L4: Newborn adaptations to extrauterine life Flashcards

1
Q

Newborn adjustments to the respiratory system

A
  • When born we stimulate the baby to cry. This helps open up the lungs
  • An increase in RR can be a sign of infection
  • Opioids can decrease fetal RR
  • We are okay with acrocyanosis (blue extremities); not central cyanosis
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2
Q

Which ducts close in the circulation system after birth

A
  • Ductus venosus
  • ductus arteriosus: If it doesn’t close completely it is still benign and you can hear swooshing sound during auscultation.
  • foreman ovale
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3
Q

Fetus circulation

TBC

A
  • Mom to baby’s liver via UC
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4
Q

Cardiovascular adaptations

A

When baby takes first breath and the cord is clamped:

  • pulmonary pressure decreases
  • Increase blood flow to lungs
  • Inc oxygen to periphery
  • the high vascular pressure cause inc pressure in the left atrium, the ventricle, and the aorta which shuts the foramen ovale
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5
Q

Explain the cardiovascular assessment

A
  • the normal HR ranges from 110-160bpm. Ranges with activity
  • should auscultate apical pulse instead of umbillical cord pulse. More accurate
  • Concerned for apnea, central cyanosis, pallor, poor feeding
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6
Q

Hematopoietic system changes

A
  • RBC and hemoglobin level are high in fetus but they will dec 2w after birth
  • They have high WBC (leukocytes)
  • they have low platelet levels hence the reason to administer vit K.
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7
Q

Thermoregulation system adaptations

A

Prone to hypothermia

Thermoregulation methods:

  • vasoconstriction
  • acrocyanosis
  • Inc metabolic activity of glucose and O2 by flexing
  • metabolize brown fat

Babies cannot not shiver

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8
Q

What are cold stress symptoms

A

Blood sugar drops so baby develops resp distress, reopening of ductus arteriosus, hyperbilirubinemia, hypoglycemia

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9
Q

Renal changes

A
  • Water loss in first few day causes 5-10% weight loss

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10
Q

GI changes

A

Babies don’t have amylase or lipase. Lipase in human milk helps babies digest fat

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11
Q

Stool changes

A

meconium to transitional stool, to milk stool within first week

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12
Q

Feeding behaviours in newborns

A
  • it’s important to monitor force, frequency, amount, and time of regurgitation
  • Babies can be fussy bc they are uncomfortable
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13
Q

Hepatic system changes

A
  • There is a decrease in the baby’s glucose blood level after birth.
  • There is a risk of hypoglycemia esp in babies with diabetic mothers (we want it to be between 2.5 to 3.0 mmol/L)
  • After day 4, the glucose level stabilizes to 4.0 to 6.0 mmol/L
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14
Q

What Immunoglobins do we pay attention to after birth

A
  • IgG: Crosses placenta for passive immunity
  • IgM: elevated levels is a sign of infection
  • IgA: is passed through breastmilk. It provides baby with a little bit of respiratory and GI infection resistance
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