Neonatal Flashcards
describe the placenta’s role
supplies fetus with O2 and nutrients and carries away waste
2 arteries and 1 vein
describe roles of arteries and vein of placenta
arteries-carry deoxygenated blood and waste away from fetus
vein-oxygenated blood and nutrients to fetus
describe hemoglobin in fetal blood
50% greater than in maternal blood
fetal can carry 20-30% more O2 than maternal hemoglobin
steps of fetal circulation
umbilical vein ductus venosus (vein to vein) right atrium foramen ovale left atrium left ventricle ductus arterosis (artery to artery) aorta/umbilical arteries placenta
what causes important changes in circulatory system
initial inflation of lungs during delivery
as baby begins to breathe after delivery…
blood flow to lungs increase, pressure in right heart decrease and foramen ovale closes
crying too much in first few days…
can reverse blood flow through foramen ovale causing transient cyanosis
when does the ductus arteriosis close off
within 1-2 days after birth
what is PDA or patent
if DA doesn’t completely close
serious defect if elevation in pulmonary pressure
what can PDA lead to
irreversible degenerative changes in heart and lungs
how much of fetal lung fluid is removed during labor and birth
2/3
s/s of cardiac problems
tachy, brady, color
this is to overcome surface tension of alveoli
inspiration
the ability to retain air is dependent on surfactant
expiration
describe surfactant
- slippery lipoprotein
- decrease surface tension in alveoli
- alveoli would collapse without surfactant and increase neonatal workload
when is surfactant produced
34-36 wks gestation
onset of breathing affected by
1) sensory stimuli aka cold, light
2) chemical stimuli aka acidosis
3) mechanical gasp reflex caused by elastic recoil of thorax
signs of respiratory distress
nasal flaring
intercostal or subcostal retractions
grunting
when should infant void by
within 24 hrs of life (98% void within 30 hrs of life)
what is renal impairment
if newborn has not voided within 48 hrs of life
kernicterus
bilirubin >21 mg/dl
s/s of reproductive problems in neonates
ambiguous genitalia
hypospadias (urethra opening in inappropriate place)
integumentary system possibilities on neonates
vernix caseosa (white) mongolian spots sweat glands nevi (stork bite) erythema toxicum
wake/sleep cycles
deep sleep, light sleep, drowsy, quiet alert
s/s of skeletal problems
molding
caput succedaneum (cap over whole head)
cephalhematoma (one protruding area on head/bleeding)
fractured clavicle
dysplasia of the hip (asymmetrical knee height)
loss of heat to environment
occurs as air currents move over infant
convection
transfer of heat between 2 objects in the environment that are not in direct contact with each other
radiation
transfer of heat from one to another when they are in direct contact
conduction
loss of heat from evaporation of water on skin
transdermal water losses
evaporation
how to keep baby warm
dry baby immediately after born, wrap, put on hat
skin to skin with mom
what occurs to conserve core temp
peripheral vasoconstriction (acronyanosis)
cold stress effects
increase in O2 consumption
increase in glucose utilization
increase in acid production
what does increased glucose utilization lead to
hypoglycemia
what does increased O2 consumption lead to
hypoxia and impaired cellular function if not corrected
describe brown fat
richer vascular and nerve supply than normal fat
present several weeks after birth
the less mature the neonate, the lower reserve of brown fat
reserves of brown fat….
are depleted with cold stress
describe infant thermoregulation
immature hypothalamus
less insulin and less subqut fat
non shivering thermogenesis (metabolism of brown fat)
when does the transitional period occur
0-30 min after birth
alert, sensory, decrease in temp, increase in HR and resp.
what sensory is not developed in infant until many months later
accommodation
what are the second and third periods after birth
2) period of decreased responsiveness (60 min to 100 hrs of age)
3) second period of reactivity (208 hrs of age)
