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NURS 320 - Exam 3 > Physiologic Responses of the Newborn at Birth > Flashcards

Physiologic Responses of the Newborn at Birth Flashcards

1
Q

When is the newborn period?

A

Birth - 28 days

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2
Q

Describe the transition from neonatal to newborn period (2)

A
  • Adjustment to extrauterine life
  • Stabilization of respiratory / circulatory systems
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3
Q

Skin thermoreceptors transmit sensations to the ______ thermoregulatory center

A

Hypothalamic

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4
Q

What is the optimal body temperature range for a newborn?

A

36.5 - 37.5 °C

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5
Q

What is the required environmental temperature for an unclothed, full-term newborn?

A

89.6 - 93.2 °F

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6
Q

Describe the characteristics of the newborn that contribute to thermoregulation (3)

A
  • Decreased subcutaneous fat / thin epidermis
  • Blood vessels closer to the skin surface (more susceptible to temperature changes)
  • Flexed posture (reduced heat loss)
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7
Q

What does a newborn temperature of 36.5 - 36.0 °C indicate?

A

Cold stress - cause for concern

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8
Q

What does a newborn temperature of 36.0 - 32.0 °C indicate?

A

Moderate hypothermia - danger, must warm baby

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9
Q

What does a newborn temperature of < 32.0 °C indicate?

A

Severe hypothermia - urgent, risk of brain damage

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10
Q

What are the effects of cold stress in a newborn? (4)

A
  • Increased basal metabolic rate –> hypoglycemia
  • Increased anaerobic metabolism –> hyperbilirubinemia
  • Decreased surfactant production –> respiratory distress
  • Release of norepinephrine
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11
Q

What are the manifestations of cold stress in a newborn? (5)

A
  • Apnea
  • Irritability
  • Lethargy
  • Tremors
  • Seizures
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12
Q

Describe the nursing interventions associated with cold stress in a newborn (3)

A
  • Heel stick for hypoglycemia
  • Increase environmental temperature (1 - 1.5 °C above body temperature)
  • Warm IV fluids prior to infusion
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13
Q

How often should skin temperature be monitored in a newborn experiencing cold stress?

A

Q 15 - 30 minutes

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14
Q

Describe the method used to increase environmental temperature for an infant experiencing cold stress

A

Warm slowly in hourly increments

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15
Q

What can occur as a result of warming an infant’s body temperature too rapidly? (2)

A
  • Hypotension
  • Apnea
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16
Q

Which type of heat loss are newborns most susceptible to?

A

Evaporation heat loss

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17
Q

When does evaporation heat loss occur?

A

Immediately after birth

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18
Q

Describe evaporation heat loss

A

Water converted into vapor

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19
Q

What are some examples of evaporation heat loss? (2)

A
  • Wet skin after birth
  • Wet skin after baths
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20
Q

Describe prevention of evaporation heat loss (2)

A
  • Dry infant thoroughly after birth
  • Place knit cap over wet hair
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21
Q

Describe convection heat loss

A

Warm skin surface to cool air currents

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22
Q

What are some examples of convection heat loss? (2)

A
  • Air vent drafts
  • O2 masks
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23
Q

Describe prevention of convection heat loss (2)

A
  • Place infant under warmer
  • Avoid air currents
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24
Q

Describe conduction heat loss

A

Warm skin surface to cool surface - DIRECT contact

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25
Q

What are some examples of conduction heat loss? (3)

A
  • Cold hands
  • Cold scales
  • Cold stethoscopes
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26
Q

Describe prevention of conduction heat loss (2)

A
  • Place a towel between infant and cold surfaces
  • Warm stethoscope prior to use
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27
Q

Describe radiation heat loss

A

Warm skin surface to cool surface - INDIRECT contact

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28
Q

What is an example of radiation heat loss?

A

Cold nearby walls / windows

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29
Q

Describe prevention of radiation heat loss

A

Place bassinet along inside walls

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30
Q

Describe the method used for oral pharyngeal suctioning (bulb suctioning)

A

Suction mucus from mouth FIRST, then nose

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31
Q

Describe the primary nursing consideration associated with wall suctioning / DeLee catheter

A

Produces vagal response - slows HR (risk of bradycardia)

32
Q

______ MUST function immediately after birth

33
Q

The first breath / gasp initiates …

A

Opening of alveoli - transition from fluid filled lungs to air filled lungs

34
Q

Describe rebound expansion of the thorax at birth (3)

A
  • Lung fluid is removed through chest compression at birth
  • Chest recoils causing passive inspiration
  • Lungs expand causing increased alveolar volume / movement of lung fluid
35
Q

How much lung fluid is absorbed within 2 hours of birth?

36
Q

How much lung fluid is absorbed within 24 hours of birth?

A

100% - bowel movement within first 24 hours to excrete remaining fluid

37
Q

What is the RR of a newborn within the first 2 hours after birth?

38
Q

What is the normal RR of a newborn?

39
Q

Describe the normal breathing pattern of a newborn

A

Breathing may periodically pause for 5 - 15 seconds with no change in color / HR

40
Q

A breathing pause of ______ indicates apnea

A

> 20 seconds

41
Q

What other signs may be associated with apnea in an infant? (2)

A
  • Skin color changes
  • Bradycardia
42
Q

Decreased peripheral circulation results in ______

A

Acrocyanosis

43
Q

Describe acrocyanosis (2)

A
  • Normally transient (lasting 2 - 4 hours)
  • -1 on Apgar score
44
Q

When is the foramen ovale functionally closed?

A

1 - 2 hours after birth

45
Q

What factors can cause the foramen ovale to remain open resulting in a murmur? (2)

A
  • Cold stress
  • Hypoxia
46
Q

What is the expected apical pulse for a newborn?

A

120 - 150 BPM

47
Q

What is the expected apical pulse for a newborn when sleeping?

48
Q

What is the expected apical pulse for a newborn when crying?

49
Q

What is the expected BP for a newborn?

50
Q

A systolic BP of ______ in a newborn should be reported

51
Q

A diastolic BP of ______ in a newborn should be reported

52
Q

Describe the initial weight loss of a newborn after birth

A

Normally lose 5 - 10% of birth weight within first 5 - 10 days

53
Q

Describe the importance of burping a newborn within the first few days after birth

A

Cardiac sphincter immature - risk of regurgitation

54
Q

What is the normal intake for an infant at 1 day old?

55
Q

What is the normal intake for an infant at 3 days old?

A

22 - 27 mL

56
Q

What is the normal intake for an infant at 1 week old?

A

45 - 60 mL

57
Q

What is the normal intake for an infant at 2 weeks old?

A

60 - 150 mL

58
Q

How often should an infant receive formula feeding?

A

Q 3 - 4 hours

59
Q

How often should an infant receive breastfeeding?

60
Q

Bilous, continuous vomiting in a newborn is ______

61
Q

Describe meconium newborn stools

A

Thick, tarry, black, dark green

62
Q

When do meconium newborn stools occur?

A

Usually within 8 - 24 hours (always within 48 hours)

63
Q

Describe transitional newborn stools

A

Thin, brown, green

64
Q

When do transitional newborn stools occur?

A

3 - 4 days old

65
Q

Describe breastfed newborn stools

A

Pale yellow, liquid

66
Q

How often do breastfed newborn stools occur?

A

Up to 10 times per day (after each feeding) - more often than formula fed

67
Q

Describe urinary characteristics of a newborn (2)

A
  • Usually void immediately after birth
  • Decreased GFR
68
Q

Initial newborn urine void is ______

69
Q

Newborns are easily ______

A

Dehydrated

70
Q

Why do newborns have increased vulnerability to infection? (3)

A
  • Immature mucous membranes
  • Immature immune cells
  • Passive immunity from mother
71
Q

Post-term / macrosomial newborns have an increased risk of ______

72
Q

Why are newborns less reactive to loud sounds postnatally?

A

They are exposed to intense noise during fetal life

73
Q

Newborns sleep for intervals of ______

A

50 - 60 minutes

74
Q

Newborns have a ______ ability

A

Self-quieting

75
Q

What is habituation?

A

Ability to ignore disturbing stimuli

76
Q

Describe orientation of a newborn (2)

A
  • Fixation on visual stimuli
  • Near sighted
77
Q

______ increases newborn sucking

NURS 320 - Exam 3 (5 decks)

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