NUR 335 EXAM 4
What is the APGAR scale? What score requires resuscitation?
- Appearance, Pulse, Grimace, Activity, Respiration;
- measure for evaluating newborn baby taken at 1 minute and 5 minutes (each
category scored from 0-2)
- Score less than 6 indicates need for resuscitation
What are the reflexes that newborns should have?
Rooting
Sucking
Fencing/tonic
Moro/startle
Palmer
Plantar
Babinski
Stepping/dancing
What are the three things that initial respirations in the neonate?
Chemical stimuli: mild hypoxia
Mechanical stimuli: compression of chest during labor
,Sensory stimuli: thermal, tactile, auditory, and light stimuli (leads to crying which
requires inspiration)
What are the 2 factors that negatively impact the transition to breathing
independently for a neonate?
- Decreased lung surfactant as a result of immature lungs (often in premature
infants)
- Severe or persistent hypoxemia and acidosis (hypoxia can result in hypotonia which
can increase the difficulty of respirations)
What are the signs of respiratory distress in a neonate?
Central cyanosis (around mouth and nose)
Tachypnea or apnea for more than 10 seconds
Grunting
Nostril flaring
Chest retractions
Hypotonia
What are the three heart shunts that close as a neonate transitions to relying on
it's own circulatory system?
Ductus venosus: allows the oxygenated blood from the umbilical cord to bypass the
liver and go directly to the inferior vena cava
,Foramen ovale: opening between the right and left atria
Ductus arteriosus: connects the pulmonary artery and the aorta
What is the neonatal response to cold?
Increased metabolic rate and increased O2 consumption
Increased muscle activity and flexion
Increased peripheral vasoconstriction
Metabolism of brown adipose tissue
What is the function of brown adipose tissue?
heat production
What is cold stress?
heat loss through convection, conduction, evaporation and radiation that results in a
temperature decrease, which requires the body to consume more energy
What are the risk factors of developing cold stress?
Being born prematurely
SGA
, Hypoglycemia
Prolonged resuscitation
Sepsis
Problems with the infant's neuro, endocrine, or cardiorespiratory systems
What are the four types of energy loss and examples in neonates?
Evaporation:
-transfer of heat when water on infant's skin is converted into water vapor; sweating
(especially on radiant warmers), crying
Conduction:
-transfer of heat from infant to a cooler surface; placing infant on warmer that is not
preheated
Convection:
-transfer of heat through drafts passing over infant's skin; AC hitting uncovered infant
Radiation:
-Occurs through transfer of heat to the cooler air; heat leaves infant's head is
uncovered
What are the signs and symptoms of cold stress?
Axillary temperature at or below 36.5°C (97.7°F)
Cool skin
Lethargy
What is the APGAR scale? What score requires resuscitation?
- Appearance, Pulse, Grimace, Activity, Respiration;
- measure for evaluating newborn baby taken at 1 minute and 5 minutes (each
category scored from 0-2)
- Score less than 6 indicates need for resuscitation
What are the reflexes that newborns should have?
Rooting
Sucking
Fencing/tonic
Moro/startle
Palmer
Plantar
Babinski
Stepping/dancing
What are the three things that initial respirations in the neonate?
Chemical stimuli: mild hypoxia
Mechanical stimuli: compression of chest during labor
,Sensory stimuli: thermal, tactile, auditory, and light stimuli (leads to crying which
requires inspiration)
What are the 2 factors that negatively impact the transition to breathing
independently for a neonate?
- Decreased lung surfactant as a result of immature lungs (often in premature
infants)
- Severe or persistent hypoxemia and acidosis (hypoxia can result in hypotonia which
can increase the difficulty of respirations)
What are the signs of respiratory distress in a neonate?
Central cyanosis (around mouth and nose)
Tachypnea or apnea for more than 10 seconds
Grunting
Nostril flaring
Chest retractions
Hypotonia
What are the three heart shunts that close as a neonate transitions to relying on
it's own circulatory system?
Ductus venosus: allows the oxygenated blood from the umbilical cord to bypass the
liver and go directly to the inferior vena cava
,Foramen ovale: opening between the right and left atria
Ductus arteriosus: connects the pulmonary artery and the aorta
What is the neonatal response to cold?
Increased metabolic rate and increased O2 consumption
Increased muscle activity and flexion
Increased peripheral vasoconstriction
Metabolism of brown adipose tissue
What is the function of brown adipose tissue?
heat production
What is cold stress?
heat loss through convection, conduction, evaporation and radiation that results in a
temperature decrease, which requires the body to consume more energy
What are the risk factors of developing cold stress?
Being born prematurely
SGA
, Hypoglycemia
Prolonged resuscitation
Sepsis
Problems with the infant's neuro, endocrine, or cardiorespiratory systems
What are the four types of energy loss and examples in neonates?
Evaporation:
-transfer of heat when water on infant's skin is converted into water vapor; sweating
(especially on radiant warmers), crying
Conduction:
-transfer of heat from infant to a cooler surface; placing infant on warmer that is not
preheated
Convection:
-transfer of heat through drafts passing over infant's skin; AC hitting uncovered infant
Radiation:
-Occurs through transfer of heat to the cooler air; heat leaves infant's head is
uncovered
What are the signs and symptoms of cold stress?
Axillary temperature at or below 36.5°C (97.7°F)
Cool skin
Lethargy
