new born assessment Flashcards
preterm birth risk factors
- smoking
- low SES
- infection
- pre-eclampsia
- previous preterm birth
- maternal older age
- assisted reproduction
- multiple pregnancies
- substance abuse and stress
fetal cardiovascular and respiratory changes when born
Adjustments from intrauterine to extrauterine environment that the infant must make to function as a unique individual
Fetus – gas transfer and nutrition from mother via placenta
Lungs – compressed during delivery, expand at birth → gasp. Also stimulated by handling and temperature change.
Cord cut – cuts off oxygen supply – triggers chemoreceptors in respiratory centre
Pressure changes pulmonary from high to lower, systemic from low to higher causes shunts to close
Stimulation of catecholamines during labour facilitates reabsorption of fluid from lungs
Surfactant is composed of surface-active phospholipids (lecithin & sphingomyelin) which are critical for alveolar stability. Peaks at 35 weeks.
effects of cord clamping
Eliminates placental vascular bed
Systemic pressure ↑ (while pulmonary pressure ↓ with lung expansion)
Pressure on the left side ↑ which forces the foramen ovale (flap) to close
Ductus arteriosis closes 2-15 hours after birth due to ↑ pO2
overcoming resistance for breathing
Resistance of lung tissue: length of airways, expansion of lungs Resistance of thorax: large heart, high diaphragm, protuberant abdomen Obstruction due to mucous, fluid etc. Surface tension in alveoli: surfactant
sensory changes that impact respiration after birth
Mechanical: Ex ‘Thoracic Squeeze’
Chemical: elevation of PCO2, decrease in O2 (cord clamping); prostaglandin (suppresses respiration) decreases when cord clamped)
Thermal: change in intra-uterine to ambient external temperatures (Convection, radiation, evaporation, conduction)
Sensory: light, visual, auditory, gravity, tactile, painful
vital signs and normals
term gestation text; 38-42
AHS; 37-42
temperature text; 36.5-37.5
AHS; 36.3-37.2
