The_Newborn - The Newborn The Newborn Overview Overview...

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Unformatted text preview: The Newborn The Newborn Overview Overview After birth, infants adapt physiologically to extrauterine life o Obtain own oxygen from the environment o Modify their systemic circulation o Obtain nutrition and hydration o Excrete wastes o Alter metabolic mechanisms: example = regulate own temperature-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Oxygenation Oxygenation o Most critical and immediate physiologic need after birth (sympathetic response) o In utero, lungs are filled w/fluid essential for normal development of lungs. Bulb syringe @ perineum. May have to French (?) First breath must force fetal lung fluid into interstitial spaces around alveoli so air can enter resp. tract. This requires a much larger negative pressure (sucking) for breath than for subsequent breathing . o Stimulation of 1 st breath due to : o Chemical changes (internal)- At birth, transitory asphyxia occurs- low oxygen- low pH- elevated carbon dioxide level- Stimulates aortic and carotid chemoreceptors- Triggers respiratory center in medulla. Forceful contraction of diaphragm results, causing air to enter lungs. W/1 st breath, will have exaggerated respiratory reaction. o o Thermal Stimuli (external) Thermal Stimuli (external) o Temp change occurs @ birth. Uterus is 20 degrees warmer than outside. This stimulates infants nerve endings in skin. o Transmitted to respiratory center in the medulla o o Mechanical or Tactile Stimuli (external) Mechanical or Tactile Stimuli (external) o Descent thru birth canal compresses fetal chest & forces fluid from lungs into upper airways. A term infant will have about 20 mL/kg of fluid in lungs. the fluid is suctioned out by nurse. 1 when pressure against chest from birth canal is released, chest recoils, drawing small amount of air into the lungs. o Tactile stimulation of infant stimulates skin sensors in infant and infant to cry. Other tactile stimuli: suctioning, drying, sounds, lights. o Surfactant decreases alveolar surface tension 0. Enables lungs to expand uniformly 1. Allows lungs to maintain expanded: surfactant keeps them partially open b/t respirations. H f Respiratory Patterns Respiratory Patterns o About of air from first breath remains in lungs to become the functional residual capacity. o Alveoli remain partially expanded w/residual air & subsequent breaths require less effort than 1 st . o Complete absorption of lung fluid may take 24 hrs. May sound moist @ first but become clearer. o Breaths are shallow & irregular o Range from 30 - 60 breaths/minute w/periods of apnea (< 15 secs). True apnea is >20 secs ....
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This note was uploaded on 05/04/2008 for the course NURS 230 taught by Professor Knobloch during the Spring '08 term at Lady of the Lake.

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The_Newborn - The Newborn The Newborn Overview Overview...

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