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Year 2 Child Health Care > Perinatal adaptions > Flashcards

Perinatal adaptions Flashcards

1
Q

What is the function of the placenta?

A 
Fetal homeostasis
Gas change
Nutrient and IgG transports
Waste product removal
Maintains acid base balance 
Produces hormones
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2
Q

What three shunts can be found within foetal circulation?

A

Foramen ovale
Ductus arteriosus
Ductus Venosus

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3
Q

What is the function of the foramen oval?

A

Allows oxygenated blood from the IVC to pass through the right atria into the lef.

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4
Q

What is the ductus arteriosus?

A

A shunt allowing blood from the pulmonary arteries to pass into the arch of the aorta

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5
Q

What is the ductus venosus?

A

A direct shunt between the umbilical vein and the IVC

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6
Q

What happens to the ductus venosus?

A

Becomes the ligamentum terres when it closes

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7
Q

What happens to the ductus arteriosus?

A

Closes and becomes the ligamentum arteriosus

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8
Q

What happens to the foramen ovale and why does this happen?

A

Closes as systemic pressure becomes higher than pulmonary.

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9
Q

What circulatory changes occur when the first breath occurs?

A

Pulmonary vascular resistance drops while systemic rises

Oxygen tension increases and PDE4 levels drop

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10
Q

What is PDE4 ?

A

The prostaglandin responsible for maintaining a patent ductus arteriosus

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11
Q

What can be administered to close the ductus arteriosus?

A

Indomethican or ibuprofen (NSAIDS)

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12
Q

What does the foetus do to prepare for birth?

A

Synthesis of surfactant and reduce the production of lung fluid.
Production of brown and subcutaneous fat
Swallos amniotic fluid

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13
Q

Where is brown fat located?

A

In between the scapulae and surrounding internal organs

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14
Q

What during labour occurs to the baby?

A

Increased maternal and foetal catelchoamines and cortisol

Vaginal delivery squeezes the lungs

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15
Q

What is PPHN?

A

Persistant Pulmonary Hypertension of the Newborn

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16
Q

What happens as a result of PPHN?

A

Foramen ovale and ductus arteriosus remain patent, as a result the pO2 of the systemic blood is low.

17
Q

What clinical sign for PPHN can be discovered using an oxygen saturation monitor?

A

The right hand will have a higher O2 sat than the left arm or leg.

18
Q

What is the treatment for PPHN?

A 
Nitric oxide
Ventilation
Oxygen
Sedation
Inotropes 
ECLS
19
Q

What is ECLS

A

Extracorpeal Membrane oxygenation

20
Q

What does NO do in PPN?

A

Acts on the bronchial smooth muscles causing relaxation and reducing the pulmonary vascular resistance.

21
Q

Why do babies struggle to self thermoregulate?

A 
They are unable to shiver
Have a large SA:VOL ratio
Loose heat through Cond Conv Radia Evap
Very little subcutaneous fat
Little to no hair
22
Q

How do babies regulate their body temperature?

A

Brown fat stores undergo lipolysis which produces heat, however this is ineffective during the first day

23
Q

What is the dangers associated with hypothermia?

A

It predisposes to many other issues

24
Q

What is the ideal body temperature for a baby?

A

36.5 degress

25
Q

What steps should be taken to keep a baby warm?

A

Hat, dry, skin to skin, blanket , warm mattress , incubator

26
Q

Why are babies at risk of hypoglycaemia ?

A

They have been use to a constant infusion of glucose via the placenta now they are on bolus loads via milk.

27
Q

How are babies able to regulate glucose?

A

Very little glucose within the milk, low insulin levels an higher glucagon levels.
Metabolic liver glycogen stores and use ketones for the brain.

28
Q

What are the three common causes of hypoglycaemia in a baby?

A

Increased energy demand- Infection or hypothermia
Low glycogen stores - Small or preterm
Inappropriate insulin levels - gestational or maternal diabetes

29
Q

What hormones leas to milk ejection?

A

Oxytocin

30
Q

What hormone leads to increased milk production?

A

Prolactin

31
Q

Where does haematopoeisis move to once born?

A

From the liver to the bone marrow

Year 2 Child Health Care (5 decks)

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