8.1c Behavioral Adaptations Flashcards
Regulating Physiologic or Autonomic Nervous System
- Infants first need to regulate their physiologic and autonomic system by regulating heart rate, respirations, temperature
Motor Organization
- After regulating physiologic factors, motor organization is next.
- Control random movements
- Improve muscle tone
- Reduce excessive activity
State Regulation
- The third level is state regulation which controls state of consciousness
- Developed sleep and wake cycles and react less to stress
- Self regulation and communication with caregiver by crying and then being helped
Attention and Social Interaction
- The last level
- Attention and social interaction
- Infant attends to visual and auditory stimuli
- They can stay alert for a long period of time
- They engage in social interaction
Brazelton Neonatal Behavioral Assessment Scale (NBAS)
- Identifies where infants fall short along the continuum of behaviors and necessary support.
- Infant should be able to attend visual
Habituation
- Ability to respond to and then inhibit responding to discrete stimulus (light, rattle, pinprick,) while asleep
Reflexes
- Assessment of several neonatal reflexes
Regulation of State
- How infants respond when aroused
Autonomic Stability
- Signs of stress
- Tremors, startles, skin color
- Related to homeostatic (self-regulator) adjustment of nervous system
Orientation
- Quality of alert states and ability to attend to visual and auditory stimuli while alert
Range of State
- Measure of general arousal level or arousability of infant
Regulation of State
- How infant responds when aroused
Sleep-Wake States
- Parents react to babies differently based on activity level, feeding patterns, and responsiveness
- Infants state of consciousness determine their responses to environmental stimuli and caregiver
Wake/Sleep States
Sleep Cycles
- Deep/Light Sleep
Wake Cycles
- Drowsy
- Quiet
- Active Alert
- Crying
Optimal state is quiet alert state with baby smiling, vocalizing, moving in synchrony with speech, watching parents faces, responding to people talking to them
State Modulation
- Newborns control their sensory input to regulate sleep/wake cycles
- The ability to make smooth transitions is state modulation
Purposeful Behavior
- Used by baby to maintain optimal arousal states
Examples - Actively withdrawing by increasing physical distance
- Rejecting or pushing away with their hands and feet
- Decrease sensitivity by falling asleep or break eye contact by turning head
- Signal behaviors such as fussing and crying
Vision
- Clearest distance 17-20 cm (distance between baby and mother during breastfeeding)
- Can recognize mother faces
- Will engage mother with eye contact
- Can imitate face expressions (sticking out tongue)
- Prefer complex patterns over non-patterned stimuli
- Prefer black and white colors
Hearing
- Can hear and differentiate sounds
- Will turn to sounds to attempt to locate source
- Responds to mothers voice
- Prefers high-pitched intonations
- Responds to rhythmic sounds
- Routine hearings recommended for all newborns
Smell
- They have highly developed sense of smell
- Able to differentiate mothers milk from other milk
Taste
- Babies use their mouth a lot, for feeding, rapid growth, and stress relief through sucking
- Infants prefer sweets
Touch
- Responsive to touch on all parts of body
- Touch and motion are essential to normal development
Temperament
- Individual variation in reactions of newborns
Habituation
- Protective mechanism to become accustomed to environmental stimuli
Consolability
- Vary in ability to be consoled or console themselves (comforted)
Cuddliness
- Important to parents to gauge ability to care for a child
Crying
- Language of an infant
- Signals hunger, pain, desire for attention, fussiness
- Response to stimuli such as cold, overstimulation, held by multiple people
- Responsiveness of crying by caregiver builds trust with caregiver that they will remove discomforts
Crying Expected Adaptations 5 hours
- Second period of reactivity
- Tachycardia/Tachypnea
- Increased muscle tone
- Skin color change
- Increased mucus production
- Passage of meconium
- RR 30-60
- No crackles
Grunting and flaring are signs of respiratory distress
A breastfed, full term newborn girl is 12 hours old and being prepared for early discharge. If present, which assessments findings could delay discharge?
- Jaundice before 24 hours is indicative of pathologic jaundice
- Glucose should be 50-60 and not lower than 40
- Acrocyanosis is normal between 7-10 days
Erythema Toxicum
- Rash that may develop on abdomen and thigh at 12 hours of life
Thermoregulation
- Maintenance and balance of heat loss and production
Newborn Heat Loss
- They are especially vulnerable because
- They do not have much subcutaneous tissue
- Blood vessels are close to the surface
- ## They have large body surface to body weight ratio
Heat loss Types
Convection - Flow of heat into ambient cooler air
Radiation - Loss of heat being near but not in contact with cold surface
Evaporation - Heat loss liquid turning to vapor
Conduction - Loss of heat from direct contact with cold surface
Prevention of heat loss
- Skin to skin contact
How infants respond to cold
- Increase muscle activity and metabolism brown fat
- ## Shivering and heat production is not available in newborns
Signs of Cold Stress
- RR increases
- Vasoconstriction leading to respiratory distress
- Right/Left cardiac valve shunting
- Anaerobic glycolysis which can lead to hypoglycemia and metabolic acidosis
