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Chapter 24

Chapter 24. Physiologic Adaptations of the Newborn. Transition to Extrauterine Life. First period of reactivity Lasts up to 30 minutes after birth Newborn’s heart rate increases to 160 to 180 beats/min Decreases after 30 minutes Decrease in motor activity after period.

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Chapter 24

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  1. Chapter 24 Physiologic Adaptations of the Newborn

  2. Transition to Extrauterine Life • First period of reactivity • Lasts up to 30 minutes after birth • Newborn’s heart rate increases to 160 to 180 beats/min • Decreases after 30 minutes • Decrease in motor activity after period

  3. Transition to Extrauterine Life—cont’d • Second period of reactivity • Occurs 4 to 8 hours after birth • Tachycardia, tachypnea occur • Meconium passed • Increased muscle tone, changes in skin color, and mucous production

  4. Physiologic Adaptations • Respiratory system • Initiation of breathing • Signs of respiratory distress • Maintaining adequate oxygen supply • Cardiovascular system • Heart rate and sounds • Blood pressure • Blood volume

  5. Physiologic Adaptations—cont’d • Hematopoietic system • Red blood cells and hemoglobin • Leukocytes • Platelets • Blood groups

  6. Physiologic Adaptations—cont’d • Gastrointestinal system • Digestion • Stools • Meconium • Feeding behaviors

  7. Physiologic Adaptations—cont’d • Hepatic system • Iron storage • Carbohydrate metabolism • Jaundice • Coagulation • Immune system

  8. Physiologic Adaptations—cont’d • Integumentary system • Caput succedaneum • Cephalhematoma • Subgaleal hematoma • Sweat glands • Desquamation • Mongolian spots • Nevi • Erythema toxicum

  9. Physiologic Adaptations—cont’d • Skeletal system • At birth more cartilage then ossified bone • Neuromuscular system • Newborn reflexes • Neurologic assessment

  10. Physical Assessment • General appearance • Vital signs • Baseline measurements of physical growth • Weight and length • Head circumference • Neurologic assessment

  11. Behavioral Characteristics • Sleep-wake states • Other factors influencing behavior of newborns • Gestational age • Time • Stimuli • Medication

  12. Behavioral Characteristics—cont’d • Sensory behaviors • Vision • Hearing • Smell • Taste • Touch

  13. Behavioral Characteristics—cont’d • Response to environmental stimuli • Temperament • Habituation • Consolability • Cuddliness • Irritability • Crying

  14. Key Points • Term infant’s various anatomic and physiologic systems have reached development and function that permits physical existence apart from mother • Infant has sensory capabilities that indicate state of readiness for social interaction • Appearance of jaundice during first day or persistence of jaundice for more than 7 days indicates a pathologic process

  15. Key Points—cont’d • Heat loss in newborn may exceed capacity to produce heat and lead to metabolic and respiratory complications that threaten newborn’s well-being • Assessment of newborn requires data from the prenatal, intrapartal, and postpartal periods • Assessment proceeds systematically so each system is thoroughly evaluated

  16. Key Points—cont’d • Some reflex behaviors are important for newborn’s survival • Personalities and behavioral characteristics of infants play major role in the ultimate relationship between infants and parents • Each full-term newborn has predisposed capacity to handle multitude of stimuli in external world

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