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BCIT Perinatal Theory One > Module Six > Flashcards

Module Six Flashcards

1
Q

Catecholamines

A

Epinephrine
Norepinephrine
Dopamine

  • Surge in response to birth process and are responsible for inc BP after birth, adaption of energy metabolism, initiation of thermogenesis
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2
Q

Cortisol

A

regulatory hormone that aids in neonates transition, aids in lung maturation, clearance of lung fluid, gut maturation, maturation of glucose metabolic pathways in the liver, maturation of the thyroid axis.

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3
Q

Initiation of Resps triggered by:

A

Chemical, Mechanical, Thermal, Sensory

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4
Q

Chemical Factors

A

Progressive decline in PO2 during labour and a drop in prostaglandin levels that results from clamping the cord

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5
Q

Mechanical

A

Squeezing of chest during vaginal delivery

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6
Q

Thermal

A

Shifts from warm intrauterine environment –> extra stimulates resp center in medulla

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7
Q

Sensory

A

Drying the neonate also stimulates resp center

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8
Q

Key Physiologic Changes

A
  • expansion of lungs with air
  • rapid dec in pulmonary vascular resistance and increase in pulmonary blood flow
  • Initiation of gas exchange across alveolar membrane
  • Pressure gradient changes (dec R side pressure, inc L side pressure)
  • Closure of circulatory shunts (foramen ovale, ductus arteriosus)
  • increase in arterial PO2

Hypoexpansion of lungs hypoxemia, persistent acidosis —> high pulmonary vascular resistance, delayed clearance of lung fluid, persistent R to L shunting

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9
Q

APGAR

A 
A- appearance (colour)
P- pulse (HR)
G- Grimace (reflexes)
A- Activity 
R- Respirations - breathing
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10
Q

Transition Period of Reactivity

A

First, Sleep, Second

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11
Q

First Period of Reactivity

A

Birth –> 30-60min
Quiet Alert State
HR 160-180 bpm settling to 100-120 by 30 mins
Resps irreg, fine crackles
transitory grunting, nasal flaring, chest retractions may be evident

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12
Q

Sleep Period of Reactivity

A

After first period
deep sleep for 60-100 mins
Stabilization- temp regulation, adequate oxygenation, circulation, resps rapid but not laboured

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13
Q

Second Period of Reactivity

A

2-6 hours after birth
lasts 10 mins - several hours
tachycardia, tachypnea, inc muscle tone, skin colour changes, passage of meconium

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14
Q

Skin-to-skin

A

stabilizes resps, thermal regulation, reduces apnea and bradycardia, improve infant state organization and self regulation, reduces stress, facilitates neurodevelopment, accelerated wt gain, decrease pain response, increase incident and duration of breast feeding

Increase self confidence, infant attachment, positive mood/behaviour, increased milk supply

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15
Q

Behavioural tasks of newborn

A

establish regulated behavioural tempo independent of the mother

Processing, storing, organizing multiple stimuli

Establishing a relationship with caregivers and environment

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16
Q

First level organization

A

regulate physiologic function

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17
Q

Second level organization

A

Motor, reduce excessive activity and improve muscletone

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18
Q

Third level organization

A

State regulation, predictable sleep and wake states, able to react to stress

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19
Q

Fourth level organization

A

atten and social reaction, able to attend to visual and auditory stimuli

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20
Q

“Organized”

A
  • regulate physiologic functioning
  • Maintain good tone
  • Modulate states
  • Interact with Environment
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21
Q

State Modulation

A

Ability to transition smoothly between states

22
Q

Deep Sleep (Quiet)

A

Regular breathing, eyes closed, no movement, no spontaneous activity except startles and occasional suck, delayed response to ext stimuli, cannot be easily roused

23
Q

Light Sleep (Active)

A

Breathing irreg, REM, may smile or be fussy, sporadic sucking, short crying sounds, responds to ext stimuli with a startle, will feed without opening eyes

24
Q

Drowsy

A

Breathing irreg, eyes open or close, variable activity level, react to stimuli with delayed responses, usually feeds well- becomes more alert

25
Q

Quiet Alert

A

Breathing reg, eyes open and bright, minimal motor activity, focused attn on any stimuli, optimal for feeding

26
Q

Active Alert

A

Breathing irreg, eyes open but not bright, considerable motor activity, sensitive to unpleasant stimuli

27
Q

Crying

A

irreg breathing, eyes tightly closed, increased motor activity, facial grimaces and colour changes, extremely responsive to unpleasant stimuli, orient to breast for feeding, needs comforting to aid into moving into a more organized state

28
Q

Alerting

A

Eyes widened and brightened, focus on stimuli

Drowsy or Active Alert - Quiet State

29
Q

Visual Response

A

Pupillary Response, focus on faces 8-12 inches away. Complex patterns, human faces, moving objects

Quiet Alert

30
Q

Auditory Response

A

Reaction to a variety of sounds, infant can locate sound if constant

Drowsy, Quiet Alert, Active Alert

31
Q

Habituation

A

Ability to lesson ones response to repeated stimuli

32
Q

Cuddliness

A

Infants response to being held- nestle and work to contour themselves to the caregivers body

33
Q

Consolability

A

Measured when infants have been crying for at least 15 seconds. The ability of infants to bring themselves or be brought to a lower state

34
Q

Self Consoling

A

Hand-mouth movement, sucking on fingers or fist, pay attention to voices or faces around them, changes in position

35
Q

Motor behaviour and activity

A

Spontaneous movements of extremities and body when stimulated vs when left alone

Smooth, rhythmical movements vs jerky

36
Q

Irritability

A

How easily infants are upset by loud noises, handling by caregivers, temperature changes, removal of blankets or clothes

37
Q

Readability

A

The cues infants give through motor behaviour and activity, looking, listening, and behaviour problems.

38
Q

Sensory Threshold

A

Level of tolerance for stimuli within which the infant can respond appropriately

39
Q

Stress Cues

A
  • Irritable
  • Disorganized sleep-wake states
  • Gaze Aversion
  • Frowning
  • Sneezing
  • Finger splaying
  • arching/stiffening
  • yawning
  • hiccoughing
  • Irreg Resps
  • Apnea
  • Inc O2 Req
  • HR Changes
40
Q

Stability Cues

A
  • Smooth Movements
  • Quiet Alert state
  • clear sleep states
  • focused gaze
  • dilated pupils
  • reg resps
  • reg HR
  • Rhythmic sucking
  • reaching or gasping
  • hand to mouth movements
  • can be consoled easily
  • rhythmic, robust crying
41
Q

Developmentally Supportive Care

A

Approach that provides individualized care of infants to maximize neurological development and reduce longterm cognitive behavioural problems

42
Q

Pink

A

Establish and maintain resps

43
Q

Transient Tachypnea of the Newborn

A

Tachypnea and signs of distress in first 1-2h

44
Q

Warm

A

Regulate temp - vulnerable for first 48h. 36.5-37.4

45
Q

thermoregulation

A

balance between heat loss and heat production

46
Q

Sweet

A

maintain BS - establish feeding in 1st few hours, feeding cues. In first few hours, transient dec in BS

47
Q

Organized

A

maintain an optimum state

48
Q

Attached

A

Promote attachment with family

49
Q

Clean

A

Employ infection control strategies

50
Q

Preterm Infant

A

Birth after 20wks- before 37wks

51
Q

Late Preterm Infants

A

34-37wks gest

52
Q

Postterm infant

A

10% of all pregnancies, 14+ days past term

BCIT Perinatal Theory One (4 decks)

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