NU 404 Unit 6 Exam Guide With
Complete Solution
Regarding the transition to extrauterine life, when does the first period of
reactivity occur? - ANSWER 30 minutes after birth
Regarding the transition to extrauterine life, when does the second period of
reactivity occur? - ANSWER 2-8 hours after birth
What are the 3 adjustments a baby must make after birth? - ANSWER
respiratory, cardiovascular, thermal
What is chemical initiation of breathing? - ANSWER when the umbilical cord
is cut (utero-placental circulation ceases)
When the umbilical cord is cut, uteroplacental circulation ceases. This causes
an increase in Pco2 and a decrease in Po2. What does this stimulate? -
ANSWER the medulla (breathing center) and causes baby to take a breath
The compression of the fetal chest during the delivery process is describes... -
ANSWER mechanical initiation of breathing
- may have crackles depending on how much fluid
C-S vs SVD - ANSWER c-section vs. spontaneous vaginal delivery.
- babies born vaginally get the mechanical initiation
- vaginal birth babies should not be as congested.
Initiation of breathing: thermal - ANSWER changes in the environment
stimulate the receptors in skin
,- babies need to maintain a neutrothermal temp to prevent cold stress
What temperature should the nursery be? - ANSWER 75
This stimuli, combined with mechanical and chemical, play a role in initiation
of breathing in the normal newborn. - ANSWER multiple sensory stimuli.
- make sure there is no grunting, flaring, or nasal retractions (GFR)
Environment... - ANSWER the cooling effect stimulates sensory impulses
- noise, light, pain
- stimulate womb for preemie babies
What are some cardiopulmonary changes for the newborn? - ANSWER -
conversion from fetal to neonatal circulation (fetal circulation is opposite of
our circulation)
- emptying the lungs of fluid (if not emptied...=impaired gas exchange)
- Co2 increased, O2 decreased, sends message to medulla (if something goes
wrong, baby will be in distress)
Surfak (docusate) - ANSWER lowers the surface tension at the oil-water
interface of feces.
- sennoside/laxative/stool softener
- 100mg bid
Contraindications of surfak (docusate) - ANSWER mineral oil
Symptoms of surfak (docusate) - ANSWER N/V, abd pain, fecal impaction,
appendicitis
,What is surfactant? - ANSWER a surface acting phospholipid (fat) that
prevents the alveoli from collapsing on expiration
- babies bodies makes this
When do alveolar sacs in the lung develop? - ANSWER at 24 weeks
When are cells of the alveoli changed into type I and type II cells? - ANSWER
by 26-28 weeks
Type I cells are responsible for - ANSWER gas exchange in the lungs
Type II cells allow for - ANSWER the production of surfactant
When do the number of type II cells increase concurrently with surfactant
productions? - ANSWER by 35-36 weeks
- it is possible for fetus to be delivered without resp. distress syndrome by
this time
African american girls do not struggle with breathing as much as - ANSWER
boys and caucasians
What do we do if baby is not breathing? - ANSWER give exogenous
surfactant (fatty substance) that prevents alveoli from collapsing on
expiration
Newborn respirations - ANSWER 30-60 breaths/min
- avg. 40
Crying increases respirations to over - ANSWER 60
Characteristics of newborn respirations - ANSWER shallow irregular breaths
with periods of apnea
, What is apnea? - ANSWER pauses in breathing lasting greater than 20
seconds
One of the most crucial adjustments that the newborn must make is -
ANSWER respirations
What is preferred if the baby is in distress? - ANSWER blow-by
- usually don't put on O2 unless they are in distress
GFR - ANSWER grunting, flaring (nasal), retractions (chest)
Respiratory rate less than 30 or greater than 60 is - ANSWER resp. distress
- tachypnea can be the first sign there is a prob
What causes transient tachypnea of newborn (TTNB)? - ANSWER retained
fetal lung fluid due to impaired clearance mechanisms
- rapid breathing, but goes away (transient)
If baby still has TTNB 2 hours later, they are - ANSWER in distress
True or false
suction mouth first, then nose - ANSWER true
Serious resp. distress usually lasts beyond - ANSWER 2 hours
Hyaline membrane disease is - ANSWER resp distress in premature infant
Signs of resp. distress? - ANSWER - changes in infant's color
- GFR
- acrocyanosis
- central cyanosis
Complete Solution
Regarding the transition to extrauterine life, when does the first period of
reactivity occur? - ANSWER 30 minutes after birth
Regarding the transition to extrauterine life, when does the second period of
reactivity occur? - ANSWER 2-8 hours after birth
What are the 3 adjustments a baby must make after birth? - ANSWER
respiratory, cardiovascular, thermal
What is chemical initiation of breathing? - ANSWER when the umbilical cord
is cut (utero-placental circulation ceases)
When the umbilical cord is cut, uteroplacental circulation ceases. This causes
an increase in Pco2 and a decrease in Po2. What does this stimulate? -
ANSWER the medulla (breathing center) and causes baby to take a breath
The compression of the fetal chest during the delivery process is describes... -
ANSWER mechanical initiation of breathing
- may have crackles depending on how much fluid
C-S vs SVD - ANSWER c-section vs. spontaneous vaginal delivery.
- babies born vaginally get the mechanical initiation
- vaginal birth babies should not be as congested.
Initiation of breathing: thermal - ANSWER changes in the environment
stimulate the receptors in skin
,- babies need to maintain a neutrothermal temp to prevent cold stress
What temperature should the nursery be? - ANSWER 75
This stimuli, combined with mechanical and chemical, play a role in initiation
of breathing in the normal newborn. - ANSWER multiple sensory stimuli.
- make sure there is no grunting, flaring, or nasal retractions (GFR)
Environment... - ANSWER the cooling effect stimulates sensory impulses
- noise, light, pain
- stimulate womb for preemie babies
What are some cardiopulmonary changes for the newborn? - ANSWER -
conversion from fetal to neonatal circulation (fetal circulation is opposite of
our circulation)
- emptying the lungs of fluid (if not emptied...=impaired gas exchange)
- Co2 increased, O2 decreased, sends message to medulla (if something goes
wrong, baby will be in distress)
Surfak (docusate) - ANSWER lowers the surface tension at the oil-water
interface of feces.
- sennoside/laxative/stool softener
- 100mg bid
Contraindications of surfak (docusate) - ANSWER mineral oil
Symptoms of surfak (docusate) - ANSWER N/V, abd pain, fecal impaction,
appendicitis
,What is surfactant? - ANSWER a surface acting phospholipid (fat) that
prevents the alveoli from collapsing on expiration
- babies bodies makes this
When do alveolar sacs in the lung develop? - ANSWER at 24 weeks
When are cells of the alveoli changed into type I and type II cells? - ANSWER
by 26-28 weeks
Type I cells are responsible for - ANSWER gas exchange in the lungs
Type II cells allow for - ANSWER the production of surfactant
When do the number of type II cells increase concurrently with surfactant
productions? - ANSWER by 35-36 weeks
- it is possible for fetus to be delivered without resp. distress syndrome by
this time
African american girls do not struggle with breathing as much as - ANSWER
boys and caucasians
What do we do if baby is not breathing? - ANSWER give exogenous
surfactant (fatty substance) that prevents alveoli from collapsing on
expiration
Newborn respirations - ANSWER 30-60 breaths/min
- avg. 40
Crying increases respirations to over - ANSWER 60
Characteristics of newborn respirations - ANSWER shallow irregular breaths
with periods of apnea
, What is apnea? - ANSWER pauses in breathing lasting greater than 20
seconds
One of the most crucial adjustments that the newborn must make is -
ANSWER respirations
What is preferred if the baby is in distress? - ANSWER blow-by
- usually don't put on O2 unless they are in distress
GFR - ANSWER grunting, flaring (nasal), retractions (chest)
Respiratory rate less than 30 or greater than 60 is - ANSWER resp. distress
- tachypnea can be the first sign there is a prob
What causes transient tachypnea of newborn (TTNB)? - ANSWER retained
fetal lung fluid due to impaired clearance mechanisms
- rapid breathing, but goes away (transient)
If baby still has TTNB 2 hours later, they are - ANSWER in distress
True or false
suction mouth first, then nose - ANSWER true
Serious resp. distress usually lasts beyond - ANSWER 2 hours
Hyaline membrane disease is - ANSWER resp distress in premature infant
Signs of resp. distress? - ANSWER - changes in infant's color
- GFR
- acrocyanosis
- central cyanosis
