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Flashcards in Newborn Care Deck (108)
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What is the first few hours of life as the neonate stabilizes respiratory and circulatory function?

Neonatal transition

1

What must happen in establishment of respiratory function?

Fluid in the lungs must be replaced by air

2

How is fluid in the lungs replaced by air?

It occurs by mechanical force or "squeezing"

3

Where is the fluid in the lungs absorbed?

Into the interstitial tissue, lymphatics and vascular system

4

How much fluid is in the lungs at birth?

Approx 20mL

5

How much fluid is in the entire respiratory tract at birth?

80-120mL

6

What does crying against closed glottis do at birth?

It creates positive pressure inflates alveoli

7

What does lungs expanding with subsequent breaths result in?

Decrease pulmonary vascular resistance

8

What does lungs expanding with subsequent breaths which decrease pulmonary vascular resistance allow?

More pulmonary blood flow (oncotic pressure)

9

What does the fetal experience in chemical stimulation of breathing?

Elevated CO2
Decreased O2
Decreased pH (acidosis)

10

What does the chemical change simulate?

Chemoreceptors in the aorta and carotid arteries

11

What happens after chemoreceptors are stimulated in the aorta and carotid arteries?

Causes stimulation of the respiratory center in medulla which triggers a breath

12

What three things are stimulated that cause a breath to trigger in an newborn?

Chemoreceptors in the aorta and carotid arteries and respiratory center in medulla

13

What is the thermal stimulation of breathing in the newborn?

The decrease in ambient temperature at birth

14

What does decrease in ambient temperature at birth stimulate?

Stimulates nerve endings in skin which sends signal to medulla which triggers a breath

15

When nerve endings in the skin are stimulated what does it send a signal to?

To the medulla which triggers a breath

16

What three things stimulate sensory of breathing?

Touch
Noise
Light

17

If newborn is depressed, what do you do to stimulate breathing?

Rub back vigorously
Flick bottom of foot

18

What is the fluid that lines the alveoli?

Surfactant

19

What is surfactant composed of?

Phospholipids
• lecithin
• sphingomyelin

20

What is the role of Surfactant?

Lowers alveolar surface tension promotes lung compliance

21

When does Lecithin production peak?

At 35 weeks

22

What does Sphingomyelin do?

Remains constant

23

What does the mature L/S ratio?

2:1

24

When a newborn grunts, what is it doing?

Attempting to increase positive pressure in alveoli to keep them down

25

What are the structures of fetal circulation?

Foramen Ovale
Ductus Ateriosus
Ductus Venosus

26

What takes place with the foramen ovale in the first breath?

Decrease in pulmonary vascular resistance
Increase in pulmonary flow

27

What does a fecrease in pulmonary vascular resistance and an increase in pulmonary flow result in?

An increase in venous flow to L heart an increased pressure in L atrium which closes the foramen ovale

28

What causes the foramen ovale to close?

Pressure change

29

When is there a permanent closure in the Foramn Ovale?

6 months