OB Class 4 Flashcards
sufficient surfactant is produced at….. and is used for…..
produced at 24-26weeks
used to keep alveoli open
why is the infant’s first breath at birth important
it must force the remaining fetal lung fluid out of the alveoli and into the interstitial spaces to allow air to enter the lungs
as the infant cries, the pressure w/in the lungs increases causing remaining fetal lung fluid to move into the interstitial spaces where it is absorbed by …. and ….. within 24hrs
absorbed by pulmonary circulatory and lymphatic systems
***within 24hrs
chemical factors that initiate breathing
chemoreceptors in the carotid arteries ad aorta sense a decreases in oxygen and increase in carbon dioxide lead to breathing
mechanical mechanism in initiating breathing
during vaginal birth the fetal chest is compressed by the birth canal leading to a recoil of the chest that draws air into the lungs
thermal mechanism that initiates breathing
temperature change
sensory mechanism that initiates breathing
tactile stimuli: sound, light, smell, pain
list newborn characteristics leading to heat loss
skin is thin
blood vessels are close to surface
there is little subQ (white) fat to provide a barrier to loss of heat
evaporation
air-drying of the skin that results in cooling
insensible water loss
conduction
movement of heat away from the body
:coming in contact with cold scale surface, cold steth
convection
transfer of heat from the infant to cooler surrounding air
radiation
transfer of heat to cooler objects that are not in direct contact with the infants
non-shivering thermogenesis
metabolism of brown fat to produce heat
:blood passes thru brown fat, is warmed and then carries heat to the rest of body
metabolizes brown fat
norepinephrine
how to assess jaundice
pressing over firm surface and observe if it blanches yellow
primary source of bilirubin in newborn
hemolysis of erythrocytes
what changes unconjugated bilirubin into conjugated form
liver
- **bilirubin is released in unconjugated form which gets absorbed into subQ fat: jaundice
- **liver must change unconjugated bilirubin to conjugated in order for it to be water soluble and excreted
what is kernicterus
bilirubin toxicity leading to permanent neurological injury
what is physiologic jaundice
caused by transient hyperbilirubinemia
considered normal
appears 2-3 days after birth
nonphysiologic/ pathologic jaundice
occurs w/in 24hrs of birth
result of abnormalities causing excessive destruction of RBCs or problems with bilirubin conjugation
**has a pathologic reason behind it
**treated with photo therapy
breastfeeding jaundice
not enough colostrum which is a laxative to eliminate bilirubin rich meconium
begins within first week of life
feedings encouraged 8-12 every 24hrs
acid base balance of newborn
tend to lose bicarb at lower levels and decreased ability to absorb it in kidneys leading to metabolic acidosis
why is the first period of reactivity the best time to begin breastfeeding
infant is wide awake, alert, and seems interested in their enviroment
they ted to latch and suck better
normal values for vitals temp HR RR BP Cap Refill
temp: 97.7- 99.6 HR: 120-160 RR: 30-60 BP: 65-96/ 30-60 Cap Refill: 3-4sec
