CH 17 - NEWBORN

Question 1

Changes in fetal structures for cardiovascular:

Answer 1

-foramen ovale (FO) = closes in minutes
-ductus arteriosus = closes in hours
-ductus venosus = closes in days

Question 2

Respiratory System Adaptations

Answer 2

-initiation of respirations: adjusting from fluid filled intrauterine environment to gaseous extra uterine environment

-sometimes it takes time for fluid to get out of the alveoli

Question 3

Role of Surfactant

Answer 3

surface tension reducing lipoprotein that prevents alveolar collapse

allows alveoli to open/close properly

premature babies have problems w/ this bc they don’t have surfactant

Question 4

Respirations of a Newborn

Answer 4

30-60
irregular, shallow, unlabored, short periods of apnea (<15 sec), symmetrical chest movements

Question 5

Characteristics Predisposing Newborn to Heat Loss:

Answer 5

1. thin skin; blood vessels close to surface
2. lack of shivering ability
3. limited use of voluntary muscle activity
4. lack of subcutaneous fat

DRY THE BABY: 1. so it wont be cold
2. stimulates baby to get going

-lose a lot of heat out of their head & that’s why we give them a hat when they’re born

Question 6

Cold Stress

Answer 6

pale
respiratory issues
hr decreases

Question 7

Conduction

Answer 7

transfer of heat from object to object when they are in direct contact w/ each other

EX: baby losing heat when you put them on a cold surface like a scale so need to put blanket on scale first

Question 8

Convection

Answer 8

flow of heat from body surface to cooler surrounding air or to air circulating over a body surface

EX: air condition, fan, open window, air drafts

Question 9

Evaporation

Answer 9

loss of heat when a liquid is converted to a vapor

EX: prevent this when we dry off the baby

Question 10

Radiation

Answer 10

loss of body heat to cooler, solid surfaces in close proximity but not in direct contact

EX: near a closed window, crib up against an external wall that has snow on it

Question 11

Thermoregulation of the Newborn

Answer 11

balance between heat loss and heat production

-heat production: thru non shivering thermogenesis

-heat loss: via 4 mechanisms leading to cold stress

-need a neutral thermal environment (NTE)

Question 12

Hepatic System Function (3):

Answer 12

-iron storage
-carbohydrate metabolism
-bilirubin conjugation

Question 13

3 Groups of Jaundice Based on Mechanism of Accumulation of Bilirubin:

Answer 13

1. overproduction
2. decreased conjugation
3. impaired excretion

Question 14

Stools Types

Answer 14

meconium - dark, sticky, 1st stool

breast fed: yellow-gold, loose, stringy to pasty, sour smelling

formula fed: yellow, yellow-green, loose, pasty, formed, unpleasant odor

-milk stool: yellow & seedy

order: meconium, then transitional, then milk stool

Question 15

How many wet diapers do we expect?

Answer 15

6-8 voidings per day considered normal

Question 16

Natural immunity:

Answer 16

physical barriers, chemical. barriers, resident nonpathologic organisms

-will get more w/ breastfed

Question 17

Acquired immunity:

Answer 17

development of circulating immunoglobulins

-absent until first invasion

Question 18

Newborn Behavioral Responses

Answer 18

-orientation: response to stimuli

-habituation: process and respond to auditory and visual stimuli; block out external stimuli

-motor maturity: control movements

-self quieting: consolability

-social behaviors: cuddling/snuggling