Neonatal

Question 1

describe the placenta’s role

Answer 1

supplies fetus with O2 and nutrients and carries away waste

2 arteries and 1 vein

Question 2

describe roles of arteries and vein of placenta

Answer 2

arteries-carry deoxygenated blood and waste away from fetus

vein-oxygenated blood and nutrients to fetus

Question 3

describe hemoglobin in fetal blood

Answer 3

50% greater than in maternal blood

fetal can carry 20-30% more O2 than maternal hemoglobin

Question 4

steps of fetal circulation

Answer 4

umbilical vein
ductus venosus (vein to vein)
right atrium
foramen ovale
left atrium
left ventricle
ductus arterosis (artery to artery)
aorta/umbilical arteries
placenta

Question 5

what causes important changes in circulatory system

Answer 5

initial inflation of lungs during delivery

Question 6

as baby begins to breathe after delivery…

Answer 6

blood flow to lungs increase, pressure in right heart decrease and foramen ovale closes

Question 7

crying too much in first few days…

Answer 7

can reverse blood flow through foramen ovale causing transient cyanosis

Question 8

when does the ductus arteriosis close off

Answer 8

within 1-2 days after birth

Question 9

what is PDA or patent

Answer 9

if DA doesn’t completely close

serious defect if elevation in pulmonary pressure

Question 10

what can PDA lead to

Answer 10

irreversible degenerative changes in heart and lungs

Question 11

how much of fetal lung fluid is removed during labor and birth

Answer 11

2/3

Question 12

s/s of cardiac problems

Answer 12

tachy, brady, color

Question 13

this is to overcome surface tension of alveoli

Answer 13

inspiration

Question 14

the ability to retain air is dependent on surfactant

Answer 14

expiration

Question 15

describe surfactant

Answer 15

• slippery lipoprotein
• decrease surface tension in alveoli
• alveoli would collapse without surfactant and increase neonatal workload

Question 16

when is surfactant produced

Answer 16

34-36 wks gestation

Question 17

onset of breathing affected by

Answer 17

1) sensory stimuli aka cold, light
2) chemical stimuli aka acidosis
3) mechanical gasp reflex caused by elastic recoil of thorax

Question 18

signs of respiratory distress

Answer 18

nasal flaring
intercostal or subcostal retractions
grunting

Question 19

when should infant void by

Answer 19

within 24 hrs of life (98% void within 30 hrs of life)

Question 20

what is renal impairment

Answer 20

if newborn has not voided within 48 hrs of life

Question 21

kernicterus

Answer 21

bilirubin >21 mg/dl

Question 22

s/s of reproductive problems in neonates

Answer 22

ambiguous genitalia

hypospadias (urethra opening in inappropriate place)

Question 23

integumentary system possibilities on neonates

Answer 23

vernix caseosa (white)
mongolian spots
sweat glands
nevi (stork bite)
erythema toxicum

Question 24

wake/sleep cycles

Answer 24

deep sleep, light sleep, drowsy, quiet alert

Question 25

s/s of skeletal problems

Answer 25

molding
caput succedaneum (cap over whole head)
cephalhematoma (one protruding area on head/bleeding)
fractured clavicle
dysplasia of the hip (asymmetrical knee height)

Question 26

loss of heat to environment

occurs as air currents move over infant

Answer 26

convection

Question 27

transfer of heat between 2 objects in the environment that are not in direct contact with each other

Answer 27

radiation

Question 28

transfer of heat from one to another when they are in direct contact

Answer 28

conduction

Question 29

loss of heat from evaporation of water on skin

transdermal water losses

Answer 29

evaporation

Question 30

how to keep baby warm

Answer 30

dry baby immediately after born, wrap, put on hat

skin to skin with mom

Question 31

what occurs to conserve core temp

Answer 31

peripheral vasoconstriction (acronyanosis)

Question 32

cold stress effects

Answer 32

increase in O2 consumption
increase in glucose utilization
increase in acid production

Question 33

what does increased glucose utilization lead to

Answer 33

hypoglycemia

Question 34

what does increased O2 consumption lead to

Answer 34

hypoxia and impaired cellular function if not corrected

Question 35

describe brown fat

Answer 35

richer vascular and nerve supply than normal fat
present several weeks after birth
the less mature the neonate, the lower reserve of brown fat

Question 36

reserves of brown fat….

Answer 36

are depleted with cold stress

Question 37

describe infant thermoregulation

Answer 37

immature hypothalamus
less insulin and less subqut fat
non shivering thermogenesis (metabolism of brown fat)

Question 38

when does the transitional period occur

Answer 38

0-30 min after birth

alert, sensory, decrease in temp, increase in HR and resp.

Question 39

what sensory is not developed in infant until many months later

Answer 39

accommodation

Question 40

what are the second and third periods after birth

Answer 40

2) period of decreased responsiveness (60 min to 100 hrs of age)
3) second period of reactivity (208 hrs of age)