Flashcards in OB Test 2: The Newborn Deck (60)
When is the neonatal transition period? Ad what are the periods?
-first 8 hours after birth
- first period of reactivity
- sleep period
- second period of reactivity
What is the first period of reactivity
First 30 minutes after birth.
Alert and hungry
Heart rate may go upto 180
Should allow this time for breast feeding and bonding
Heart rate and motor activity decrease as they sleep
Second period of reactivity
4-8 hours post birth
Baby awake and ready to feed
If bottle fed, this is the first feeding
May pass meconium
Active body parts
Why is the neonatal period so important
Go from intrauterine cardiopulmonary circulation to doing it themselves
What are the different indicators of respiration?
What's the most important initial step for a newborn
For the baby to start breathing
What is surfactant and what is the ratio?
Have to have stimulation to breath can be from chemical, CO2 increase and thermal stimulation
L:S ratio is 2:1
What is periodic breathing?
May have pauses upto 20 seconds, no color changes
What is apnea?
Pause longer then 20 seconds and requires stimulation
No neurological development
What is respiratory distress?
#1 is tacipnea
30-60 respiratory rate
Look for nasal flaring as baby uses accessory muscles
What is the cardio pressure before birth? And after birth?
High pulmonary vascular resistance: lungs full of water
Low systemic vascular resistance: little resistance to blood leaving heart
Pressure in heart is right to left
Low pulmonary vascular resistance: full of air so not much resistance
High systemic vascular resistance
Pressure is left to right
What is a foremen ovale?
Hole between atria of the heart that closes 1-2 hours post birth
Pressure increases on left side that closes due to pressure change
What is the ductus arteriosus?
Connects aorta to pulmonary vein so it goes to across the aorta before in the lungs
Close within 15 hours of birth due to high oxygen levels
What is the heart rate in cardiovascular transition
What is the blood pressure in cardiovascular transition
What is a PDA murmer?
Common because it takes time for ductus arteriosus not closed
Happens between S1 and S2
What is the neonatal hemoglobin blood value?
80% blood cells carry this
Higher at 14-24 g/dL
What is the hematocrit neonatal blood value?
Higher than 44-64%
What is the WBC neonatal blood value?
18,000 at birth and 24,000 the next day.
Better indicator is a crp (c-reactive protein)
Don't have good inflammatory response
What is neonatal blood value blood group and type
Established 4 months of gestation. Check rH factor.
What are the two types of thermogenesis
Neutral thermal environment
What is non-shivering thermogenesis
Do not regulate temperature well
This is why we use radiant Warmers
Brown fat metabolism
What is brown fat metabolism
Newborns metabolize it for heat
By shivering up glucose and oxygen
When heat up fat end up with acidosis
What it NTE
Neutral thermal environment
T: 97.7 - 99.4 F
What is cold stress
Can be fatal
Increased CO2 levels
Hyper bilirubin causes jaundice
Size and amount of adaptor tissue, gestational age and birth weight determine how he thermoregulates
What are the four heat loss mechanisms?
Conduction: cold touching warm skin
Convection: air current, maintain nursery temp at 80, keep away from window
Radiation: not in direct contact with
What are important milestons in the newborn renal system
First void within 24 hours
Document their first void
Kidney immature so not concentrated well
What is suck and swallow
Required for nutrient intake