neonate

Question 0

Explore the initiation of breathing and the opposing factors

Answer 0

Initiation of breathing is caused by birth and the sudden change in temperature and environment

Opposing Factors

1. Alveolar surface tension, the presence of surfactant
2. viscosity of lung fluid within the respiratory tract
3. degree of lung compliance

Question 1

Understand the five circulatory structure that are involved with the fetus and what circulatory changes are made from fetus to neonate

Answer 1

1. increased aortic pressure and decreased venous pressure
2. increased systemic pressure and decreased pulmonary artery pressure
3. closure of the foramen ovale
4. Closure of the ductus arteriosus
5. closure of the ductus venosus

Question 2

Identify and explain the five areas of apgar scoring

Answer 2

Breathing effort - not breathing(0), slow (1) cries (2)
Heart rate - no hr(0), HR < 100 (1), HR >100 (2)
Muscle tone - loose (0), some (1), active (2)
Grimace response or reflex - no reflex (0), some grimace (1), lots (2)
skin color - blue (0), body pink, blue extremities (1), all pink (2)

Question 3

Describe how newborns lose body heat and produce heat

Answer 3

Losing body heat

• convection (air con)
• radiation (putting something warm on cold)
• evaporation (bath)
• conduction (cold hands onto a warm)
• major heat loss is radiation and convection

Heat production

• muscular activity
• NST is a metabolizing the newborn’s store brown adipose tissue to provide heat

Question 4

Describe the initial physical assessment of the neonate

Answer 4

Baby is place in a radiant warmer for initial assessment involving the APGAR score one and five minute

• head(fontanelles, sutures, hair)
• face
• skin (lanugo, stork bite, milia, mongolian spots)
• neck (turner syndrome)
• body
• extremities
• hands and feet
• genitals (labia majora covering)
• spine (spina bifida)

Question 5

Explain iron storage and RBC production

Answer 5

iron is stored for the first 5 months, after that supplement or food containing iron are given to prevent anemia

Question 6

Explain transition of stool and describe the characteristics of urinary functions

Answer 6

Meconium - thick, tarry black or green (passed usually 8 to 24h)
Transition - thin brown to green (48 to 72hour)
If breast fed can be pale or liquid. Can be once every 5 to 7 days

• first void q24h
• pink stains (brick dust spots) may appear in male diapers caused by urates
• blood on female diapers (pseudomenstration)

Question 7

Basic reflex of newborn

Answer 7

sucking
grasping
steping
moro (startled)
rooting
babinski

Question 8

Signs of newborn distress

Answer 8

increased resp rate
sternal retraction
nasal flaring
grunting
excessive mucous
grimacing
cyanosis
abd distention
vomiting
absence of urine and stool within 24h
temp instability 
jitteriness