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OB > Ch. 22 Physiologic and behavioral adaptations of newborns > Flashcards

Ch. 22 Physiologic and behavioral adaptations of newborns Flashcards

1
Q

How long does the 1st period of reactivity last

A

30min after birth

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2
Q

Describe the newborns heart, respirations, bowel sounds during the 1st period of reactivity

A

HR= 160-180 then falls to 100-120 after 30min
RR= irregular 60-80b/m grunting nasal flaring, infant is alert
Bowel sounds audible

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3
Q

How long odes the period of decreased responsiveness last

A

60-100min

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4
Q

During the decreased responsiveness period the infant is

A

sleep or has decrease activity

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5
Q

How long does the 2nd period of reactivity last

A

2-8hr after birth and last 10min to several hours

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6
Q

Describe the HR and RR during the 2nd period of reactivity

A

tachycardia and tachypnea may occur.

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7
Q

How does clamping the cord aid in initiating breathing

A

it causes a rise in BP, which increases circulation and lung perfusion

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8
Q

What are the chemical factors that aid in the initiating breathing

A

activation of chemoreceptors (decrease levels of O2 and increase levels of CO2) stimulate the respiratory center in the medulla

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9
Q

Describe the mechanical factors that initiate breathing

A

intrathoracic pressure resulting from compression of the chest during vaginal birth helps draw air into the lungs

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10
Q

Describe how crying aids in breathing

A

it increases the distribution of aid in the lungs and promotes expansion of the alveoli. positive pressure created by crying helps keep the alveoli open

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11
Q

What are the thermal factors associated with breathing

A

newborn enters extrauterine environment where temp is lower which stimulates the receptors in the skin, resulting in stimulation of the respiratory center in medulla

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12
Q

What is the importance of surfactant

A

lowers surface tension, reducing the pressure required to keep the alveoli open

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13
Q

What happens with absent or decreased surfactant

A

more pressure must be generated for inspiration, which can soon tire the infant

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14
Q

What is the average RR for newborn

A

30-60b/min w/periods of pauses less than 20sec

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15
Q

T/F Apneic periods longer than 20sec indicates a path problem

A

True

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16
Q

T/F Newborns are by preference nose breathers

A

True; therefore cyanosis or asphyxia can occur w nasal blockage

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17
Q

T/F RR less than 30sec or greater than 60 should be evaluated

A

true

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18
Q

Define acrocyanosis

A

bluish discoloration of hands and feet

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19
Q

Define central cyanosis

A

abnormal and signifies hypoemia. lips and mucus membranes are bluish

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20
Q

When does the ductus arteries close

A

for term infant; w/in the 1st hr after birth. permanent closure at 3-4wk

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21
Q

What is the HR range for newborn

A

120-160b/min

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22
Q

What is the HR range for newborn asleep

A

85-100b/min

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23
Q

What is the range for BP for infant

A

Systolic; 60-80

Dyastolic; 40-50

24
Q

What are the pros of delayed cord clamping

A

(greater 2min) improves hematocrit and iron status and decreasing anemia

25
Q

What is the RBC range in a newborn

A

4.6-5.2mill

26
Q

What is the hemoglobin level of a newborn

A

13.7-20.1 at birth, decreasing gradually to 12-20 during 1st 20wk

27
Q

What are the hematocrit levels for infant

A

51-56% by wk 8 @ 39-59%

28
Q

What is polycythemia

A

central venous hematocrit greater than 65%; can occur in infants from delayed cord clamping, maternal hypertension or diabetes, IUGR

29
Q

What is the normal WBC count

A

9000=30,000

30
Q

T/F Serious infection is not tolerated well by the newborns because leukocytes are slow to recognize protein

A

True

31
Q

What is the platelet count range

A

150,000-300,000

32
Q

Define thermoregulation

A

maintenance of balance b/w heat loss and heat production

33
Q

What is the physiologic characteristics of neonates that put them at a higher risk for heat loss

A

have thin layer of subcutaneous fat, blood vessels are close to the surface of the skin

34
Q

What are the 4 modes of heat loss in the neonate

A

convection (body-air)
radiation (draft)
evaporation ( damp skin)
conduction (warm crib)

35
Q

In reguards to heat loss skin to skin contact

A

reduces conductive and radiant heat loss and enhances newborn temp control

36
Q

T/F in an effort to conserve heat, newborns assume a position of flexion that helps guard against loss because it diminishes the amount of body surface exposed to the environment

A

True

37
Q

What happens to the brown fat with cold stress

A

it is rapidly depleted

38
Q

What are the effects of cold stress

A

RR increase w/need for oxygen, oxygen and energy are diverted from brain and cardiac function, growth to thermogenesis for survival, pulmonary vasoconstriction; decreases oxygen uptake by lungs and decreases oxygen to tissues leading to aerobic glycolosis metabolic acidosis

39
Q

T/F 6-8 voidings per day of pale, straw colored urine indicate adequate fluid intake

A

true

40
Q

What causes the weight loss experienced by most newborns during the 1st few days

A

extracellular loss

41
Q

At birth the term infant has an iron stores to last

A

4-6wk

42
Q

Where should breastfeed infants receive iron supplementation

A

4months

43
Q

What is jaundice

A

visibly yellowish color of skin and sclera caused by serum levels of unconjugated bilirubin

44
Q

Which organ is responsible for the conjugation of bilirubin

A

liver

45
Q

T/F unconjugated bilirubin is insoluble

A

true

46
Q

Jaundice is likely to appear when bilirubin levels exceed

A

5-6

47
Q

______ jaundice appears after 24hrs usually w/o treatment

A

Physiologic

48
Q

______ Jaundice appears after within 24hrs of birth

A

Patho

49
Q

Describe what breastfeeding associated jaundice is

A

lack of effective breastfeeding contributes to the hyperbilirubinemia (dehydration = less stress to eliminate it)

50
Q

Why do newborns receive vitamin K

A

to protect clotting problems; they lack intestinal bacteria needed to make their own

51
Q

Define Caputo Succedaneum

A

edematous area of the scalp, most commonly found on the occiput; extends across sutures and usually disappears within 3-4days

52
Q

What is a cephalhematoma

A

Collection of blood between a skull bone and its periosteum (does not cross the suture line). Resolves in 3-6wks

53
Q

Define subgaleal hemorrhage

A

Bleeding into the subgleal compartment; commonly associated with vacuum extraction

54
Q

What are the early signs of subgaleal hemorrhage

A

Boggy scalp, pallor, tachycardia, increasing head circumference

55
Q

What are the two test used to assess for hip displacement

A

Barlow and Ortolani

56
Q

What is the Babinski relfex

A

Beginning at the heal stroke upwards along lateral aspect of sole the move finger across ball of foot. All toes hyperextend with dorsiflexion of big toe

57
Q

What is the average time the newborn sleeps in a day

A

17hrs

OB (24 decks)

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