NSPN 7100 CORE REVIEW QUESTIONS AND
ANSWERS SET A+
✔✔S/S of uterine rupture - ✔✔- abnormal FHR
- cessation of contractions
- abdo pain
- vaginal bleeding
- shock
✔✔What is the most critical infant adaption? - ✔✔Establishing effective respirations
✔✔Catecholamine surge responsible for: - ✔✔- increased BP after birth
- adaptation of energy metabolism
- initiation of thermogenesis from brown fat
✔✔Cortisol responsible for: - ✔✔- lung maturation
- clearance of lung fluid
- gut maturation
- maturation of thyroid axis
✔✔What are the four parts of initiation of fetal breathing? - ✔✔Mechanical: chest
compression exiting birth canal
Thermal: change in temperature from intrauterine to extrauterine world
Sensory: lights, sound, drying
Chemical: low arterial Po2 and drop in prostaglandin
✔✔Key physiological transition changes - ✔✔1. lungs now organ of gas exchange
2. left sided pressure increases, right sided pressure decreases
3. FO and DA close
4. arterial Po2 increases
5. expansion of lungs with air
6. decrease in pulmonary resistance
7. increase in pulmonary blood flow
, ✔✔Persistent pulmonary HTN of the newborn - ✔✔hypo expansion of the lungs,
hypoxemia and persistent acidosis result in high pulmonary vascular resistance,
delayed clearance of lung fluid and persistent right to left shunting
✔✔First period of reactivity - ✔✔First 30 min, best time to establish feeding and
attachment, quiet alert
✔✔Sleep - ✔✔following first period of reactivity, a 60-100 minute sleep to do a lot of
physiologic stabilizing
✔✔Second period of reactivity - ✔✔Approx 2-8 hours after birth, meconium usually
passed, may be brief tachycardia, tachypnea, increased muscle tone
✔✔Fetal benefits of skin to skin - ✔✔stabilizing respirations, reduce apneas, calm,
reduce pain, help establish breastfeeding, attachment, thermoregulation, improves
organization, accelerated weight gain
✔✔Maternal benefits of skin to skin - ✔✔attachment, increased confidence, helps milk
supply, helps produce oxytocin to contract uterus, positive mood
✔✔4 levels of fetal adaptation - ✔✔1. physiological needs
2. motor organization
3. state regulation
4. attention and social interaction
✔✔An organized infant is one who - ✔✔maintains physiological stability, maintains
good tone, can transition smoothly between states and interact with environment
✔✔6 sleep awake states - ✔✔Deep sleep, active sleep, drowsy, quiet alert, active alert,
crying
✔✔Sleep wake states can be affected by: - ✔✔room temperature, amount of light,
gestational age, proximity to parent
✔✔Stress cues - ✔✔finger splaying, yawning, grimace, irregular HR and RR, sneezing,
apnea, arching, irritable
✔✔Stability cues - ✔✔smooth movements, quiet alert, focused gaze, dilated pupils,
sucking, reaching, grabbing, regular RR and HR, calm
✔✔Developmentally supportive care - ✔✔aim to maximize neurodevelopment and
decrease long term cognitive and behavioural problems
ANSWERS SET A+
✔✔S/S of uterine rupture - ✔✔- abnormal FHR
- cessation of contractions
- abdo pain
- vaginal bleeding
- shock
✔✔What is the most critical infant adaption? - ✔✔Establishing effective respirations
✔✔Catecholamine surge responsible for: - ✔✔- increased BP after birth
- adaptation of energy metabolism
- initiation of thermogenesis from brown fat
✔✔Cortisol responsible for: - ✔✔- lung maturation
- clearance of lung fluid
- gut maturation
- maturation of thyroid axis
✔✔What are the four parts of initiation of fetal breathing? - ✔✔Mechanical: chest
compression exiting birth canal
Thermal: change in temperature from intrauterine to extrauterine world
Sensory: lights, sound, drying
Chemical: low arterial Po2 and drop in prostaglandin
✔✔Key physiological transition changes - ✔✔1. lungs now organ of gas exchange
2. left sided pressure increases, right sided pressure decreases
3. FO and DA close
4. arterial Po2 increases
5. expansion of lungs with air
6. decrease in pulmonary resistance
7. increase in pulmonary blood flow
, ✔✔Persistent pulmonary HTN of the newborn - ✔✔hypo expansion of the lungs,
hypoxemia and persistent acidosis result in high pulmonary vascular resistance,
delayed clearance of lung fluid and persistent right to left shunting
✔✔First period of reactivity - ✔✔First 30 min, best time to establish feeding and
attachment, quiet alert
✔✔Sleep - ✔✔following first period of reactivity, a 60-100 minute sleep to do a lot of
physiologic stabilizing
✔✔Second period of reactivity - ✔✔Approx 2-8 hours after birth, meconium usually
passed, may be brief tachycardia, tachypnea, increased muscle tone
✔✔Fetal benefits of skin to skin - ✔✔stabilizing respirations, reduce apneas, calm,
reduce pain, help establish breastfeeding, attachment, thermoregulation, improves
organization, accelerated weight gain
✔✔Maternal benefits of skin to skin - ✔✔attachment, increased confidence, helps milk
supply, helps produce oxytocin to contract uterus, positive mood
✔✔4 levels of fetal adaptation - ✔✔1. physiological needs
2. motor organization
3. state regulation
4. attention and social interaction
✔✔An organized infant is one who - ✔✔maintains physiological stability, maintains
good tone, can transition smoothly between states and interact with environment
✔✔6 sleep awake states - ✔✔Deep sleep, active sleep, drowsy, quiet alert, active alert,
crying
✔✔Sleep wake states can be affected by: - ✔✔room temperature, amount of light,
gestational age, proximity to parent
✔✔Stress cues - ✔✔finger splaying, yawning, grimace, irregular HR and RR, sneezing,
apnea, arching, irritable
✔✔Stability cues - ✔✔smooth movements, quiet alert, focused gaze, dilated pupils,
sucking, reaching, grabbing, regular RR and HR, calm
✔✔Developmentally supportive care - ✔✔aim to maximize neurodevelopment and
decrease long term cognitive and behavioural problems
