Term
| What is the placenta responsible for? |
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Definition
| In the fetus the placenta is responsible for gaseous exchange. |
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Term
| When can extrauterine life be supported? |
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Definition
| At 24 weeks lung structures and cells are differentiated to the point that extrauterine life can be supported. |
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Term
| When is surfactant detectable? |
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Definition
| Surfactant secretion is detectable between 25 and 30 weeks gestation |
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Term
| When does alveolar stability occur? |
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Definition
| Alveolar stability does not occur til between 33 and 36 weeks. |
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Term
| What are indications of lung stability? |
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Definition
| The L-S ratio and PG level |
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Term
| What does fetal breathing in utero helped develop? |
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Definition
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Term
| When does absorption of fetal fluid occur? |
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Definition
| Absorption of fetal fluid occurs during the first hour of life through the lymphatics. |
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Term
| What happens to the pressures in the heart? |
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Definition
| Pressures in the right half of the heart and the pulmonary circulation fall below that of the left side of the heart and the systemic system. |
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Term
| What happens to openings in the lungs and liver? |
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Definition
| bypasses close (the ductas venosus, the foramen ovale, and the ductus arteriosus). |
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Term
| How does pulmonary circulation change? |
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Definition
| becomes a high-flow, low-resistance circuit. |
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Term
| How does systemic circulation change? |
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Definition
| lower-flow, higher-resistance circuit. |
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Term
| What is the assessment of L&D -> nursery? |
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Definition
Mat\fetal history
Resuscitation
apgar
L&D assessment
Dubowitz
growth charts
newborn assessment |
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Term
| What history is necessary to know? |
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Definition
who -description of mom and pregnancy
what-description of baby now
when-age and rom
how many-twins,triplets,etc.
why- ptl,classic section
labs-ABO,RH,VDRL\RPR,Rubella,HEP,GBS |
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Term
| What does APGAR stand for? |
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Definition
A - Appearance
P - Pulse
G - Grimace (Cry)
A - Activity (Bone)
R - Respirations
10 = perfect score |
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Term
| What is the behavioral assessment of the newborn? |
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Definition
sleep/awake states-awake to deep sleep
assess behaviorally in the quiet -alert state
Some reflexes are accentuated in different states
changes to note physiologically occur in REM sleep
Assess within the first 4 hours of birth |
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Term
| What are the normal parameters for the newborn? |
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Definition
Heart rate 90-160
Resp rate 40-60
Apnea<15 secs
temp 36.5-37.3
b/p -maps (58/36-81/51)
dxt 60-90
pink
growth-HC,AG,wt
uop |
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Term
| What are the abnormal parameters for the newborn? |
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Definition
HR<90 or>180
RR >70
Apnea >20 secs or s\s
hypothermia\temp inst
hypotension or pphn
hypoglycemia
pale, grey, jaundiced
LGA,SGA,IUGR
oliguria, anuria |
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Term
| What is the thermogenic system? |
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Definition
Heat loss
Thermogenesis
Cold stress
Hyperthermia |
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Term
| What is the first period of reactivity? |
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Definition
Lasts up to 30 minutes after birth
Newborn’s heart rate increases to 160 to 180 beats/min
Decreases after 30 minutes to baseline
Infant is alert and has spontaneous startles, crying, and head movement |
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Term
| What is the period of decreased responsiveness? |
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Definition
Lasts from 60 to 100 minutes
Infant is pink
Respirations are rapid and shallow up to 60 breaths per minute
Sleeps or has a marked decrease in motor activity |
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Term
| What is the 2nd period of reactivity? |
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Definition
Lasts from 10 minutes to several hours
Occurs between 2 and 8 hours after birth
Tachycardia, tachypnea occur
Meconium passed
Increased muscle tone, changes in skin color, and mucus production |
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Term
| What are the physiologic adaptations of the respiratory system? |
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Definition
Initiation of breathing
Signs of respiratory distress |
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Term
| What are the physiologic adaptations of the cardiovascular system? |
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Definition
Heart rate and sounds
Blood pressure
Blood volume
Signs of risk for cardiovascular problems |
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Term
| What are the physiologic adaptations of the hematopoetic system? |
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Definition
Red blood cells and hemoglobin
Leukocytes
Platelets
Blood groups |
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Term
| What are the physiologic adaptations of the themogeneic system? |
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Definition
Heat loss
Thermogenesis
Cold stress
Hyperthermia |
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Term
| What are the physiologic adaptations of the renal system? |
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Definition
Fluid and electrolyte balance
Signs of risk for renal problems |
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Term
| What are the physiologic adaptations of the GI system? |
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Definition
Digestion
Stools
Meconium
Feeding behaviors
Signs of risk for gastrointestinal problems |
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Term
| What are the physiologic adaptations of the hepatic system? |
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Definition
Iron storage
Carbohydrate metabolism
Contribution of bilirubin and newborn jaundice
Coagulation
Signs of risk for hepatic system problem |
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Term
| What are the physiologic adaptations of the immune system? |
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Definition
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Term
| What are the physiologic adaptations of the integumentary system? |
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Definition
Vernix caseosa
Acrocyanosis
Sweat glands
Desquamation
Mongolian spots
Nevi
Erythema toxicum
Signs at risk for integumentary problems |
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Term
| What are the physiologic adaptations of the reproductive system? |
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Definition
Female
Male
Swelling of breast tissue |
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Term
| What are the physiologic adaptations of the skeletal system? |
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Definition
Caput succedaneum
Cephalhematoma
Subgaleal hematoma
Spine and extremities
Signs of risk for skeletal problems |
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Term
| What are the physiologic adaptations of the neuromuscular system? |
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Definition
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Term
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Definition
Ortolani relocates the dislocation of the hip joint
Positive sign is a distinctive 'clunk' |
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Term
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Definition
| easily performed by adducting the hip (bringing the thigh towards the midline) while applying light pressure on the knee, directing the force posteriorly. If the hip is dislocatable - if the hip can be popped out of socket with this maneuver - the test is considered positive |
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Term
| What are the norms of newborn skin? |
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Definition
peeling, lanugo, vernix, petechiae, milia, Mongolian spots, birth marks, ear tags, peeling
Caput, molding, Cephalhematoma, neck extensions past breech
acrocyanosis, mottling, conjunctiva hemorrhage |
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Term
| What are common newborn problems? |
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Definition
-Jaundice
-Hyperbilirubinemia
-Hypoglycemia
-Hypocalcemia |
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Term
| What is the therapy for hyperbilirubinemia? |
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Definition
-phototherapy
-exchange transfusions |
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Term
| What are abnormal findings of the newborn? |
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Definition
cephalohematoma,lg bulging fontanels,
decreased pulses,apnea,cyanosis,pallor,plethora,jaundice
organomegaly, hypospadius,chorde
jaundice,paralysis,hip clunks
hair tufts, spinal openings
excess oral secretions |
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Term
| What are the factors influencing newborn behavior? |
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Definition
Gestational age
Time
Stimuli
Medication |
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Term
| What are sensory behaviors? |
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Definition
Vision
Hearing
Smell
Taste
Touch |
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Term
| What are the responses to environmental stimuli? |
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Definition
Temperament
Habituation
Consolability
Cuddliness
Irritability
Crying |
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Term
| A newborn is placed under a radiant heat warmer. The nurse knows that thermoregulation presents a problem for newborns because? |
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Definition
they have a relatively thin layer of subcutaneous fat that provides poor insulation.
The newborn has little thermal insulation. Furthermore, the blood vessels are closer to the surface of the skin. Changes in environmental temperature alter the temperature of the blood, thereby influencing temperature regulation centers in the hypothalamus. |
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