Newborn Adaptations (Respiratory) Flashcards
This deck ONLY looks at newborn adaptations for the respiratory system!!!! (33 cards)
How does clamping the cord inhbit (to prohibit from doing something) respirations?
Another chemical factor may also play a role: it is thought that, as a result of clamping the cord, there is a drop in levels of a prostaglandin that can inhibit respirations.
During the first breaths what must be retained? Why?
With the first breaths, some air must be retained in the alveoli so subsequent breaths are easier
How long does the first phase of transition last for?
The first phase of the transition period lasts up to 30 minutes after birth and is called the first period of reactivity
What does the transition period represent?
This transition period represents a time of vulnerability for the newborn and warrants careful observation by nurses. To detect disorders in adaptation soon after birth, nurses must be aware of normal features of the transition period
What is acrocyanosis?
Acrocyanosis, the bluish discoloration of hands and feet, is a normal finding in the first 7 to 10 days after birth.
What is a late sign of respiratory distress in newborns? What is a result of?
*Centeral Cyanosis signifies hypoxemia (low levels of O2 in the blood)
central cyanosis the lips and mucous membranes are bluish. It can be the result of inadequate delivery of oxygen to the alveoli, poor perfusion of the lungs that inhibits gas exchange, or cardiac dysfunction. Because central cyanosis is a late sign of distress, newborns usually have significant hypoxemia when cyanosis appears.
After the first period of reactivity, the newborn either sleeps or has a marked decrease in motor activity, what is this refered to as?
The period of decreased responsiveness
What are the 4 respiratory system adaptations that help respirations begin?
1.) Chemical
2.) Mechanical
3.) Thermal
4.) Sensory
How do mechanical factors help respirations begin? (2 main things)
1.) Respirations in the newborn can be stimulated by changes in intrathoracic pressure resulting from compression of the chest during vaginal birth.
1.5) As the fetus passes through the birth canal, the chest is compressed. With birth this pressure on the chest is released, and the negative Intrathoracic pressure helps draw air into the lungs.
2.) Crying increases the distribution of air in the lungs and promotes expansion of the alveoli. The positive pressure created by crying helps to keep the alveoli open.
What can tachypena in newborns be a result from?
Tachypnea can result from inadequate clearance of lung fluid, or it can be an indication of newborn respiratory distress syndrome (RDS).
Characteristics of normal newborn respirations?
1.) Shallow and irregular
2.) 30-60 breaths/min
3.) Respiratory rate increases with activity
4.) Periodic breathing includes pauses lasting less than 20 seconds
Before the onset of labour, what apperars to promote fluid clearnce from the lungs?
Catecholamine Surge
-Shortly before the onset of labour there is a catecholamine surge that appears to promote fluid clearance from the lungs, which continues during labour. The movement of lung fluid from the air spaces takes place through active transport into the interstitium, with drainage occurring through the pulmonary circulation and lymphatic system
In newborns in the lungs what must be replaced?
Liquid must be replaced with an equal volume of air
When does the “second stag of reactivity” occur? How long does it last for?
occurs roughly between 2 and 8 hours after birth and lasts from 10 minutes to several hours
Characteristics of the “period of decresed responsiveness?
(How long does it last for? resperations characteristics? Bowel sounds? Abdomen characteristics?)
usually lasts from 60 to 100 minutes. During this time the newborn is pink and respirations may be rapid and shallow (up to 60 breaths/min) but not laboured. Bowel sounds are audible, and peristaltic waves may be noted over the rounded abdomen.
uring the first phase of transition, how alert will the newborn be? are bowel sounds audible? will meconium be passed?
The newborn is alert and may have spontaneous startles, tremors, crying, and movement of the head from side to side. Bowel sounds are audible, and meconium may be passed
Characteristics of the “second stage of reactivity”?
(HR, Muscle tone, Meconium,)
Brief periods of tachycardia and tachypnea occur, associated with increased muscle tone, skin colour changes, and mucus production. Meconium is commonly passed during this phase. Most healthy newborns experience this transition regardless of type of birth. Physiological immaturity prevents this in very preterm newborns.
How do thermal factors help respirations begin?
*With birth the newborn enters the extrauterine environment, in which the temperature is significantly lower.
1.) Exposure to the profound change in environmental temperature stimulates receptors in the skin, resulting in stimulation of the respiratory centre in the medulla.
*Cold stress may be important for initializing breathing, but prolonged exposure should be avoided.
In very preterm babys, what prevents the second period of reactivity? Why?
Physiological immaturity prevents this in very preterm newborns.
During the first stage of transition what is the fetuses HR, respirations, like?
The newborn’s heart rate increases rapidly to 160 to 180 beats per minute (bpm) but gradually falls by 30 minutes of age to a baseline rate between 100 and 160bpm. Respirations may be irregular, with variation in the rate between 60 and 80 breaths/min. Fine crackles may be present on auscultation; audible grunting, nasal flaring, and retractions of the chest may also be noted, but these should resolve within the first hour of birth
How do Type 2 cells decease surface tension?
Subsequently, with lower surface tension the pressure required to keep the alveoli open with inspiration is reduced, which prevents total alveolar collapse on exhalation, thereby maintaining alveolar stability
What must the first breaths be strong enough to move/do?
Lung expansion and first breaths must be strong enough to move fluids that fill the fetal airway from the trachea to the terminal air sacs
What type of alveoli cells produce surfactant?
The type II cells make and produce surfactant, a group of phospholipids that reduce the alveolar surface tension.
How do chemical factors begin respirations? (4 things)
1.) The activation of chemoreceptors in the carotid arteries and aorta results from the relative state of hypoxia associated with labour.
2.) there appears to be a cumulative effect that results in progressive decline in Po2, increased Pco2, and lowered blood pH.
3.) Decreased levels of oxygen and increased levels of carbon dioxide are involved in initiating newborn breathing by stimulating the respiratory centre in the medulla.
4.) Another chemical factor may also play a role: it is thought that, as a result of clamping the cord, there is a drop in levels of a prostaglandin that can inhibit respirations.
