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Bioscience for Midwifery > ULO 9- Changes in neonatal physiology & adaption to extra-uterine life > Flashcards

ULO 9- Changes in neonatal physiology & adaption to extra-uterine life Flashcards

1
Q

List 5 methods to reduce heat loss in infants

A
  • skin-to-skin
  • warm blankets
  • room temperature even
  • Wrapping
  • dry thoroughly after baths
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2
Q

Describe: Barlow’s test

A

examines the baby’s hip joints for laxity and the capability for the joint to dislocate with ease

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3
Q

Describe: Moro reflex

A

is the startle reflex

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4
Q

Explain: 2 cells in the neonate lungs and their function

A

Alveolar Type 1 pneumocytes- responsible for gas exchange

Alveolar Type 2 pneumocytes- produce surfactant

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5
Q

Explain: Surfactant

A

is a fluid that reduces surface tension, increases surface area for gas exchange and prevents alveoli from collapsing

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6
Q

What are the normal ranges of a newborns observations

A

Respiratory rate- 40-60 breaths per minute
FHR- 110-160 bpm
Temp- 36.5-37.5 degrees C

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7
Q

Describe: Acrocyanosis

A

is when peripheral circulation is immature and the infant has blue hands and feet with a pink body. Is normal and will typically pink up within 24hrs

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8
Q

Define: Thermogenesis

A

is the process of heat production

- is the bodies mechanism of balancing the body’s heat loss with heat gain

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9
Q

Explain: Hypothermia, Hypoxia and Hypoglycaemia and their relationship to each other

A

Hypothermia- low body temperature
Hypoxia- low oxygen levels
Hypoglycaemia- low glucose levels

Low oxygen levels lead to a low body temperature which then contributes to low glucose levels

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10
Q

What is the capacity of a newborns stomach

A

5-7mls (approx 1 Tablespoon)

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11
Q

What are the average newborn assessment measurements?

A

Heel to crown length: 50-55cm
Head circumference: 35-40cm
Average weight: 3.5-4kg

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12
Q

Explain: 4 ways newborns can lose heat

A

Evaporation- after being born, having a bath
Conduction- when a baby is put onto a cold surface
Convection- when heat is transferred to the infant
Radiation- baby being put near an open cold window

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13
Q

Adaptive changes at birth- Cardiopulmonary

What factors help stimulate breathing at birth

A
  • pressure of the birth canal and the release of pressure from lungs once expelled
  • contractions cause mild asphyxia in the fetus
  • mild asphyxia and acidosis induced by cord clamping sensitise medullary chemoreceptors increasing drive to breath
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14
Q

Adaptive changes at birth

What cardiopulmonary changes happen at birth

A
  • A few minutes after cord ceases to pulsate, placental blood flow ceases.
  • Ductus venosus and hypogastric arteries close
  • The lungs fill with air, and vasodilation of pulmonary circulation occurs
  • The foramen ovale and ductus arteriosus close.
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15
Q

Adaptive changes at birth

What happens in the Haematological system

A
  • newborn blood volume 80ml/kg

- haemoglobin high 165-175

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16
Q

Adaptive changes at birth

How can midwives facilitatate cardiopulmonary adaptive changes

A
  • clearing newborn’s airway
  • using tactile stimulation
  • assessing condition of newborn using Apgar
17
Q

Newborn Assessment

List all the components you are checking for

A

Observaions

  • Oxygen saturation
  • Temperature
  • Respiration
  • FHR

Palpate: fetal skull bones, fontanelles and sutures

Observe

  • posture
  • tone, movements
  • colour

Assess

  • Face: symmetry and movment
  • Eyes: shape, clear, dishcharge, lids
  • Ears: placement, shape, cartilage
  • Nose: placement patency
  • Mouth: lips, tongue, gums, palate, reflexes
  • Neck: motion, appearance
  • Back: spine shape, intact skin
  • Chest: size, shape, breast tissue, nipples
  • Arms & Hands: motion, symmestry, attitude and creases
  • Abdomen: shape, umbilical area, palpability
  • Hips: motion
  • Legs & Feet: motion, symmetry, atitude, reflex
  • Genitalia: gender, complete formation
18
Q

Adaptive changes at birth

When should a baby have passed meconium

A

majority pass by 24hrs post birth

ALL by 72hours post birth

19
Q

What are the 4 reflexes involved in breastfeeding

A

Rooting
Suckling
Swallowing
Breathing

20
Q

Explain the 4 reflexes involved in breastfeeding

A
  • Rooting reflex is elicited when the baby’s mouth is touched gently, such as by the nipple. The baby responds by turning the head towards the stimulus and opening the mouth wide
  • Suckling reflex is complex. When the baby feels the mouth is full as far back as the hard palate and the back of the tongue, he will use jaws, tongue and cheek muscles to suckle
  • Swallowing reflex is well developed in the term infant and the baby swallows about 0.6 ml at each mouthful
  • Breathing is coordinated with swallowing by an upper airways reflex to prevent aspiration
21
Q

How long does it usually take for a newborn to find their way to its mothers breast

A

45-55minutes

22
Q

When is surfactant produced from

A

32 weeks

23
Q

Transition to extra-uterine life

Describe: Lung fluid

A

is a clear fluid that facilitates cell proliferation and differentiation.

24
Q

Transition to extra-uterine life

How is lung fluid removed from the body

A
  • absorbed from the alveoli by osmosis
  • expelled through upper airways
  • sneeze
25
Q

What triggers the closing of the foramen ovale

A

when oxygenated blood returning to the heart via the pulmonary veins increases the pressure within the left atrium

26
Q

Transition to extra-uterine life- Immunological adaptions

When does colonisation first occur for the neonate

A

occurs first from the maternal genital tract, then from the mother’s skin, and finally from other people and the general environment

27
Q

Transition to extra-uterine life- Renal system

What can Urates do

A

may cause pink or brick-red staining on the napkin. While common and a normal finding in the first few days of life, the presence of urates in the urine of babies more than a few days old may indicate dehydration

28
Q

Explain: Stepping response

A

When the baby is supported in a standing position with the soles of the feet on a firm surface, the infant will simulate walking. The presence of this reflex indicates mature extension and flexion mechanisms

Bioscience for Midwifery (8 decks)

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