MODULE 6 THE NEONATE QUESTIONS
WITH CORRECT ANSWERS
placenta aais aathe aaorgan aaof aawhat aafor aathe aababy aain aaeutero aa- aaAnswer aagas
aaexchange
How aadoes aafluid aaexit aainfants aalungs aa- aaAnswer aacatecholamine aasurge aathat
aaseems aato aapromote aafluid aaclearance aafrom aathe aalungs, aawhich aacontinues
aaduring aalabou
catecholamines aaare aaresponsible aafor aa- aaAnswer aaincreased aablood aapressure
aaafter aabirth, aaadaptation aaof aaenergy aametabolism, aaand aafor aainitiation aaof
aathermogenesis aafrom aabrown aafat
Cortisol aais aaa aakey aaregulatory aahormone aathat aaaids aa- aaAnswer aain aathe
aaneonate's aatransition aato aaextrauterine aalife
cortisol aabegins aato aaincrease aaat aa- aaAnswer aaincrease aaat aa30 aaweeks, aaincrease
aafurther aaduring aalabour, aaand aapeak aaseveral aahours aaafter aabirth
Cortisol aaaids aain: aa- aaAnswer aaLung aamaturation aa(anatomy aaand aasurfactant)
Clearance aaof aalung aafluid
Gut aamaturation
Maturation aaof aaglucose aametabolic aapathways aain aathe aaliver
Maturation aaof aathe aathyroid aaaxis
major aaadaptations aaassociated aawith aatransition aaoccur aaduring aa- aaAnswer aafirst aa6-
8hr aaof aalife
most aacritical aaadaptation aarequired aais aathe aa- aaAnswer aaestablishment aaof
aaeffective aarespirations
chemical aafactors aathat aainitiate aarespirations aa- aaAnswer aaProgressive aadecline aain
aapO2 aaduring aalabour aaand aaa aadrop aain aaprostaglandin aalevels aathat aaresults aafrom
aaclamping aaof aathe aacor
Key aaphysiological aachanges aathat aaoccur aaduring aatransition aato aaextrauterine aalife
aaare aa- aaAnswer aaexpansion aaof aalungs aawith aaair
,rapid aadecrease aain aapulmonary aavascular aaresistance aaand aaincrease aain
aapulmonary aablood aaflow
initiation aaof aagas aaexchange aaacross aathe aaalveolar aamembrane
pressure aagradient aachanges aa(decreased aaright aaside aapressure/increased aaleft
aaside aapressure aain aaheart)
closure aaof aacirculatory aashunts aa(foramen aaovale, aaductus aaarteriosus)
rise aain aaarterial aapO2
persistent aapulmonary aahypertension aaof aathe aanewborn aa- aaAnswer aaHypo-
expansion aaof aathe aalungs, aahypoxemia, aaand aapersistent aaacidosis aaresult aain aahigh
aapulmonary aavascular aaresistance, aadelayed aaclearance aaof aalung aafluid, aaand
aapersistent aaright aato aaleft aashunting
Some aaof aathe aafactors aathat aaare aabelieved aato aastimulate aaa aanewborn aato aatake
aahis/her aafirst aabreath aaare: aa- aaAnswer aaChemical: aafactors aain aaa aanewborn's
aablood aa(low aaoxygen, aahigh aacarbon aadioxide, aaand aalow aapH) aawhich aastimulate
aarespiratory aacenter aain aabrain.
Thermal: aachange aain aatemperature aafrom aaintrauterine aaenvironment aato
aaextrauterine aaenvironment aastimulate aaskin aareceptors aawhich aastimulate
aarespiratory aacenter.
Mechanical: aarelease aaof aapressure aaon aaa aababy's aachest, aaas aathe aachest aais
aaborn, aamay aastimulate aabreathing aaand aachest aaexpansion.
Sensory: aastimulation aafrom aadrying, aalights, aasounds, aasmells aaall aainvolved aain
aastimulation aaof aarespiratory aacenter.
major aachanges aathat aatake aaplace aain aaa aanewborn's aacardiopulmonary aasystem
aaduring aathe aatransition aato aaextrauterine aalife aaare: aa- aaAnswer aathe aalungs
aabecome aathe aaprimary aaorgan aaof aagas aaexchange aa(instead aaof aathe aaplacenta);
aathe aalungs aainflate, aafluid aais aacleared aafrom aathe aaalveoli, aapulmonary aavascular
aaresistance aadecreases aarapidly aaand aathere aais aaincreased aapulmonary aablood
aaflow.
The aapressure aagradient aain aathe aanewborn's aaheart aashifts. aaRight aasided aapressure
aawhich aawas aahigh aain aafetal aacirculation aadecreases, aaand aaleft aasided aapressures
aawhich aawere aalow aanow aaincreases. aaAs aaa aaresult aathe aaforamen aaovale aacloses.
Rising aapO2 aacauses aasmooth aamuscle aacells aain aathe aaductus aaarteriosus aato
aaconstrict aathereby aaclosing aathe aashunt.
Removal aaof aathe aalow aapressure aaplacental aasystem aaincreases aathe aapressure aain
aaa aanewborn's aacirculation aawhich aaincreases aacirculation aaand aapulmonary
aaperfusion.
What aais aathe aarole aaof aalung aasurfactant? aa- aaAnswer aaSurfactant aalowers aathe
aasurface aatension aaof aathe aaalveoli aathereby aareducing aathe aapressure aarequired aato
aakeep aathe aaalveoli aaopen. aaDecreased aasurface aatension aaalso aaresults aain
aaincreased aalung aacompliance.
Apgar aascore aa- aaAnswer aaAppearance aa(color)
, Pulse aa(heart aarate)
Grimace aa(reflexes) aaalso aaknown aaas aaresponse aato aastimulation
Activity aa(muscle aatone)
Respirations aa(breathing)
A aascore aaof aa4 aato aa6 aaat aaone aaminute aaindicates aa- aaAnswer aaan aainfant aais
aahaving aasome aadifficulty
A aascore aaof aa7 aaor aaabove aaat aaone aaminute aaindicates aathat aa- aaAnswer aainfant
aais aamaking aaa aagood aaadjustment aato aaextrauterine aalife.
A aascore aaof aa3 aaor aaless aaat aaone aaminute aaindicate aa- aaAnswer aasevere aadistress
An aaApgar aaof aa7 aaor aaless aaat aa5 aaminutes aawarrants aa- aaAnswer aaanother
aaassessment aaof aathe aafive aaparameters aaat aa10 aaminutes.
First aaperiod aaof aareactivity aatimeframe aa- aaAnswer aaWithin aaminutes aaafter aabirth
aaand aalasting aafor aa30-60 aaminutes
during aaFirst aaperiod aaof aareactivity aainfants aaare aaand aanote aaany aachanges aain
aaHR aa& aaResps aa- aaAnswer aainfants aaare aain aaa aaquiet aaalert aastate: aaeyes aawide
aaopen aaand aacapable aaof aaresponding aato aatheir aaenvironment
- aaHeart aarate aaincreases aato aa160-180 aabpm, aathen aasettles aato aa100-120 aabpm
aaby aa30 aaminutes aaof aaage. aa
- aaRespirations aamay aabe aairregular aaand aafine aacrackles aamay aabe aaaudible aaon
aaauscultation aaof aalung aafields. aaTransitory aagrunting, aanasal aaflaring, aaand aachest
aaretractions aamay aabe aaevident.
Following aathis aainitial aaperiod aaof aareactivity, aainfants aasleep aagenerally aa- aaAnswer
aagenerally aago aainto aaa aadeep aasleep, aalasting aafor aa60-100 aaminutes. aaDuring aathis
aadeep aasleep, aamany aaphysiologic aaneeds aastabilize: aa
- aatemperature aaregulation aaand aaadequate aaoxygenation aaand aacirculation
- aaRespirations aamay aabe aarapid aabut aanot aalabored.
Second aaperiod aaof aareactivity aatakes aaplace aawhen aa- aaAnswer aaapproximately
aabetween aatwo aato aasix aahours aaafter aabirth aaand aacan aalast aafrom aa10 aaminutes aato
aaseveral aahours. aa
- aamay aabe aabrief aaperiods aaof aatachycardia aaand aatachypnea, aaincreased aamuscle
aatone, aaand aaskin aacolor aachanges
- aaMeconium aais aausually aapassed aain aathis aaperiod.
what aathree aaperioids aaare aatypical aapatterns aafor aanormal, aahealthy, aaterm
aanewborns aa- aaAnswer aainitial aareactivity, aasleep, aaand aasecond aareactivity
preterm aabirth aaor aabirth aaasphyxia aamay aaalter aainfants' aa- aaAnswer aabehaviour
aaduring aathis aatransition aaperiod
WITH CORRECT ANSWERS
placenta aais aathe aaorgan aaof aawhat aafor aathe aababy aain aaeutero aa- aaAnswer aagas
aaexchange
How aadoes aafluid aaexit aainfants aalungs aa- aaAnswer aacatecholamine aasurge aathat
aaseems aato aapromote aafluid aaclearance aafrom aathe aalungs, aawhich aacontinues
aaduring aalabou
catecholamines aaare aaresponsible aafor aa- aaAnswer aaincreased aablood aapressure
aaafter aabirth, aaadaptation aaof aaenergy aametabolism, aaand aafor aainitiation aaof
aathermogenesis aafrom aabrown aafat
Cortisol aais aaa aakey aaregulatory aahormone aathat aaaids aa- aaAnswer aain aathe
aaneonate's aatransition aato aaextrauterine aalife
cortisol aabegins aato aaincrease aaat aa- aaAnswer aaincrease aaat aa30 aaweeks, aaincrease
aafurther aaduring aalabour, aaand aapeak aaseveral aahours aaafter aabirth
Cortisol aaaids aain: aa- aaAnswer aaLung aamaturation aa(anatomy aaand aasurfactant)
Clearance aaof aalung aafluid
Gut aamaturation
Maturation aaof aaglucose aametabolic aapathways aain aathe aaliver
Maturation aaof aathe aathyroid aaaxis
major aaadaptations aaassociated aawith aatransition aaoccur aaduring aa- aaAnswer aafirst aa6-
8hr aaof aalife
most aacritical aaadaptation aarequired aais aathe aa- aaAnswer aaestablishment aaof
aaeffective aarespirations
chemical aafactors aathat aainitiate aarespirations aa- aaAnswer aaProgressive aadecline aain
aapO2 aaduring aalabour aaand aaa aadrop aain aaprostaglandin aalevels aathat aaresults aafrom
aaclamping aaof aathe aacor
Key aaphysiological aachanges aathat aaoccur aaduring aatransition aato aaextrauterine aalife
aaare aa- aaAnswer aaexpansion aaof aalungs aawith aaair
,rapid aadecrease aain aapulmonary aavascular aaresistance aaand aaincrease aain
aapulmonary aablood aaflow
initiation aaof aagas aaexchange aaacross aathe aaalveolar aamembrane
pressure aagradient aachanges aa(decreased aaright aaside aapressure/increased aaleft
aaside aapressure aain aaheart)
closure aaof aacirculatory aashunts aa(foramen aaovale, aaductus aaarteriosus)
rise aain aaarterial aapO2
persistent aapulmonary aahypertension aaof aathe aanewborn aa- aaAnswer aaHypo-
expansion aaof aathe aalungs, aahypoxemia, aaand aapersistent aaacidosis aaresult aain aahigh
aapulmonary aavascular aaresistance, aadelayed aaclearance aaof aalung aafluid, aaand
aapersistent aaright aato aaleft aashunting
Some aaof aathe aafactors aathat aaare aabelieved aato aastimulate aaa aanewborn aato aatake
aahis/her aafirst aabreath aaare: aa- aaAnswer aaChemical: aafactors aain aaa aanewborn's
aablood aa(low aaoxygen, aahigh aacarbon aadioxide, aaand aalow aapH) aawhich aastimulate
aarespiratory aacenter aain aabrain.
Thermal: aachange aain aatemperature aafrom aaintrauterine aaenvironment aato
aaextrauterine aaenvironment aastimulate aaskin aareceptors aawhich aastimulate
aarespiratory aacenter.
Mechanical: aarelease aaof aapressure aaon aaa aababy's aachest, aaas aathe aachest aais
aaborn, aamay aastimulate aabreathing aaand aachest aaexpansion.
Sensory: aastimulation aafrom aadrying, aalights, aasounds, aasmells aaall aainvolved aain
aastimulation aaof aarespiratory aacenter.
major aachanges aathat aatake aaplace aain aaa aanewborn's aacardiopulmonary aasystem
aaduring aathe aatransition aato aaextrauterine aalife aaare: aa- aaAnswer aathe aalungs
aabecome aathe aaprimary aaorgan aaof aagas aaexchange aa(instead aaof aathe aaplacenta);
aathe aalungs aainflate, aafluid aais aacleared aafrom aathe aaalveoli, aapulmonary aavascular
aaresistance aadecreases aarapidly aaand aathere aais aaincreased aapulmonary aablood
aaflow.
The aapressure aagradient aain aathe aanewborn's aaheart aashifts. aaRight aasided aapressure
aawhich aawas aahigh aain aafetal aacirculation aadecreases, aaand aaleft aasided aapressures
aawhich aawere aalow aanow aaincreases. aaAs aaa aaresult aathe aaforamen aaovale aacloses.
Rising aapO2 aacauses aasmooth aamuscle aacells aain aathe aaductus aaarteriosus aato
aaconstrict aathereby aaclosing aathe aashunt.
Removal aaof aathe aalow aapressure aaplacental aasystem aaincreases aathe aapressure aain
aaa aanewborn's aacirculation aawhich aaincreases aacirculation aaand aapulmonary
aaperfusion.
What aais aathe aarole aaof aalung aasurfactant? aa- aaAnswer aaSurfactant aalowers aathe
aasurface aatension aaof aathe aaalveoli aathereby aareducing aathe aapressure aarequired aato
aakeep aathe aaalveoli aaopen. aaDecreased aasurface aatension aaalso aaresults aain
aaincreased aalung aacompliance.
Apgar aascore aa- aaAnswer aaAppearance aa(color)
, Pulse aa(heart aarate)
Grimace aa(reflexes) aaalso aaknown aaas aaresponse aato aastimulation
Activity aa(muscle aatone)
Respirations aa(breathing)
A aascore aaof aa4 aato aa6 aaat aaone aaminute aaindicates aa- aaAnswer aaan aainfant aais
aahaving aasome aadifficulty
A aascore aaof aa7 aaor aaabove aaat aaone aaminute aaindicates aathat aa- aaAnswer aainfant
aais aamaking aaa aagood aaadjustment aato aaextrauterine aalife.
A aascore aaof aa3 aaor aaless aaat aaone aaminute aaindicate aa- aaAnswer aasevere aadistress
An aaApgar aaof aa7 aaor aaless aaat aa5 aaminutes aawarrants aa- aaAnswer aaanother
aaassessment aaof aathe aafive aaparameters aaat aa10 aaminutes.
First aaperiod aaof aareactivity aatimeframe aa- aaAnswer aaWithin aaminutes aaafter aabirth
aaand aalasting aafor aa30-60 aaminutes
during aaFirst aaperiod aaof aareactivity aainfants aaare aaand aanote aaany aachanges aain
aaHR aa& aaResps aa- aaAnswer aainfants aaare aain aaa aaquiet aaalert aastate: aaeyes aawide
aaopen aaand aacapable aaof aaresponding aato aatheir aaenvironment
- aaHeart aarate aaincreases aato aa160-180 aabpm, aathen aasettles aato aa100-120 aabpm
aaby aa30 aaminutes aaof aaage. aa
- aaRespirations aamay aabe aairregular aaand aafine aacrackles aamay aabe aaaudible aaon
aaauscultation aaof aalung aafields. aaTransitory aagrunting, aanasal aaflaring, aaand aachest
aaretractions aamay aabe aaevident.
Following aathis aainitial aaperiod aaof aareactivity, aainfants aasleep aagenerally aa- aaAnswer
aagenerally aago aainto aaa aadeep aasleep, aalasting aafor aa60-100 aaminutes. aaDuring aathis
aadeep aasleep, aamany aaphysiologic aaneeds aastabilize: aa
- aatemperature aaregulation aaand aaadequate aaoxygenation aaand aacirculation
- aaRespirations aamay aabe aarapid aabut aanot aalabored.
Second aaperiod aaof aareactivity aatakes aaplace aawhen aa- aaAnswer aaapproximately
aabetween aatwo aato aasix aahours aaafter aabirth aaand aacan aalast aafrom aa10 aaminutes aato
aaseveral aahours. aa
- aamay aabe aabrief aaperiods aaof aatachycardia aaand aatachypnea, aaincreased aamuscle
aatone, aaand aaskin aacolor aachanges
- aaMeconium aais aausually aapassed aain aathis aaperiod.
what aathree aaperioids aaare aatypical aapatterns aafor aanormal, aahealthy, aaterm
aanewborns aa- aaAnswer aainitial aareactivity, aasleep, aaand aasecond aareactivity
preterm aabirth aaor aabirth aaasphyxia aamay aaalter aainfants' aa- aaAnswer aabehaviour
aaduring aathis aatransition aaperiod
