Thermoregulation

Question 1

Brown adipose tissue can be found

Answer 1

Axilla
From 26 weeks
Kidneys and adrenals

Question 2

Hyperthermia is defined as

Answer 2

Heat gain is greater than heat loss

Temperature too high leads to tissue damage

Question 3

Ideal neonatal temperature range

Answer 3

36.5-37.5◦C

Question 4

Neonates gain heat by

Answer 4

Radiation

Question 5

Neonates loses heat by

Answer 5

Evaporation

Question 6

Which neonates are most at risk of hypothermia

Answer 6

Birth weight below 2nd centile

Question 7

Fetus

Answer 7

Maternal temperature increases in pregnancy. Core temperature increases by half a degree.

Amniotic fluid (Liquor). Has a function for maintaining temperature. Allows heat from the fetus to diffuse to fetus maintain a normal body temperature during uterine life
Infection - If the mother’s core temperature goes up to 38 degrees it’s important you make a note about this e.g. flu.

Question 8

Maternal

Answer 8

Exercise - their core temperature has gone up by half a degree. We have to advise women to be careful to not harm muscoskeletal system and the environment is well ventilated. Aware of what temperature her body is going up to when she is exercising.

Aqua aerobics are recommended as they cannot damage muscoskeletal system in water and in the pool will keep the womens temperature down.

Teratogenic abnormalities - high temperature may have affects on the baby.

Question 9

Neonate

Answer 9

• Large surface area to volume ratio. Loose more heat from their skin. As adult we have a lower surface area to volume ratio

if the baby is of a lower gestation, lower centile, then they will have a lower birth weight - large surface area to volume ratio will increase. They will lose more heat from their skin much quicker than a large person.

• Centile - low birth weight and low centile - large surface area to volume ratio

Question 10

Heat loss & Heat gain

Answer 10

• Evaporation - baby will evaporate amniotic fluid from its skin, in this process energy will be used by neonate.
• Convection - air currect. Cold air and hot air
• Radiation - overhead heaters the baby can gain heat from the radiate heat which will be going down onto the baby’s body. External environment where there could be cold air which rises up and moves around the room
• Conduction - baby can lose and gain heat. Putting baby next to a surface where they gain or lose heat. Cold surfaces - baby will be losing heat by conduction onto the cold surface. Baby doing skin to skin they will gain heat by being next to something that is warmer than them

Question 11

Heat production in the neonate - cues

Answer 11

• Metabolic activity
• Crying - might be the baby is cold. Crying is a way of generating heat
• Hyperactive - might be unable to feed - the baby might be cold. Check temperature
• Jitteriness - movements of hands and feet that look like the baby is having a fit. Hand down on the body of baby it will stop the jitteriness which can distinguish from an actual fit. Blood sugar might have dropped down as they use their own energy to maintain temperature

Question 12

Brown adipose tissue (BAT) - early days and months of life. The tissue minimises itself. There for the baby to have a store of energy when its born.

Answer 12

• From 26 weeks - starts to form BAT. brown due to alot of mitochondria and a large blood supply
• Mitochondria - storing energy in any cells
• Kidneys and Adrenals - BAT is found here
• Neck and clavicles - BAT is found here
• Axilla - this is where we take the baby’s temperature BAT is found here.
Might be measuring activity of BAT on thermometer which is why you need to observe baby’s cues as well as keeping eye on thermometer

Question 13

Care of newborn

Answer 13

• Dry the baby - warm towel ready
• Skin to skin contact - always have a warm towel over the bay
• Behaviour - observe baby’s behaviour e.g. cues for low temperature
• Note temperature
• Feeding history - how much the baby’s been able to feed. Low blood sugar, neonatal jaduince
• Wrapping and swaddlingn- shouldnt advise parents to be swaddled. Baby should be able to lift up hands from the blanket
• Baths - until a baby is able to maintain its own temperature, advise it shouldnt be bathed.
If the baby is term and well - couple of days to maintain temperature
Low gestation - might take longer to maintain temperature

Question 14

Minimise risk of hypothermia

Answer 14

• Care of the newborn in the 1st hour of life
Being prepared for the birth
Dry towel
Skin to skin
Leaving baby on skin to skin for as long as possible
Before checking baby and removing baby from skin to skin. Take temperautre of the baby
Shouldnt take the baby away from the mother and examine until you take temperature of the baby
Recheck the temperature after examination