Final Review Flashcards
Fetal Circulation
Clamping the umbilical cord after birth eliminates the placenta as a reservoir for blood.
Onset of respirations causes a rise in PO2 in the lungs and a decrease in pulmonary vascular resistance, which…
Increases pulmonary blood flow and increases pressure in the left atrium, which…
Decreases pressure in the right atrium of the heart, which causes closure of the foramen ovale (closes within minutes after birth secondary to a decreased pulmonary vascular resistance and increased left heart pressure).
With an increase in oxygen levels after the first breath, an increase in systemic vascular resistance occurs, which…
Decreases vena cava return, which reduces blood flow in the umbilical vein (constricts, becomes a ligament with functional closing).
Closure of the ductus venosus (becomes a ligament) causes an increase in pressure in the aorta, which forces closure of the ductus arteriosus within 10 to 15 hours after birth.
More insulin in the infant
Less surfactant (lubrication in the lungs)
Infant Respirations
30 to 60 breaths per minute; irregular,
shallow, unlabored; short periods of apnea (<15 seconds); symmetrical chest movements
T/F
A respiratory rate of 44 breaths per minute
would be considered a normal finding in a
newborn.
TRUE
Retractions
Chest muscles pull in around the bones
Grunting
snoring/
apnea
pauses in breathing 15-20 secs
cyanosis
blue skin color lips/chest/stomach
oxygen level too low
Jaundice
Yellow skin. Bilirubin build-up in the blood/
Heat Loss
- Thin skin; blood vessels close to the surface
- Lack of shivering ability; limited stores of metabolic
substrates (glucose, glycogen, fat) - Limited use of voluntary muscle activity
- Large body surface area relative to body weight
- Lack of subcutaneous fat; little ability to conserve heat by changing posture
- No ability to adjust own clothing or blankets to achieve warmth
- Infants cannot communicate that they are too cold or too warm
Conduction
transfer of heat from object to object
when the two objects are in direct contact with each other
Convection
flow of heat from body surface to cooler
surrounding air or to air circulating over a body surface
Evaporation
loss of heat when a liquid is converted
to a vapor
Radiation
loss of body heat to cooler, solid surfaces
in close proximity but not in direct contact
Thermoregulation
Balance btwn heat production and heat loss
- Heat production: primarily through nonshivering thermogenesis
- Heat loss via four mechanisms leading to cold stress
weight gain calories
To gain weight the newborn requires an intake of 108 kcal/kg/day from birth to 6 months of age
Newborns usually lose 10% of the body weight due to burning brown fat
Infant Stool
Meconium: first 24 hours dark green/black/tarry
- Breast-fed newborns: yellow-gold, loose, stringy to pasty, sour-smelling
- Formula-fed newborns: yellow, yellow-green, loose, pasty, or formed, unpleasant odor
T/F
When assessing the stools of a 1-week-old newborn who is being breast-fed, which would the nurse expect to find?
Yellow gold loose stool
Natural Immunity
physical barriers, chemical
barriers, and resident nonpathologic organisms
Acquired Immunity
Development of circulating immunoglobulins; formation of activated lymphocytes
- Absent until after first invasion by foreign
organism or toxin
- Newborn primarily dependent on three
immunoglobulins: IgG, IgA, and IgM
IgG
major immunoglobulin and the most abundant, making up about 80% of all circulating antibodies
ONLY immunoglobulin the crosses the PLACENTA (starting 20-22 wks)
IgA
is the second most abundant immunoglobulin in the serum.
This immunoglobulin is believed to protect mucous membranes from viruses and bacteria. IgA is predominantly found in the gastrointestinal and respiratory tracts, tears, saliva, COLOSTRUM, and BREAST MILK
IgM
found in blood and lymph fluid and is the first immunoglobulin to respond to infection.
You have to GET SICK
T/F
A nurse is assessing the sensory capabilities of a newborn. Which is the least mature sense at birth?
Vision
