ob chapter 26 Flashcards
What is the most critical priority for a newborn after birth?
Initiation and maintenance of respirations.
Why is establishing respirations immediately after birth essential?
Respiratory acidosis can develop rapidly, leading to cerebral hypoxia and long-term neurologic damage.
What happens if respiratory activity does not begin immediately?
Acidosis increases, and the newborn’s defense mechanisms become inadequate to reverse it. By 2 minutes, severe acidosis is already developing.
What is the second major priority for newborns?
Establishment of extrauterine circulation.
What must be maintained to support newborn adaptation to life?
Fluid and electrolyte balance.
Why is controlling body temperature important for newborns?
Newborns are at risk for hypothermia, which can lead to cold stress and metabolic complications.
What is required to support newborn growth and development?
Intake of adequate nutrition.
What must be established for waste elimination?
Effective voiding and stooling patterns.
How can infections be prevented in newborns?
Hand hygiene, sterile procedures, and early vaccination (e.g., Hepatitis B).
What emotional need is a priority for newborns?
Establishment of a newborn–parent/caregiver relationship.
How does low birth weight affect respiratory function?
It increases the risk of respiratory distress due to immature lungs.
How does intrauterine growth restriction (IUGR) affect respiration?
It may lead to underdeveloped lung structures.
Why does maternal diabetes increase the risk of respiratory issues?
It can cause delayed lung maturation in the newborn.
How does premature rupture of membranes (PROM) contribute to respiratory distress?
It increases the risk of infection and lung immaturity.
Why does maternal use of barbiturates or narcotics close to birth impact respiration?
These drugs can cause respiratory depression in the newborn.
What does meconium staining indicate in relation to newborn respiration?
It suggests potential aspiration, which can block airways and cause respiratory distress.
How do irregularities detected on the fetal heart monitor relate to respiratory difficulty?
They may indicate fetal distress and hypoxia before birth.
What risk does cord prolapse pose to a newborn’s respiration?
It can cause oxygen deprivation due to impaired blood flow.
Why is a low Apgar score (<7 at 1 or 5 minutes) concerning?
It suggests possible respiratory or circulatory compromise.
How does postmaturity (postterm birth) affect lung function?
It may lead to meconium aspiration or placental insufficiency affecting oxygen supply.
Why are small-for-gestational-age (SGA) infants at risk for respiratory issues?
They may have underdeveloped lungs and insufficient fat stores to regulate temperature.
How does a breech birth impact respiration?
It increases the risk of airway obstruction or aspiration.
Why does multiple birth increase respiratory distress risk?
It is often associated with preterm birth and underdeveloped lungs.
What are the three initial steps in newborn resuscitation?
(a) Establish an airway, (b) Expand the lungs, and (c) Initiate and maintain effective ventilation.
What should be done if a newborn’s heart rate falls below 60 bpm despite effective ventilation?
Chest compressions should be started.
What additional step is taken if the heart rate remains inadequate (<60 bpm) even with ventilation and chest compressions?
Epinephrine 1:10,000 should be administered intravenously to stimulate heart action.
Narcan (Naloxone)
Reverses the effects of narcotics if maternal opioid use has caused newborn respiratory depression.
Epinephrine
Stimulates heart action if the newborn’s heart rate remains <60 bpm despite ventilation and chest compressions.
Surfactant
Given to preterm newborns to replace the natural surfactant that has not yet formed in their lungs, helping improve lung function.
What causes Respiratory Distress Syndrome (RDS)?
A low level or absence of surfactant, leading to alveolar collapse.
What is the role of surfactant in the lungs?
It reduces surface tension to keep alveoli open during expiration.
Why are preterm newborns at high risk for RDS?
Surfactant does not form until the 34th week of gestation.
What percentage of low-birth-weight (LBW) infants develop RDS?
About 30%.
What percentage of very low-birth-weight (VLBW) infants develop RDS?
About 50%.
Does RDS occur in full-term newborns?
Rarely, as they usually have adequate surfactant.
What happens to body temperature in RDS?
It may be low.
What nasal sign indicates RDS?
Nasal flaring.
What chest movements suggest respiratory distress?
Sternal and subcostal retractions.
What respiratory rate indicates tachypnea in newborns?
More than 60 breaths per minute.
What mucous membrane sign suggests hypoxia?
Cyanosis.
What is the primary treatment for RDS?
Surfactant replacement therapy.
What supportive therapy is provided for RDS?
Oxygen administration.
