Newborn Transition & Care: 9 DONE

Question 1

Cardiovascular

what happens to pulmonary resistance in vessels?

Increased?

When does foramne ovale close?

When does Patent ductus arteriosus close?
Closes in response to?

Permanent closure?
Reopens due to?

Answer 1

1. Pulmonary resistance in vessels drops and allows for greater blood flow and gas exchange
2. Increased pressure & blood flow from left side of the heart
3. Functional closure of the foramen ovale at birth
4. Patent ductus arteriosus functionally closes within 24 hours

Closes in response to increased O2 and prostaglandin E

Permanent closure 3-4 weeks
Reopens due to hypoxia

Question 2

Glucose metabolism

When does initial drop in newborn glucose occur?

what levels increase and what levels decrease?

Key to stabalization?

Glucose levels stabilize by?

Answer 2

Initial drop in newborn glucose occurs 30-90 minutes after birth

Glucagon levels increase and insulin levels decrease as liver begins to regulate blood glucose

Newborn has limited glycogen/fat stores

Initiation of newborn feedings key to stabilization

Glucose levels stabilize by 2-3 day of life

Question 3

Hematologic

Babies are born with?
Rapid break down of what leads to what?
Releases?
Natural laxative?

Answer 3

Babies are born with alot of RBC, but their bodies break it down extra quickly.

Rapid breakdown of excess red blood cells!!!!!! leads to jaundice!!!!!

Releases bilirubin which is broken down by liver and bacteria in the duodenum.

Colostrum is a natural laxative which helps get rid of bilirubin

Bilirubin is excreted in urine and stool
Dependent on PO intake and passage of meconium

Peaks 72-96 hours after birth
Decreases to normal by day 14 day

Question 4

APGAR Score

What are the 5 things assessed?

What gets a score of 1?

Answer 4

Heart rate
Respiratory effort
Muscle tone
Reflex Irritability
Color

-slow, <100
-slow, weak cry
-Some flexion of extremities
-Grimace
-Body pink, extremities blue (acrocyanosis)

Question 5

Vital Signs

Temp?
Resp rate?
Heart rate?

Answer 5

Temp - 97.5-98.6

Resp rate - 30-60

Heart rate - 110-160

B/P not routine (only assessed if suspicion or known cardiac issues)

Question 6

Skin to skin

Benefits

Answer 6

Maintains neutral thermal environment

Bonding
Stimulates feeding
Builds immunity
Decreases stress

Question 6

Thermoregulation

Methods of heat loss? 4

Answer 6

1. Convection – air movement – heat lost to cooler air
2. Radiation – heat loss to cooler surface not in direct contact
3. Evaporation – moisture vaporization from the skin, thin skin
4. Conduction – heat lost to cooler surface directly in contact with newborn

Question 7

Gestational Age Assessment

How does scoring work?

Answer 7

Ballard Score

*6 physical measures

*6 neuromuscular measures

*Higher score= higher gestational age!!!!