpm; temperature: 97.7 |
| Weight loss considered normal for newborn | 10% of body weight the first few days of life |
| Reason for vitamin K injections | to prevent excessive bleeding by bringing clotting time to normal range |
| Cause of physiologic jaundice | breakdown of RBC’s leading to increased levels of bilirubin |
| How can thermoregulation present a problem with a newborn? | too much heat loss can cause cold stress |
| How does colostrum protect the infant from infection? | it is high in IgA which helps protect the newborn against some GI and respiratory tract infections |
| What is the most critical physiological change required of the newborn? | respiration through lung expansion |
| Iron stores in a newborn | stored in the liver during the last 3 months of gestation and should last a newborn for 5 months |
| Patent ductus arteriosus occurs when? | the ductus arteriosus reopens causing a decrease in blood pressure or oxygen saturation leading to a return to fetal-type circulation |
| Most critical nursing action after birth | ensure airway is patent and functioning |
| Demerol and how it affects newborn temperature. | when given to a laboring woman before delivery can interfere with metabolism of brown fat in the newborn, resulting in neonatal hypothermia |
| 4 major categories of stimuli that initiate respiration | sensory, chemical, thermal, and mechanical |
| Physiologic mechanisms responsible for closure of shunts | shifts in pressures in the heart, an increase in blood oxygenation level, and cord clamping |
| Primary source of heat loss | radiation |
| Why are newborns at risk for dehydration in the 1st days of life? | antidiuretic hormone (vasopressin) function is limited |
Created by:
laotracuata
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