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107 Ch. 24

Newborn Adaptations

What is the neonatal period birth to 28th day of life
what are 2 phases of transition period for neonate 1st/2nd periods of reactivity
what happens in 1st period of reactivity lasts up to 30 min. after birth, HR incr to 160-180, then falls to 100-120. May have crackles, grunting, nasal flaring, retractions of chest (all signs of resp distress usually)
what is 2nd period of reactivity 4-8 hrs after birth, tachy/tachypnea, meconium passed, incr muscle tone, color, spitty/gaggy
what are normal respirations for newborn 30-60 b/min with periodic breathing(pauses), apnea(stop 5-15sec) nose breathers, suction mouth first
what are 4 causes of respiration in NB chemical: pH more acidic, incr CO2, decr O2 mechanical:squeeze in vag canal (C-sect not, so hard to get pink) Thermal: shock stimulates to breath Sensory: lights, smells, snds, touch, gravity
what is surfactant and how help lungs keep alveoli walls from being sticky and collapsing, lowers surface tension, so less inspiratory pressure needed to keep alveoli open Peaks - 35 wks
what is Functional Residual Capacity Air that resides in lung to keep open
What happens to HR in baby birth: 110-140 cry: 175-180 sleep: 80-90
How asses NB HR ascultate 1 min., murmurs normal if stay pink
Normal NB BP NB: 60/40, 80/50 1st hour: drop 15mm 10 days: 95/45, 100/75
How does circulation change to neonate 300ml with 100ml incr. Preterm > term b/c > plasma vol. Late clamping of cord incr volume
what are lab values for NB Hb: 14-24, Hct: 44-64%, then drops WBCs 1st day incr (23,000-24) then drop to 11,500
what are signs of resp distress >160, retractions, flaring of nares, cyanosis, grunting, seesaw resp, asymmetry
why a risk of hemorrhaging and clotting deficiency No Vit K at birth, casue gut is sterile adn made from intestinal bacteria. Give IM of Vit. K
what is normal blood glucose 40-60mg/dl adult: 70-110
what is thermogenesis non-shivering, how does baby keep warm, brown fat adn incr metabolic activity in brain, heart, liver
what does cold stress do to baby vasoconstricts, decr 02 to lungs and perfusion to tissues, anaerobic glycolysis then acidosis = hypoglycemia
what are four methods of heat loss conduction: heat loss w/ contact, warmed crib Convection: heat loss from air mvmt, cap/blanket radiation: heat loss, no contact, away from windows evaportation: dry after bath
what is TNZ, thermal neutral zone for full term 89.6-93.2F, lower for adults, higher for preterm
what enzymes are not produced in NB lipase, pancreatic amylase (6mos), amlase(3mos)
when is meconium seen 1st 24-48 hours, sterile 3rd day - transitional stools 4th - milk stools
Sucking reflexes are coordinated wtih swallowing by when after 33wks
what is jaundice manifestation of bilirubin in tissues above 5mg/dl
when is iron stored for NB stored in utero
what is kernicterus yellow staining of brain cells lead to bilirubin encephalopathy. s/s: CNS depression/excite, lethargy, seizures
what is normal values of unconjugated bilirubin 0.2 - 1.4 jaundice not good if before 24 hrs
what is caput succedaneum swelling of scalp, cross suture line
what is cephalhematoma blood underneath, not cross suture line, may cause jaundice
what is subaleal hematoma Bleeding beyond bone vital to early detect, monitor LOC and decr Hct
what is telangiectatic nevic stork bite, fades
what is erythema toxicum newborn rash
what is vernix caseosa cheese like coating after birth
what is milia sebaceous glands (white pearls)
what is nevus flammeus port wine, permanent
what is desquamation peeling, sign of post maturity
what determines term infant in reproductive system F: vag discharge, not as edematous M: rugae on scrotum, lgr,
what do signs of asymmetry of folds of skin in legs indicate hip dysplagia, do Ortolani Test
what is polydatyly? syndactyly? poly: xtra digits syn: fused digits
Know these reflexes moro(startle), plantar grasp, Babinski(foot), rooting, suck, fencing(tonic neck), stepping when upright, crossed extension
These help determine term or preterm posture: flexed/extended square window: bend hand/not arm recoil, popliteal angle, scarf sign, heel to ear: term fights plantar creases: lots/smooth ear boing!
what is witche's milk baby discharge from breast
what is optimum awake state quiet alert others: drowsy/active alert/crying
what is habituation expose to same stimuli, decr response
Created by: palmerag