Neonate Transition

Question 0

What is the initiation of breathing

Answer 0

Pulmonary ventilation must be established through lung expansion following birth

A marked increase in the pulmonary circulation must occur

The first breath of life – the gasp in response to mechanical and reabsorptive, chemical, thermal, and sensory changes associated with birth

Question 1

Normal respiration in NeoNates

Answer 1

30 to 60 breaths/min

Question 2

3 Factors opposing the first breath

Answer 2

• Alveolar surface tension, the presence of surfactants
• the viscosity of lung fluid within the respiratory tract
• lung compliance

Question 3

Explain the APGAR scoring

Answer 3

Assessment done within one min and five minute after birth to evaluate the physical condition of the newborn. If the score is less than 7 after 5 min then it is repeated up to 20 min.
Heart rate
Respiratory effort
Muscle Tone
Reflex irritability
Color

Question 4

How does newborn lose body heat

Answer 4

Convection -loss of heat from the warm body surface to the cooler air currents
Radiation - losses occur when heat transfers from the heated body surface to cooler surfaces and objects not in direct contact with the body. (walls of room or incubator)

Evaporation - loss of heat incurred when water is converted to vapor.

Conduction - loss of heat to a cooler surface by direct skin contact. (chilled hands, stethescope, cold scales)

After drying the newborn, major heat loss are from radiation and convection because of the newborn’s large body surface area compared to its weight.

Question 5

How does a newborn produce heat?

Answer 5

-Basal metabolic rate, muscular activity and chemical thermogenesis (NST)

NST is the mechanism in which the body metabolizes the store of brown adipose tissue to provide heat to the peripheral circulation

appears about 26 to 30 weeks

Question 6

Explain iron storage and RBC production

Answer 6

• iron is stored for the first 5 month
• newborn irons stores are determined by total body hemoglobin content and length of gestation
• After 6 month, food containing iron must be taken to prevent anemia

Question 7

What are the transition of stools for a neonate

Answer 7

-meconium, which is thick, tarry black or green are passed within 8 to 24hours after birth.

The transitional which is (thin brown to green) stools are passed for 48 to 72 hours.

Breast fed stools - pale yellow, liquid and can be once every 5 to 7 days

Question 8

Describe the characteristics of newborn urinary function

Answer 8

93% voids within the first 24 hour
occasionally pink stains (brick dust spots) may appear, caused by urates.
Blood on female diapers are called pseudomentruation. Related to withdrawal of maternal hormones

Question 9

Basic reflexes of neonates

Answer 9

sucking
grasping
rooting
stepping
babinski
moro

Question 10

Signs of Newborn distress

Answer 10

• Increased respiratory rate (over 60)
• sternal retraction
• nasal flaring
• grunting
• excessive mucous
• facial grimacing
• cyanosis (central - skin - lips)
• abdominal distention, mass
• vomiting of bile stained material
• absence of meconium within 24hours
• absence of urine within 24 hour
• temperature instability
• jitterness or low blood glucose levels