OB study guide exam 2.docx - OB study guide exam 2 Newborn Transitioning and Nursing Management Fetal to neonatal circulation a murmur can be heard due

OB study guide exam 2.docx - OB study guide exam 2 Newborn...

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OB study guide exam 2 Newborn Transitioning and Nursing Management Fetal to neonatal circulation - a murmur can be heard due to the fetal shunts being opened but should close and be resolved by 24 hours o 3 structures: o Ductus venosus -allows the majority of the umbilical vein blood to bypass the liver and merge with blood moving through the vena cava, bringing it to the heart sooner-closes within a few days after birth constricts after birth when cord is cut becomes a ligament o foramen ovale -Allows more then half the blood entering the right atrium to cross directly over to the left atrium bypassing the lungs Breathing begins, pressure in the L side of heart increases & formen ovale is held closed o ductus arteriosus -connects the pulmonary artery directly to the aorta bypassing the pulmonary circuit-closes within a few hours after birth - when the umbilical cord is clamped, the first breath is taken and lungs begin to function o systemic vascular resistance increases and blood return to the heart via the inferior vena cava decreases - Heart Rate o immediately after birth: 110- 160 o it begins to decrease since the birth: 120-130 - Blood Volume o depends on the amount of blood transferred from the placenta at birth o Benefits of delayed cord clamping (3mintues after birth) improving the newborn’s cardio-pulmonary adaptation preventing iron-deficient anemia in full term newborns without increasing hypervolemia-related risks and increased iron stores increasing blood pressure improving oxygen transport increasing red blood cell flow o low blood volume= low oxygenation, poor perfusion - Blood components o large red blood cells but few in number RBC will increase as cell size decreases larger cells can carry more oxygen o WBC increase related to birth trauma Respiratory System - Initiation of breathing triggered by 4 types of stimuli o Mechanical- squeezing during birth help get the fluid out of the lungs may need help by removing fluid from mouth (clearing airway) c-section babies do not have that squeeze to help remove fluid may need more suctioning transient tachypnea of newborn may occur (60 breaths per minute) o Chemical- CO2 in the air triggering to breath
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o Thermal- warmth o Sensory- rubbing baby, auditory, visual stimuli - Surfactant is necessary for breathing o a surface tension reducing lipoprotein found in the newborns lungs, prevents alveolar collapse, lines the inside of alveoli o premature babies without surfactant will receive synthetic surfactant - Positive pressure by crying at birth helps keep the alveoli open/ maintains expansion of the lungs Heat Loss - Thermoregulation is the process of maintaining a balance between heat loss and heat production - temperature ranges from 97.9 to 99.7 (36.6 to 37.6) - Characteristics: o thin skin and blood vessels close to surface o Lack of shivering ability to produce heat until 3 months old o Limited stores of metabolic substances (glucose, glycogen, fat) o
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