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OB > Ch23 study guide (physiologic/behavioral adaptations of the newborn) > Flashcards

Ch23 study guide (physiologic/behavioral adaptations of the newborn) Flashcards

1
Q

protein manufactured in type II cells of the lungs that reduces surface tension, thereby decreasing the pressure required to keep alveoli open with inspiration and preventing total alveolar collapse on exhalation
(alveolar stability is maintained)

A

surfactant

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2
Q

maintenance of balance between heat loss and heat production

A

thermoregulation

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3
Q

generation of heat

A

thermogenesis

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4
Q

heat production process unique to the newborn accomplished primarily by brown fat metabolism and secondarily by increased metabolic activity in the brain, heart, and liver

A

nonshivering thermogenesis

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5
Q

environment in which heat balance for the newborn is maintained
- it is at the temperature that allows the newborn to maintain a normal body temperature to minimize oxygen and glucose consumption

A

neutral thermal environment

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6
Q

flow of heat from heat from the body surface to cooler ambient air
- two measures to reduce heat loss using this method are to keep the ambient air at 24*C and wrap the infant who is in an open bassinet

A

convection

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7
Q

loss of heat from the body surface to a cooler, solid surface not in a direct contact but in relative proximity
- to prevent this type of heat loss, cribs and examining tables are placed away from outside windows and care is taken to avoid direct air drafts

A

radiation

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8
Q

loss of heat that occurs when a liquid is converted to vapor

  • in the newborn, heat loss occurs when moisture from the skin is vaporized
  • this heat loss can be intensified by failure to dry the newborn directly after birth or by drying the newborn too slowly after a bath
A

evaporation

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9
Q

loss of heat from the body surface to cooler surfaces in direct contact

  • when admitted to the nursery, the newborn is placed in a warmed crib to minimize heat loss
  • placing a protective cover on the scale when weighing the newborn will also minimize heat loss by this method
A

conduction

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10
Q

high body temperature (37.5C) that develops more rapidly in the newborn than in the adult

  • the newborn has a decreased ability to increase evaporative skin water losses because of a relatively large body surface and sweat glands that do not function sufficiently to allow the newborn to sweat
  • it can cause neurologic injury and increased risk of seizures and (if severe) heat stroke and death
A

hyperthermia

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11
Q

pinkish, easily blanched areas on the upper eyelids, nose, upper lip, back of the head, and nape of the neck
- they are also known as “stork bites”, “angel kisses”, or “salmon patches”

A

telangiectatic nevi (nevus simplex)

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12
Q

overlapping of the cranial bones to facilitate passage of the fetal head through the maternal pelvis during the process of labor and birth

A

molding

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13
Q

generalized, easily identifiable edematous area of the scalp, usually over the occiput

A

caput succedaneum

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14
Q

collection of blood between skull bone and its periosteum as a result of pressure during birth
- it does not cross a suture line

A

cephalhematoma

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15
Q

bluish-black pigmented areas usually found on back and buttocks

A

Mongolian spots

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16
Q

bluish discoloration of the hands and feet, especially when chilled
- it is a normal intermittent finding over the first 10 days after birth related to vasomotor instability and capillary stasis

A

acrocyanosis

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17
Q

white cheesecake substance that coats and protects the fetus’s skin while in utero

A

vernix caseosa

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18
Q

white facial pimples caused by distended sebaceous glands

A

milia

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19
Q

yellowish skin discoloration caused by elevated serum levels of unconjugated (indirect) bilirubin

A

jaundice

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20
Q

nonpathologic unconjugated hyperbilirubinemia that occurs in approximately 60% of term newborns
- it appears after 24hrs of age and usually resolves without treatment

A

physiologic jaundice

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21
Q

acute manifestations of bilirubin toxicity that occur during the first weeks after birth
- these can include lethargy, hypotonia, irritability, seizures, coma, and death

A

acute bilirubin encephalopathy

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22
Q

irreversible, long-term consequences of bilirubin toxicity such as hypotonia, delayed motor skills, hearing loss, cerebral palsy, and gaze abnormalities

A

kernicterus

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23
Q

hyperbilirubinemia that can be manifested by breastfed newborns

  • early onset, which begins in the first 2-5days of age, is associated with ineffective breastfeeding
  • the etiology of the late onset form, which can begin at age 5 or 10 days of age and persists up to 12 weeks, is uncertain but could be related to factors found naturally in breast milk
A

breast milk jaundice

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24
Q

thick, dark green-black stool formed during fetal life and usually passed within 24hr of birth

A

meconium

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25
Q

sudden, transient newborn rash characterized by erythematous macules, papules, and small vesicles found anywhere on the body

A

erythema toxicum

erythema neonatorium; flea bite dermatitis

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26
Q

condition in which the urethral opening is located on the ventral side of the surface of the penis

A

hypospadias

27
Q

condition in which the urethral opening is located on the dorsal side of the surface of the penis

A

epispadias

28
Q

accumulation of fluid in the scrotum, around the testes

A

hydrocele

29
Q

small whitish areas found on the gum margins and at the juncture of the hard and soft palates

A

Epstein pearls

30
Q

head to rump development in the newborn

A

cephalocaudal development

31
Q

soft, downy hair on face, shoulders, and back

A

lanugo

32
Q

bruise

A

ecchymosis

33
Q

peeling of the skin that occurs in the term infant a few days after birth as vernix cases is removed
- if present at birth, it may be an indication of postmaturity

A

desquamation

34
Q

vascular lesion visible at birth as pink and flat but darkens with time, becoming red or purple and pebbly in consistency

  • it varies in size, shape, and location, but it is usually found on the neck and face
  • it does not blanch under pressure or disappear
A

port-wine stain (nevus flammeus)

35
Q

birthmark consisting of dilated, newly formed capillaries occupying the entire dermal and subnormal layers with associated connective tissue hypertrophy
- it is typically a raised, sharply demarcated bright or dark red, rough-surfaced swelling, usually found as a single lesion on the head

A

strawberry hemangioma (nevus vascularis)

36
Q

slightly blood-tinged mucoid vaginal discharge associated with an estrogen decrease after birth

A

psuedomenstruation

37
Q

foreskin

A

prepuce

38
Q

skeletal abnormality resulting in a hip that dislocates easily

A

developmental dysplasia of the hips (DDH)

39
Q

small, white, firm cysts seen at the tip of the foreskin

A

epithelial pearls

40
Q

missing digits

A

oligodactyly

41
Q

extra digits

A

polydactyly

42
Q

fused fingers or toes

A

syndactyly

43
Q

variations in the state of consciousness of a newborn infant

A

sleep-wake states

44
Q

the two sleep states

A

deep and light

45
Q

the newborn sleeps about ________ hours a day, with periods of wakefulness gradually _________

A

16-19 hours a day

increasing

46
Q

the four wake states

A

drowsy
quiet-alert
active-alert
crying

47
Q

the optimum state of arousal in which the infant can be observed smiling, responding to voices, watching faces, vocalizing, and moving in synchrony with speech

A

quiet-alert

48
Q

ability of the newborn to respond to internal and external environmental factors by controlling sensory input and regulating the sleep-wake states, thereby making smooth transitions between states

A

state modulation

49
Q

protective mechanism that allows the infant to become accustomed to environmental stimuli
- it is a psychologic and physiologic phenomenon in which the response to a constant or repetitive stimulus is decreased

A

habituation

50
Q

quality of alert states and ability to attend to visual and auditory stimuli while alert

A

orientation

51
Q

individual variations in a newborn’s primary reaction pattern

A

temperament

52
Q

place infant in a supine position and apply pressure to soles of the feet with fingers when the lower limbs are semi-flexed
- legs extend against examiner’s pressure

A

magnet

53
Q

place infant supine on flat surface and make a loud abrupt noise

  • symmetric abduction and extension of the arms, fingers fan out, thumb and forefinger form a C
  • arms are then adducted into an embracing motion and return to relaxed flexion and movement
A

moro

54
Q

place finger in palm of hand or at vase of toes

- infant’s fingers curl around examiner’s finger or toes curl downward

A

grasp

55
Q

place infant prone on flat surface, run finger down side of back, first on one side and then down the other side 4-5cm lateral to spine
- trunk flexes and pelvis swings toward stimulated side

A

truncal incurvation (Galant)

56
Q

tap over forehead, bridge of nose, or maxilla when eyes are open
- blinks for first 4 or 5 taps

A

glabellar (Myerson sign)

57
Q

use finger to stroke sole of foot beginning at heel, upward along lateral aspect of sole, then across ball of foot
- all toes hyperextend, with dorsiflexion of big toe (“positive response”)

A

babinski (plantar)

58
Q

anal sphincter response to touch by opening and closing

A

wink reflex

59
Q

undescended testes

A

cryptorchidism

60
Q

touch infant’s lip, cheek, or corner of mouth with nipple or finger
- turns head toward stimulus and opens mouth ready to take hold and suck

A

rooting

61
Q

place sleepy infant in a supine position, then turn head quickly to one side
- arm and leg on one side to which head is turned extend while opposite arm and leg flex

A

tonic neck (fencing)

62
Q

hold infant vertically, allowing one foot to touch table surface
- infant alternates flexion and extension of feet

A

stepping (walking)

63
Q

touch or depress tip of tongue

- tongue is forced outward

A

extrusion

64
Q

place infant in a supine position, then extend one leg, press knee downward, and stimulate bottom of foot
- opposite leg flexes, adducts, and then extends

A

crossed extension

OB (35 decks)

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