Chapter 23 Flashcards
Neonatal Period
Birth to 28 days
Adaptions in the First 6-8 Hours
Maintaining respirations, adjusting to circulatory changes, regulating temperature, eliminating wastes, regulating weight
First Period of Reactivity
Lasts up to 30 minutes after birth
HR increases to 160-180 BPM but decreases after 30 min
Infant is alert
Period of Decreased Responsiveness
Lasts from 60-100 minutes
Newborn either sleeps or has a marked decrease in motor activity
Second Period of Reactivity
Occurs 2-8 hours after birth
Lasts from 10 minutes to several hours
Tachycardia, tachypnea, increased muscle tone, improved skin color, mucous production, meconium typically passed
Signs of Respiratory Distress
Nasal flaring
Intercostal or subcostal retractions
Grunting
Acrocyanosis
Normal finding in the first 24 hours after birth
Blood Pressure
Systolic should be 60-80
Diastolic should be 40-60
Signs of Risk for Cardiovascular Problems
Persistent tachycardia
Persistent bradycardia
Skin color: pallor, cyanosis
Hematopoietic System
Fetus needs additional RBCs for transport of oxygen in utero
May have low WBCs
Blood volume should be adequate
Heat Loss Occurs by…
Convection (drafts coming from open doors)
Radiation (near cold surfaces)
Evaporation (moisture on the skin)
Conduction (cold objects coming into contact)
Thermogenic System
Babies use brown fat to regulate their temperature
Cold stress can lead to hypothermia or hypoglycemia
Renal System
Newborns pee 2-6 times for the first few days, and after day 4 they pee 6-8 times a day
98% of newborns void within 30 hours of life
Gastrointestinal System
Cardiac sphincter not fully developed, can lead to regurgitation and vomiting
Audible bowel sounds within the first few hours of birth
Return to birth weight within 10-14 days
Physiologic Jaundice
Caused by transient hyperbilirubinemia
Never present during the first 24 hours of life
Jaundice visible when bilirubin level is > 5 mg/dL
Occurs in 60% of term infants and 80% of preterm infants
Nonphysiologic Jaundice
May occur in the first 24 hours
Caused by abnormalities causing destruction of erythrocytes
Breastfeeding-Associated Jaundice
Early-onset jaundice
Lack of effective breastfeeding contributes to hyperbilirubinemia
Breast Milk Jaundice
Late-onset jaundice
Bilirubin levels rise after the first 3-5 days
Treat with phototherapy; may discontinue breastfeeding
Closely monitor bilirubin levels
Hepatic System
Lack of intestinal bacteria needed to synthesize vitamin K results in transient blood coagulation deficiency between the second and fifth days of life
Immune System
Less effective at fighting off infections
IgG
Crosses placenta and provides temporary immunity
IgM
First immunoglobulin produced when exposed to an infection
IgA
Receive some from colostrum and breast milk
Must be produced by the infant
Neuromuscular System
Almost completely developed at birth
Normal tremors, tremors of hypoglycemia, and seizure activity must be differentiated
Newborn Reflexes
Root reflex
Suck reflex
Startle (Moro) reflex
Tonic neck reflex (fencing)
Grasp reflex
Babinski reflex
Step reflex
Most Critical Adaptation to Extrauterine Life
Establish effective respirations
Jaundice is considered pathologic if…
It appears within the first 24 hours of life
Serum bilirubin levels increase by more than 6 mg/dL in 24 hours
Serum bilirubin exceeds 15 mg/dL at any time
