Answer: A newborn refers to an infant within the first few hours after birth; a neonate refers to an infant within the first month after birth. (p 1963) 2.What are the initial steps in the stabilization of a newborn?
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Answer: The initial stabilization of a newborn includes the following specific steps: Warming the newborn to prevent hypothermia, positioning the newborn, clearing the airway if necessary as well as drying and stimulating breathing. (p 1963) 3.What is the preferred method of maintaining a newborn’s body heat? Answer: The newborn can be kept warm by placing him or her on prewarmed towels or blankets, drying, and then replacing the wet towels with dry, prewarmed towels. Once resuscitation is complete, the newborn can stay warm if placed on the mother’s chest, or abdomen, on another heat source, or under a radiant warmer. (p 1963) 4.What is the fetal transition stage, and why is it vital in resuscitation? Answer: In utero (ie, in the pregnant woman’s womb), a fetus receives its oxygen from the placenta . The fetal lung is collapsed and filled with fluid, receiving only 10% of the total blood supply. As the fetus is delivered, a rapid series of events needs to occur to enable the newborn to breathe. This process is called fetal transition . The first breath is triggered by mild hypoxia and hypercapnia related to partial occlusion of the umbilical cord during normal delivery. Tactile stimulation and cold stress also promote early breathing. As the newborn’s lungs become filled with air, the pulmonary vascular resistance drops, causing more blood to flow to the lungs, picking up oxygen to supply to the body. Any event that delays this decline in pulmonary pressure can lead to delayed transition, hypoxia, brain injury, and, ultimately, death. (p 1964) 5.What is the APGAR score, and why is it used? Answer: The Apgar score, named after Dr. Virginia Apgar, who developed the measure in 1953, helps record the condition of the newborn in the first few minutes after birth based on five signs. This score can help paramedics determine the need for specific resuscitation measures and the effectiveness of their resuscitation efforts to facilitate the transition from fetus to newborn. Each sign is assigned a value of 0, 1, or 2. The Apgar score is the sum total of these values and is typically recorded at 1 and 5 minutes after birth. If the 5-minute Apgar score is less than 7, the newborn’s condition should be reassessed and an additional score assigned every 5 minutes until 20 minutes after birth. If resuscitation is necessary, the Apgar score is completed by determining the result of the resuscitation. (p 1967) 6.What is the difference between acrocyanosis and central cyanosis? Answer: Many newborns become centrally pink but have blue hands and feet (acrocyanosis). This is considered normal. If the newborn has a normal breathing pattern and a pulse rate of greater than 100 beats/min but maintains central cyanosis of the trunk or of the mucous membranes, provide supplemental free-flow oxygen. If there is no other warming source available, keep the newborn on the mother’s chest and continue to manage the airway.
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