Newborn Flashcards
What is the neonatal period?
First 28 days
Switch from fetal to newborn circulation
from Placental to pulmonary gas exchange
what does a successful transition from fetal to newborn circulation require?
Increased pulmonary flow, removal of placenta, closure of foramen ovale, ductus venosus, & ductus arteriosus
How does the foramen ovale close?
Pressures in the left atrium are greater than the right after birth.
how do umbilical vessels close?
shifts in pressure in the heart and lungs.
Circulatory changes in newborn
umbilical cord is clamped. First breath is taken & lungs begin to function. There is a rapid decrease in pulmonary vascular resistance and an increase in pulmonary blood flow.
Newborn normal heart rate
110-160’s decreases to 120-130 bpm
T or F: Murmurs are usually benign
True
Most Crucial Adaptation for the newborn
Respiratory
What does surfactant do on inspiration in a newborn?
Prevents atelectasis and facilitates elastic recoil
What are the signs of respiratory distress?
Cyanosis, tachypnea, expiratory grunting, sternal retractions, and nasal flaring.
What is the temperature range for a newborn?
97.9F-99.7F (36.6C-37.6C)
Newborn characteristics that make them prone to heat loss
- Thin skin with blood vessels close to the surface
- Increased skin permeability to water
- Lack of shivering till 3 months
- Limited metabolic substrates (glucose, glycogen, fat)
- Limited use of movement to produce heat
- Large surface area to body mass ratio
Convection heat loss & nursing action
flow of heat from the body to cooler
ambient air-wrap the baby
Radiation heat loss & nursing action
loss of heat from body surface to a cooler
solid surface not in direct contact but in close
proximity-drafty window
Evaporation heat loss & nursing action
loss of heat when liquid evaporates-dry
infant well
Conduction heat loss & nursing action
Loss of heat from body surface to cooler
surfaces in direct contact-pre warm the infant warmer
The newborn attempts to conserve heat and increase heat production by
non-shivering thermogenesis of brown fat
What is non-shivering thermogenesis
a process in which brown fat (adipose tissue) is oxidized in response to cold exposure.
What is cold stress?
Excessive heat loss that requires a newborn to use compensatory mechanisms (such as nonshivering thermogenesis and tachypnea) to maintain core body temperature
How to prevent cold stress?
*Pre-warming blankets and hats
*Drying the newborn completely after birth
*Encouraging skin-to-skin contact with the mother if the newborn is stable
*Promoting early breastfeeding to provide fuels for nonshivering thermogenesis
*Using heated and humidified oxygen
*Deferring bathing until the newborn is medically stable
Hepatic
newborn’s liver slowly assumes functions of the placenta during fetal life
Iron Storage
if mother’s intake of iron was adequate, iron has been stored in newborn’s liver until 6 mo of age.
how does hepatic function differ from the adult?
Fetal circulation less efficient at O2 exchange; so fetus needs
additional RBC;s for transport of O2 in utero; therefore, the
levels of RBCs, hemoglobin, and hematocrit are higher than
those in the adult.