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OB chapter 9

physiologic adaptation of the newborn to birth

What happens when an infant lacks surfactant? atelectasis
What stimulates the brain to begin respirations? decreased Po2, increased Pco2, and decreased pH resulting in acidosis
Why are c-section babies more at risk for respiratory complications? these babies do not experience chest compression followed by chest recoil
What are normal changes in pulmonary circulation after birth? the three fetal shunts are closed to allow the neonate’s blood to circulate to the lungs for oxygenation and the liver for filtration
Most common cause of heat loss in newborns large body surface area in relation to weight, thin skin and very little subcutaneous fat for insulation
What does cold stress in the newborn lead to? increased BMR, oxygen consumption, depletion of glycogen stores and resulting acidosis
Brown fat develops at 28 weeks gestation and is found around the neck; in the axillae; around the kidneys, adrenals, and sternum; between the scapula; and along the abdominal aorta. Typically disappears by 3 months of age; is used for nonshivering thermogenesis
Examples of Convection air conditioning or people moving around
Examples of Radiation crib near a cold window, walls of the incubator are cold
Examples of Evaporation amniotic fluid on the skin of the newborn
Examples of Conduction chilled hands, cold scales, cool examining tables, and a cold stethoscope
symptoms that show a newborn isn’t warm enough. hypoglycemia, acidosis, jaundice, and respiratory distress
normal vitals for newborn respirations:30-60 bpm; temperature: 97.7
Weight loss considered normal for newborn 10% of body weight the first few days of life
Reason for vitamin K injections to prevent excessive bleeding by bringing clotting time to normal range
Cause of physiologic jaundice breakdown of RBC’s leading to increased levels of bilirubin
How can thermoregulation present a problem with a newborn? too much heat loss can cause cold stress
How does colostrum protect the infant from infection? it is high in IgA which helps protect the newborn against some GI and respiratory tract infections
What is the most critical physiological change required of the newborn? respiration through lung expansion
Iron stores in a newborn stored in the liver during the last 3 months of gestation and should last a newborn for 5 months
Patent ductus arteriosus occurs when? the ductus arteriosus reopens causing a decrease in blood pressure or oxygen saturation leading to a return to fetal-type circulation
Most critical nursing action after birth ensure airway is patent and functioning
Demerol and how it affects newborn temperature. when given to a laboring woman before delivery can interfere with metabolism of brown fat in the newborn, resulting in neonatal hypothermia
4 major categories of stimuli that initiate respiration sensory, chemical, thermal, and mechanical
Physiologic mechanisms responsible for closure of shunts shifts in pressures in the heart, an increase in blood oxygenation level, and cord clamping
Primary source of heat loss radiation
Why are newborns at risk for dehydration in the 1st days of life? antidiuretic hormone (vasopressin) function is limited
Created by: laotracuata