NM717 Module 5 Newborn Midwifery Care of the
Newborn Kelsey review guide p. 214-220, 222-
223, 226-231/Newest Update
Save
Immediate extrauterine —immediate transition from intrauterine to extrauterine
newborn transition life
Immediate extrauterine —respiration,
newborn transition —circulation,
depends on changes in —thermoregulation, and
four major areas: —glucose regulation
Biochemical Factors in —relative hypoxia at the end of labor
initiation of respiration
Physical stimuli Factors in —cold, gravity, pain, light, noise
initiation of respiration
Physiologic Factor in Recoil from pressure on thorax while passing through
initiation of respiration vagina
Sustained respiration a. Central nervous system (CNS) respiratory center
depends on coordinated b. Aortic and carotid chemoreceptors
response of the c. Thoracic mechanoreceptors
following d. Diaphragm and respiratory muscles
a. Assist in conversion from fetal to extrauterine
Initial breathing serves the circulation
following purposes b. Clear lungs of fluid
c. Establish lung volume and expand alveoli
, a. Respiratory rate 30 to 60 breaths per minute
b. Irregular/fluctuating pattern
Characteristics of normal
c. Diaphragmatic and abdominal breathing
newborn respiration
d. Obligate nose breathing
e. Absence of nasal flaring, grunting, and retractions
Transition from fetal to adult circulation begins with
Circulatory changes clamping of the umbilical cord and continues
throughout the first weeks of life
a. Low-pressure system, including placenta (low-
resistance circuit)
Characteristics of fetal b. Minimal circulation to lungs; bypassed via foramen
circulation ovale and ductus arteriosus
c. Foramen ovale favors circulation of most oxygen-
rich blood to the brain
a. Increased systemic resistance due to loss of
placental circuit
b. Increased pressure in left atrium causes functional
closure of foramen ovale
c. Initial respiration opens pulmonary vasculature,
Transition from fetal to
favoring circulation to lungs
neonatal circulation
d. Increased oxygenation of circulating blood causes
constriction and functional closure of ductus
arteriosus
e. Absence of placental circulation closes ductus
venosus
a. Convection
Thermoregulation
b. Conduction
Mechanisms of neonatal
c. Radiation
heat loss
d. Evaporation
a. Shivering (inefficient)
Thermoregulation
b. Muscle activity (limited benefit)
Neonate creates heat in
c. Thermogenesis by metabolism of brown adipose
three ways:
tissue (BAT)
, (1) BAT stores are decreased in preterm and growth-
High risks infants with restricted fetuses
ineffective Thermogenesis (2) Hypoglycemia decreases efficiency of BAT
metabolism
a. Increased oxygen consumption, leading to relative
hypoxia and acidosis
b. Metabolism of BAT and release of fatty acids
Thermoregulation
decreases pH
Consequences of cold
c. Increased use of glucose, depletion of glycogen
stress
stores, and hypoglycemia
d. Worsening hypoglycemia and acidosis may result in
respiratory distress
a. Skin-to-skin contact on mother's chest or abdomen
with blanket over both
b. Prewarm blankets and resuscitation area
Thermoregulation c. Dry the newborn immediately and replace wet
Management/Interventio blankets
ns to promote d. Regulate room temperature and minimize exposure
to air convection
e. Postpone newborn bath at least two hours
f. Keep newborn warm and wrapped
Glucose regulation a. Predominantly in liver
Glycogen stores b. Accumulated in third trimester
a. Infants of diabetic mothers
b. Small for gestational age (SGA) or large for
Glucose regulation Risk gestational age (LGA)
factors for neonatal c. Preterm or post-term
hypoglycemia d. Intrapartum—perinatal acidemia, beta-agonist
tocolysis, IV glucose administration
e. Maternal substance abuse
Newborn Kelsey review guide p. 214-220, 222-
223, 226-231/Newest Update
Save
Immediate extrauterine —immediate transition from intrauterine to extrauterine
newborn transition life
Immediate extrauterine —respiration,
newborn transition —circulation,
depends on changes in —thermoregulation, and
four major areas: —glucose regulation
Biochemical Factors in —relative hypoxia at the end of labor
initiation of respiration
Physical stimuli Factors in —cold, gravity, pain, light, noise
initiation of respiration
Physiologic Factor in Recoil from pressure on thorax while passing through
initiation of respiration vagina
Sustained respiration a. Central nervous system (CNS) respiratory center
depends on coordinated b. Aortic and carotid chemoreceptors
response of the c. Thoracic mechanoreceptors
following d. Diaphragm and respiratory muscles
a. Assist in conversion from fetal to extrauterine
Initial breathing serves the circulation
following purposes b. Clear lungs of fluid
c. Establish lung volume and expand alveoli
, a. Respiratory rate 30 to 60 breaths per minute
b. Irregular/fluctuating pattern
Characteristics of normal
c. Diaphragmatic and abdominal breathing
newborn respiration
d. Obligate nose breathing
e. Absence of nasal flaring, grunting, and retractions
Transition from fetal to adult circulation begins with
Circulatory changes clamping of the umbilical cord and continues
throughout the first weeks of life
a. Low-pressure system, including placenta (low-
resistance circuit)
Characteristics of fetal b. Minimal circulation to lungs; bypassed via foramen
circulation ovale and ductus arteriosus
c. Foramen ovale favors circulation of most oxygen-
rich blood to the brain
a. Increased systemic resistance due to loss of
placental circuit
b. Increased pressure in left atrium causes functional
closure of foramen ovale
c. Initial respiration opens pulmonary vasculature,
Transition from fetal to
favoring circulation to lungs
neonatal circulation
d. Increased oxygenation of circulating blood causes
constriction and functional closure of ductus
arteriosus
e. Absence of placental circulation closes ductus
venosus
a. Convection
Thermoregulation
b. Conduction
Mechanisms of neonatal
c. Radiation
heat loss
d. Evaporation
a. Shivering (inefficient)
Thermoregulation
b. Muscle activity (limited benefit)
Neonate creates heat in
c. Thermogenesis by metabolism of brown adipose
three ways:
tissue (BAT)
, (1) BAT stores are decreased in preterm and growth-
High risks infants with restricted fetuses
ineffective Thermogenesis (2) Hypoglycemia decreases efficiency of BAT
metabolism
a. Increased oxygen consumption, leading to relative
hypoxia and acidosis
b. Metabolism of BAT and release of fatty acids
Thermoregulation
decreases pH
Consequences of cold
c. Increased use of glucose, depletion of glycogen
stress
stores, and hypoglycemia
d. Worsening hypoglycemia and acidosis may result in
respiratory distress
a. Skin-to-skin contact on mother's chest or abdomen
with blanket over both
b. Prewarm blankets and resuscitation area
Thermoregulation c. Dry the newborn immediately and replace wet
Management/Interventio blankets
ns to promote d. Regulate room temperature and minimize exposure
to air convection
e. Postpone newborn bath at least two hours
f. Keep newborn warm and wrapped
Glucose regulation a. Predominantly in liver
Glycogen stores b. Accumulated in third trimester
a. Infants of diabetic mothers
b. Small for gestational age (SGA) or large for
Glucose regulation Risk gestational age (LGA)
factors for neonatal c. Preterm or post-term
hypoglycemia d. Intrapartum—perinatal acidemia, beta-agonist
tocolysis, IV glucose administration
e. Maternal substance abuse
