Chapter 21 Flashcards
What lines the alveoli of the lungs and reduces surface tension to keep the alveoli open?
Surfactant
When does fetal lung fluid move into the interstitial space?
before, during and after birth
What two systems absorb lung fluid after birth?
Lymphatic and vascular systems
What 4 factors combine to stimulate the respiratory center in the brain and initiate respirations at birth?
Chemical, Mechanical, Thermal, and Sensory
What are the 4 cardiovascular adaptions that occur after birth in the transition from fetal to neonatal circulation?
- Increases in blood O2 levels
- Shifts in pressure in the heart and lung
- Closing of the umbilical vessels
- closing of the ductus arteriosus, foramen ovale, and the ductus venosis,
What 3 newborn characteristics lead to heat loss?
- Skin with little subcutaneous fat
- Blood vessels close to the surface
- Large skin surface
What are the 4 methods of heat loss in a newborn?
Evaporation, conduction, convection, radiation
What is the difference between conduction and convection?
conduction is the transfer of temperature by direct contact
convection is the transfer of temperature by circulating air
What 5 methods in the neonate produce heat?
Increased activity, flexion, metabolism vasoconstriction, nonshivering therogenesis (brown fat)
What negative effects can the methods of heat production in a neonate cause?
increase oxygen and glucose consumption, respiratory distress, hypoglycemia, and jaundice
What 6 effects can “Cold Stress” place on the body of the neonate?
Increased oxygen need, decreased surfactant production, respiratiory destress, hypoglycemia, Metabolic acidosis, Jaundice
What is a major difference in neonate erythrocytes vs. the erythrocytes of an older child?
Shorter lifespan
What does the nurse give a new born to help increase its clotting factors?
Vitamin K
What are the blood glucose levels of a newborn on day one?
40-60
What are the blood glucose levels of a newborn after day one?
50-100
What are the characteristics of the stools from a breast feed infant?
Frequent, seedy and mustard- colored
What percentage of a newborn is composed of water?
75%
What is the only Ig to cross the placenta?
IgG
What Ig protects a neonate from gram negative bacteria?
IgM
What Ig is passed from the mother to the new born through breast milk?
IgA
What is the R/R of a new born?
30-60
What is the pulse of the new born?
120-160
What is the average systolic of a new born?
65-95
What is the average diastolic of a new born?
30-60
What condition can occur after the first 24 hours of life as a result of hemolysis of red blood cells and immaturity of the liver?
Physiologic Jaundice
What condition begins in the first 24 hours and may require treatment with phototherapy?
Pathologic Jaundice
What can cause Breast Milk Jaundice?
lack of sufficient intake
After birth how soon should the neonates first void be?
within 24 hours
How soon should you first assess a neonate after birth?
immediately
What 5 characteristics should the nurse assess for in the shape of the neonate head?
Molding, Fontanels, Caput, Cephalhematoma, Facial Symmetry
What 5 characteristics are measured in the neonate?
Weight, Length, Head and Chest circumference, Eyes and ears, Reflexes
What are signs of Hypoglycemia in the new born?
Jitteriness, tremors, poor muscle tone, sweating, tachypena, grunting, cyanosis, apnea, diaphoresis, low temperature, poor suck reflex, high-pitched cry, lethargy, irritability, seizures, coma
What are the characteristics of the new born female genitalia?
Labia majora should be large and completely cover the clitoris and labia minora, Genitalia may be darker than the surrounding skin, a small amount of vaginal discharge is normal
What are the characteristics of the new born male genitalia?
The scrotum should be pendulous, genitalia may be dark brown, palpation of the scrotum determines if the testes have descended
What is the cheesy substance found on the skin of the new born?
Vernix
What is the fine hair that covers the body of the new born?
Lanugo
What are the white spots seen on a new born that look like acne?
Millia
What is the normal sound of a new born cry?
Lusty, Strong
How does the nurse perform the Barlow Test?
Adduct the hips, and apply gentle pressure down and back with the thumbs. In hip dysplasia, the examiner can feel the femoral head move out of the acetabulum
How does the nurse perform the Babinski Reflex test?
By stroking the lateral sole of the infant’s foot from the heel forward and across the ball of the foot. This causes the toes to flare outward and the big toe to dorsiflex.
What is the Moro Reflex?
It is a flaring action that occurs when the infants head and trunk are allowed to drop back 30 degrees.
What is the Palmar grasp reflex?
The hand closes into a tight fist when the infant’s palm is touched near the base of the fingers.
What is the Plantar grasp reflex?
When the infant’s foot is touched below the toes, the toes will curl over the nurses fingers.
What is the Rooting reflex?
When the infants cheek is touched near the mouth, its head will turn toward that side.
What is the Sucking reflex?
When the mouth or palate is touched the infant begins to suck
What is the Tonic Neck Reflex?
The infants extend the arms and leg on the side to which the head is turned and flexes the extremities on the other side.
What is the Stepping Reflex?
When held upright with just the feet touching a surface the infant will lift one foot and then the other.
