NSG 3323 Lecture Notes - Lecture 27: Functional Residual Capacity, Sphingomyelin, Lecithin

27 views8 pages
13 Dec 2018
Department
Course
Professor
Thursday, October 4, 2018
Physiologic Responses of the Newborn to Birth (27):
Intrauterine to Extrauterine:
Neonatal period —> birth through 28th day of life
Neonatal transition = first 6-8 hours of life in which the newborn transitions form
intrauterine to extrauterine life by stabilizing respiratory and circulatory functions
Neonatal Period: Birth - 28 days of life
Neonate transitions from intrauterine to Extra-uterine life
First 6-8 hours:
1. respiration
2. circulation changes
3. temperature regulation
4. nutritional maintanence
5. waste elimination
6. weight regulation
7. behavioral adjustment
Respirations:
Intrauterine factors
Fetal lung development
Fetal breathing movements
Initial respirations triggered by: Mechanical, chemical, tactile, sensory, and thermal
Facts About Surfactant:
Composed of surface-active phospholipids lecithin and sphingomyelin critical for
alveolar expansion and stability
L/S ration 2:1
Lines the lungs to lower surface tension, assists in the establishment of functional
residual capacity, keeps alveoli sacs partially, and open at end of exhalation
1
Unlock document

This preview shows pages 1-3 of the document.
Unlock all 8 pages and 3 million more documents.

Already have an account? Log in
Thursday, October 4, 2018
Characteristics of Newborn Respirations:
Normal Respiratory Indicators:
Respiratory rate: 30-60 bpm
Obligatory nose breathers
Periodic breathing
Respiratory distress indicators:
Apnea
Dyspnea
Central cyanosis
See-saw breathing
Nasal flaring/retractions/respiratory grunting
Cardiovascular System Changes:
Increased aortic pressure and decreased venous pressure
Closure of foramen oval, ductus arteriosus, and ductus venosus
Heart rate = 110-160 BPM (count for a full minute)
Varies with sleep/wake cycle
Blood pressure: 50-70/30-45 —> lowest in life, and varies with birth weight and
gestational age
Average Mean AP = 31-61 mmHG
Capillary refill less than 3 seconds
Heart murmurs —> transient in 90% of cases
Coagulation factors = absence of intestinal flora to synthesize vitamin K in newborn
administration of vitamin K at birth
Thermoregulatory System Maintenance of Thermal Balance:
In utero, fetus surrounded by amniotic fluid, temperature fairly constant with mothers
temperature. At birth, baby must adapt to extrauterine temperature the baby:
Doesn't shiver
Cannot change position to warm, cries, restless
2
Unlock document

This preview shows pages 1-3 of the document.
Unlock all 8 pages and 3 million more documents.

Already have an account? Log in
Thursday, October 4, 2018
Increased respirations and uses energy
Decreased subcutaneous fat, thin epidermis
Blood vessels close to skin
Temperature Regulation:
Neonate responds to cold by:
Increased metabolic rate
Increase muscle activity
Peripheral vascular constriction
Brown fat (brown adipose tissue) metabolism
Non-shivering Thermogenesis:
Gains heat through use of brown fat
Axilla/inter-scapular area/around kidneys
Can warm infant by as much as 100%
Brown fat rich in vascular/ nerve supply, depleted with cold stress
Less mature infant has less brown fat
Cold Stress:
Increased respiratory rate
Vasoconstriction = PO2 decreased with vasoconstriction of skin vessels
BMR increases —> uses oxygen/energy for brain function/heat
Hypoglycemia
Jittery, cry different, and weak suck
Blood pH drops
Metabolic acidosis
Respiratory acidosis
Nursing Actions:
Dry infant after birth —> evaporation
Remove wet blankets direct —> radiation and conduction
3
Unlock document

This preview shows pages 1-3 of the document.
Unlock all 8 pages and 3 million more documents.

Already have an account? Log in

Document Summary

Physiologic responses of the newborn to birth (27): Neonatal period > birth through 28th day of life. Neonatal transition = rst 6-8 hours of life in which the newborn transitions form intrauterine to extrauterine life by stabilizing respiratory and circulatory functions. Neonatal period: birth - 28 days of life. First 6-8 hours: respiration, circulation changes, temperature regulation, nutritional maintanence, waste elimination, weight regulation, behavioral adjustment. Initial respirations triggered by: mechanical, chemical, tactile, sensory, and thermal. Composed of surface-active phospholipids lecithin and sphingomyelin critical for alveolar expansion and stability. Lines the lungs to lower surface tension, assists in the establishment of functional residual capacity, keeps alveoli sacs partially, and open at end of exhalation. Closure of foramen oval, ductus arteriosus, and ductus venosus. Heart rate = 110-160 bpm (count for a full minute) Blood pressure: 50-70/30-45 > lowest in life, and varies with birth weight and gestational age. Heart murmurs > transient in 90% of cases.

Get access

Grade+20% off
$8 USD/m$10 USD/m
Billed $96 USD annually
Grade+
Homework Help
Study Guides
Textbook Solutions
Class Notes
Textbook Notes
Booster Class
40 Verified Answers
Class+
$8 USD/m
Billed $96 USD annually
Class+
Homework Help
Study Guides
Textbook Solutions
Class Notes
Textbook Notes
Booster Class
30 Verified Answers

Related Documents