Chapter 23

Question 1

Newborn Physiological Adaptations

Answer 1

Initiation and maintaining respirations
Fetal to neonatal circulation
Neurological change of thermoregulation
Digestion and waste elimination
Weight

Question 2

changes in babies when they are 1st term:

Answer 2

circulation, breathing, temperature regulation, eating

Question 3

when babies are first born number one thing

Answer 3

get them to breathe, can use a bulb syringe

Question 4

babies born by C section more likely to have

Answer 4

respiratory distress because they aren’t squeezed

Question 5

as soon as babies are born put in

Answer 5

a warmer and cleaned

Question 6

use what to help babies breathe

Answer 6

surfactant

Question 7

Transition

Answer 7

Transition to extrauterine life first 6-8 hours after birth
Mediated by the sympathetic nervous system
Time of vulnerability for infant-close observation by nurse

Question 8

Internal stimuli

Answer 8

• In utero blood shunted away from lungs-transplacental gas exchange
  
  • Multiple triggers
  • Chemical factors: Decreased Po2, increased Pco2, decreased pH

Question 9

External stimuli

Answer 9

Thermal factors: Skin stimuli
Sensory factors: Response to sounds and light
Mechanical factors: Chest compression draws air to lungs

Question 10

Surfactant

Answer 10

protein manufactured by type II cells of the lungs
Surfactant lowers surface tension=
reduces the pressure required to keep the alveoli open with inspiration

Question 11

respirations

Answer 11

30-60 per min
Periodic breathing
Obligate nose breathers until 3-4 weeks of age
Abdominal breathing

Question 12

Periodic breathing

Answer 12

paused up to 20 seconds, most commonly during REM sleep (periodic breathing is normal)

Question 13

mother effects on baby breathing

Answer 13

drugs mom took before labor can slow down respiratory rate, too hot/cold, mother diabetic

Question 14

Respiratory Distress

Answer 14

Nasal flaring, retractions, grunting, stridor, gasping
RR 60
RR can be slowed due to meds during labor, sepsis, hypothermia, hyperthermia, hypoglycemia
TTN (fast breathing)

Question 15

in utero babies get oxygen from

Answer 15

moms placenta

Question 16

Ductus Arteriosus

Answer 16

Connects the pulmonary artery and aorta
Maintained by placental prostaglandins
Closes first hour after birth
(can have surgery to keep open)

Question 17

Ductus Venosus

Answer 17

Shunts blood away from liver into inferior vena cava
Closes first 2 min after birth
(can have surgery to keep open)

Question 18

Foramen Ovale

Answer 18

Connects the R & L atrium-when lungs inflate increased pressure L atrium -closes

Question 19

Circulatory Transition

Answer 19

Increase in PO2
Shifts in pressure of heart, lungs, and circulatory system
Umbilical cord clamped (once cord is clamped pressure in heart goes up)
Fetal structures close
Pulmonary vessels dilate

Question 20

Thermoregulation

Answer 20

Balance between heat loss and heat production

Question 21

Inherent Risk of Newborn for Poor Thermal Regulation

Answer 21

Large surface area proportional to mass
Thin layer of SQ fat, vessels close to surface of skin
Decreased ability to produce heat (babies can’t produce heat)

Question 22

Heat loss occurs by:

Answer 22

convection, radiation, evaporation, conduction

Question 23

convection -

Answer 23

flow of heat form body surface to cooler ambient air

Question 24

radiation -

Answer 24

Loss of heat from body surface to a cooler solid surface in proximity (windows, doors, ducts)

Question 25

evaporation -

Answer 25

Dry after birth and bath

Question 26

conduction -

Answer 26

Loss of heat from the body surface to cooler surfaces in direct contact-scales, warmer, crib

Question 27

Thermogenesis -

Answer 27

In response to cold, baby tries to generate heat by increasing muscle activity Vasoconstrict Acrocyanosis babies can't shiver

Question 28

Acrocyanosis

Answer 28

hands and feet look blue ( happens when they vasoconsrict)

Question 29

The Newborn Response to Hypothermia

Answer 29

Restlessness Vasoconstriction Metabolism increases Metabolism of highly vascular brown fat (stored fat in baby) Decrease in core temp until nonshivering thermogenesis fails start breathing faster and burning more calories then causes hypoglycemia because it uses sugar

Question 30

Hazards of Cold Stress

Answer 30

``` Increased need for oxygen Respiratory distress Decreased surfactant production Hypoglycemia Metabolic acidosis Jaundice (need to heat them up and replace their energy) ```