OB - Newborn Test
Neonatal Period birth through 28th day of life
Physiological adjustment to extrauterine life - establish and maintain respirations
- adjusting to circulatory changes
- regulating temperature
- ingesting, retaining, and digesting nutrients
- eliminating waste
- regulating weight
Behavioral tasks (1) establishing a regulated behavioral tempo independent of the mother, which
involves self-regulating arousal, self-monitoring changes in state, and patterning sleep
(2) processing, storing, and organizing multiple stimuli
(3) establishing a relationship with caregivers and the environment
Major adaptions from intrauterine to extrauterine occur when First 6-8 hours after birth
Events during transition of birth are mediated where Sympathetic Nervous System
What predictable changes occur during newborn transition Heart rate
Respirations
temperature
GI function
The birth transition is a time of _________ and requires careful ___________ vulnerability
,observation
How will a nurse be able to detect disorders in adaption after birth? Nurse must know the normal
features of the transition period
Three stages of newborn transition - 1st period of reactivity - first 30 minutes after birth
- Period of decreased responsiveness - Lasts 60-100 minutes
- 2nd period of reactivity - first 2-8 hours of life
What should be seen in 1st period of reactivity Newborn is alert
exhibits exploring activity
makes sucking sounds
rapid HR and RR
fine crackles on auscultation
audible grunting, nasal flaring, retractions - cease in 1st hour
bowel sounds audible
meconium may pass
How should HR be at birth HR at 160-180 but slows to 100-120 after 30 minutes
What should be seen in period of decreased responsiveness NB quiet and begins to rest/sleep
Color is pink
Respirations are up to 60; shallow and unlabored
Bowel sounds are audible
peristaltic waves may be noted over rounded abdomen
,2nd period of reactivity Lasts 10 minutes to several hours
Gag & chokes on mucus accumulating in mouth
Brief periods of tachycardia and tachypnea
What is associated with brief period of tachycardia and tachypnea in 2nd period of reactivity increased
muscle tone
changes in skin color
mucous production
Who does and does not experience this transition period Newborns do regardless of gestational age or
type of birth
Preterm infants do not because of physiologic immaturity
Initiation of breathing Chemical factors
Mechanical factors
Thermal factors
Sensory factors
Chemical factors periods of hypoxia and hypercapnia which activate chemoreceptors which stimulate
respiratory center in medulla
Mechanical factors chest is compressed during birth which releases pressure after birth and crying
increases air in lungs and alveoli are able to expand
Thermal factors Low room temp stimulates receptors in skin which stimulates respirations through
medulla
, Sensory Factors Handling of the infant and suctioning the mouth and nose, drying infant at birth
Establishing respirations Breaths are shallow and irregular 30-60 bpm
Apneic periods less than 20 seconds during sleep
Auscultation of bilateral breath sounds should be loud and clear
Abdominal breathing is normal
Being in the extrauterine environment and umbilical cord clamping are? Profound adaptations that are
necessary for survival
The transition period is what for respirations? Most critical establishment of effective respirations
Most newborns can breathe __________after birth and maintain adequate _________ spontaneously
oxygenation
Preterm infants often encounter ___________ difficulties related to ___________ lungs respiratory
immature
Signs of respiratory distress nasal flaring
retractions - intercostal and subcostal
grunting with respirations
What usually represents an upper airway obstruction suprasternal or subclavicular retraitions with
stridor or gasping
What are seesaw or paradoxic respirations? Exaggerated rise in abdomen with respiration as chest falls
Neonatal Period birth through 28th day of life
Physiological adjustment to extrauterine life - establish and maintain respirations
- adjusting to circulatory changes
- regulating temperature
- ingesting, retaining, and digesting nutrients
- eliminating waste
- regulating weight
Behavioral tasks (1) establishing a regulated behavioral tempo independent of the mother, which
involves self-regulating arousal, self-monitoring changes in state, and patterning sleep
(2) processing, storing, and organizing multiple stimuli
(3) establishing a relationship with caregivers and the environment
Major adaptions from intrauterine to extrauterine occur when First 6-8 hours after birth
Events during transition of birth are mediated where Sympathetic Nervous System
What predictable changes occur during newborn transition Heart rate
Respirations
temperature
GI function
The birth transition is a time of _________ and requires careful ___________ vulnerability
,observation
How will a nurse be able to detect disorders in adaption after birth? Nurse must know the normal
features of the transition period
Three stages of newborn transition - 1st period of reactivity - first 30 minutes after birth
- Period of decreased responsiveness - Lasts 60-100 minutes
- 2nd period of reactivity - first 2-8 hours of life
What should be seen in 1st period of reactivity Newborn is alert
exhibits exploring activity
makes sucking sounds
rapid HR and RR
fine crackles on auscultation
audible grunting, nasal flaring, retractions - cease in 1st hour
bowel sounds audible
meconium may pass
How should HR be at birth HR at 160-180 but slows to 100-120 after 30 minutes
What should be seen in period of decreased responsiveness NB quiet and begins to rest/sleep
Color is pink
Respirations are up to 60; shallow and unlabored
Bowel sounds are audible
peristaltic waves may be noted over rounded abdomen
,2nd period of reactivity Lasts 10 minutes to several hours
Gag & chokes on mucus accumulating in mouth
Brief periods of tachycardia and tachypnea
What is associated with brief period of tachycardia and tachypnea in 2nd period of reactivity increased
muscle tone
changes in skin color
mucous production
Who does and does not experience this transition period Newborns do regardless of gestational age or
type of birth
Preterm infants do not because of physiologic immaturity
Initiation of breathing Chemical factors
Mechanical factors
Thermal factors
Sensory factors
Chemical factors periods of hypoxia and hypercapnia which activate chemoreceptors which stimulate
respiratory center in medulla
Mechanical factors chest is compressed during birth which releases pressure after birth and crying
increases air in lungs and alveoli are able to expand
Thermal factors Low room temp stimulates receptors in skin which stimulates respirations through
medulla
, Sensory Factors Handling of the infant and suctioning the mouth and nose, drying infant at birth
Establishing respirations Breaths are shallow and irregular 30-60 bpm
Apneic periods less than 20 seconds during sleep
Auscultation of bilateral breath sounds should be loud and clear
Abdominal breathing is normal
Being in the extrauterine environment and umbilical cord clamping are? Profound adaptations that are
necessary for survival
The transition period is what for respirations? Most critical establishment of effective respirations
Most newborns can breathe __________after birth and maintain adequate _________ spontaneously
oxygenation
Preterm infants often encounter ___________ difficulties related to ___________ lungs respiratory
immature
Signs of respiratory distress nasal flaring
retractions - intercostal and subcostal
grunting with respirations
What usually represents an upper airway obstruction suprasternal or subclavicular retraitions with
stridor or gasping
What are seesaw or paradoxic respirations? Exaggerated rise in abdomen with respiration as chest falls
