NUR 401 Module 4
1. Initiation of Respirations: a number of factors combine to stimulate the respiratory center in the brain
and initiate respirations at birth. includes chemical, mechanical, thermal, and sensory.
lungs will sound wet for 24 hours after birth
2. Stimulation of Respirations: chemical: chemoreceptors in aorta that respond to changes.
mechanical: in vaginal birth, fetal chest is compressed in the canal so some fluids is forced out.
thermal: temperature changes initiate the respiratory changes, sensors in skin detect and send to the brain
sensory: tactile stimuli stimulate skin sensors, warming and drying the baby stimulates the baby to breath
3. Cardiovascular Adaptations: the transition from fetal to neonatal circulation causes an increase in
blood oxygen levels, shifts in pressure in the heart and lungs, closing of the umbilical vessels, then closing of the ductus
arteriosus/venosus, and foramen ovale.
possible asphyxia and pulmonary hypertension may cause the foramen ovale to open
4. Foramen Ovale: opens only from right to left, closes when pressure in the left atrium is greater than the right,
forces blood from right atrium into the RV and pulmonary artery, blood flow through heart and lungs changes from
fetal to neonatal circulation
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,when the body takes its first breath this occurs
5. Ductus Arteriosus: closes gradually as oxygenation improves, functional closure within hours to some days
after birth (not uncommon to hear a slight murmur when its still closing.
will dilate if there's low levels of oxygen in the blood
6. Ductus Venosus: permanent closure occurs by 1-2 weeks post birth.
7. Thermoregulation Adaptations: methods of heat production include restlessness, crying, flexion,
increased activity, metabolism rises, vasoconstriction, nonshivering thermogenesis (brown fat), all increase oxygen and
glucose consumption.
8. Hematologic Adaptations: erythrocytes, hemoglobin, and hematocrit are higher because less oxygen
was available in fetal life than after birth, leukocytes and WBC are elevated (WBC count will decrease during sepsis),
clotting factors have not been activated yet (that's why vitamin K is given).
9. Gastrointestinal Adaptations: stomach capacity is very small (6 mL/kg at birth), intestines are imma-
ture, and stools progress from a thick greenish/black meconium to a loose greenish/brown stool, breastfed stool will
be frequent, seedy, and mustard color.
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, need to see 1st stool in the first 12 hrs after birth
10. Hepatic Adaptations: important liver functions include maintenance of blood glucose levels, conjugation
of bilirubin, production of factors necessary blood coagulation are still forming, storage of iron, and metabolism of
drugs are immature.
11. Urinary Adaptations: the ability of the kidneys to filter, reabsorb, maintain fluid and electrolyte balance
is less than an adults, their bodies are composed of 75% water, the first void should occur within the first 24 hrs, and
normal diuresis after birth will cause a 5-10% weight loss.
12. Immune Adaptations: less effective at fighting off infections, IgG crosses the placenta in utero and
provides a temporary passive immunity, IgM helps protect against gram-negative bacteria, IgA doesn't cross the
placenta and must be produced by the infant.
13. Psychosocial Adaptations: the periods of reactivity: first period of reactivity, period of decreased
responsiveness, and second period of reactivity.
14. First Period of Reactivity: infants are wide awake, alert, seems interested in their surroundings,
temperature may be decreased, heart rate may be elevated, and typically want to feed at this time.
15. Period of Decreased Responsiveness: after the first hour, the baby falls into a deep sleep and
3/9
1. Initiation of Respirations: a number of factors combine to stimulate the respiratory center in the brain
and initiate respirations at birth. includes chemical, mechanical, thermal, and sensory.
lungs will sound wet for 24 hours after birth
2. Stimulation of Respirations: chemical: chemoreceptors in aorta that respond to changes.
mechanical: in vaginal birth, fetal chest is compressed in the canal so some fluids is forced out.
thermal: temperature changes initiate the respiratory changes, sensors in skin detect and send to the brain
sensory: tactile stimuli stimulate skin sensors, warming and drying the baby stimulates the baby to breath
3. Cardiovascular Adaptations: the transition from fetal to neonatal circulation causes an increase in
blood oxygen levels, shifts in pressure in the heart and lungs, closing of the umbilical vessels, then closing of the ductus
arteriosus/venosus, and foramen ovale.
possible asphyxia and pulmonary hypertension may cause the foramen ovale to open
4. Foramen Ovale: opens only from right to left, closes when pressure in the left atrium is greater than the right,
forces blood from right atrium into the RV and pulmonary artery, blood flow through heart and lungs changes from
fetal to neonatal circulation
1/9
,when the body takes its first breath this occurs
5. Ductus Arteriosus: closes gradually as oxygenation improves, functional closure within hours to some days
after birth (not uncommon to hear a slight murmur when its still closing.
will dilate if there's low levels of oxygen in the blood
6. Ductus Venosus: permanent closure occurs by 1-2 weeks post birth.
7. Thermoregulation Adaptations: methods of heat production include restlessness, crying, flexion,
increased activity, metabolism rises, vasoconstriction, nonshivering thermogenesis (brown fat), all increase oxygen and
glucose consumption.
8. Hematologic Adaptations: erythrocytes, hemoglobin, and hematocrit are higher because less oxygen
was available in fetal life than after birth, leukocytes and WBC are elevated (WBC count will decrease during sepsis),
clotting factors have not been activated yet (that's why vitamin K is given).
9. Gastrointestinal Adaptations: stomach capacity is very small (6 mL/kg at birth), intestines are imma-
ture, and stools progress from a thick greenish/black meconium to a loose greenish/brown stool, breastfed stool will
be frequent, seedy, and mustard color.
2/9
, need to see 1st stool in the first 12 hrs after birth
10. Hepatic Adaptations: important liver functions include maintenance of blood glucose levels, conjugation
of bilirubin, production of factors necessary blood coagulation are still forming, storage of iron, and metabolism of
drugs are immature.
11. Urinary Adaptations: the ability of the kidneys to filter, reabsorb, maintain fluid and electrolyte balance
is less than an adults, their bodies are composed of 75% water, the first void should occur within the first 24 hrs, and
normal diuresis after birth will cause a 5-10% weight loss.
12. Immune Adaptations: less effective at fighting off infections, IgG crosses the placenta in utero and
provides a temporary passive immunity, IgM helps protect against gram-negative bacteria, IgA doesn't cross the
placenta and must be produced by the infant.
13. Psychosocial Adaptations: the periods of reactivity: first period of reactivity, period of decreased
responsiveness, and second period of reactivity.
14. First Period of Reactivity: infants are wide awake, alert, seems interested in their surroundings,
temperature may be decreased, heart rate may be elevated, and typically want to feed at this time.
15. Period of Decreased Responsiveness: after the first hour, the baby falls into a deep sleep and
3/9
