Exam 2- NN Assessment 1+2 Flashcards
(94 cards)
The newborn is the first ____ hours after birth
24
The neonatal period consists of:
1st month of neonatal life (28 days)
Trace fetal blood flow starting blood leaving the placenta via the umbilical vein through the fetal circulation and back to the placenta.
Placenta, umbilical vein, ductus venosus, IVC, RA, foramen ovale, LA, LV, Upper body/brain, SVC, RA, RV, ductus arteriosus, distal aorta, lower body, umbilical artery, placenta.
What happens to fetal circulation after birth?
Placental blood flow stops, aortic pressure increases, clamping of the umbilical vein increases SVR, lung expansion decreases PVR, increased PaO2 leads to pulmonary vasodilation.
Discuss the intracardiac pressures during the transition phase. What causes the foramen ovale to close?
Decreased RA pressure + Increased LA pressure leads to closure of the foramen ovale.
When does complete closure of the foramen ovale occur?
2-3months
What causes the closure of the ductus arteriosus?
Increased SVR and Increased PaO2 and decreased PVR leads to constriction of the ductus arteriosus.
When does the ductus arteriosus closure occur?
Functional closure occurs 1-8 days, anatomic closure requires 1-4 months.
When does the ductus venosus close?
Constricts 1-3 hours postnatally. Blood flow into the liver and increase in portal venous pressure.
Fetal breathing begins at ___ weeks
11 weeks, however, this movement decreases throughout pregnancy.
Fetal lung liquid is an ultrafiltrate of plasma with of volume of _____ml/kg
30ml/kg. Partial reabsorption occurs during L/D and 2/3 is expelled during birth.
Retained liquid in the fetal lung can lead to…
Transient Tachypnea of the Newborn (TTN).
Babies 1st breath occurs…
9 seconds after delivery
Lung inflation releases what?
surfactant
Name the 5 parameters of the APGAR
Heart Rate Respiratory Effort Muscle Tone Reflex Irritability Color
How do you score HR on Apgar?
> 100=2
<100=1
Absent=0
How do you score Respiratory effort on Apgar
Robust Crying=2
Irregular, slow, shallow, or gasping resp=1
Absent=0
How do you score reflex irritability on Apgar?
Active coughing and sneezing=2
Grimace=1
No response=0
How do you score Muscle Tone on Apgar?
Active movement=2
Some flexion of extremities=1
Absent/limp=0
How would you score Color on Apgar?
Pink=2
Acrocyanotic (trunk pink, extremities blue)=1
Cyanotic=0
When is Apgar scored?
at 1 min and 5 min after birth
What is a normal Apgar score?
8-10
What Apgar score would signify moderate impairment?
4-7
What Apgar score would require immediate resuscitation?
0-3
