1 / 17

Physiological Transition of the Newborn: Adapting to Life Outside the Womb

This chapter explores the various adaptations of the newborn's respiratory, cardiovascular, thermogenic, hematopoietic, gastrointestinal, genitourinary, immunological, and psychosocial systems.

lstout
Download Presentation

Physiological Transition of the Newborn: Adapting to Life Outside the Womb

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Chapter 17 Physiological Transition of the Newborn

  2. Adaptations of theRespiratory System • Intrapulmonary fluid • Reduces pulmonary resistance to blood flow • Facilitates initiation of air breathing • Surfactant • Decreases surface tension within alveoli

  3. The First Breath • Internal stimuli • Chemical factors • External stimuli • Sensory factors • Thermal factors • Mechanical factors

  4. Cardiopulmonary Transitions • Increased pulmonary blood volume • Conversion from fetal to neonatal circulation • Immediate assessment necessary • Skin color • Respiratory rate; breathing pattern

  5. Cardiopulmonary Adaptation • Increased aortic pressure and decreased venous pressure • Increased systemic pressure and decreased pulmonary pressure • Closure of foramen ovale, ductus arteriosus, and ductus venosus

  6. Assessing the Cardiovascular Transition • Pulse • Within 30 minutes—120 to 160 bpm • Capillary refill • <3 seconds adequate • >4 seconds possible underlying problem

  7. Thermogenic Adaptation • Newborns are homeothermic • Neutral thermal environment • Cold stress • Large body area • Limited subcutaneous fat • Limited ability to shiver • Thin skin and blood vessels close to surface

  8. Adaptations to Increase Heat Production • Increased BMR and muscle activity • Peripheral vasoconstriction • Nonshivering thermogenesis • Brown adipose tissue

  9. Mechanisms for Neonatal Heat Loss • Evaporation • Insensible water loss • Conduction • Convection • Radiation

  10. Hematopoietic Adaptation • Blood volume • Blood components • Erythrocytes and hemoglobin • Hematocrit • Leukocytes • Platelets

  11. Hepatic adaptation • Glycogen and blood glucose maintenance • Iron storage • Conjugation of bilirubin • Coagulation of blood

  12. Hyperbilirubinemia • Physiologic jaundice—appears 24 to 48 hours after birth; transient • Pathologic jaundice—present at birth or within 24 hours • Breastfeeding jaundice—2to 4 days • Breast milk jaundice—7 days; peaks at 10 days

  13. Gastrointestinal Adaptation • Stomach and digestive enzymes • Intestinal peristalsis • Meconium

  14. Genitourinary Adaptation • Kidney function • Bladder capacity 6 to 44 mL • Fluid requirements—60 to 80 mL/kg • Urine output 1 to 3 mL/kg/hour • Nursing assessments • Careful monitoring of I/O • Assess appearance of urine

  15. Immunological Adaptation • Active acquired immunity • Passive acquired immunity • Immunoglobulins

  16. Psychosocial Adaptation • Early stages of activity • First period of reactivity • Period of inactivity and sleep • Second period of reactivity

  17. Behavioral States • Sleep • Deep, quiet; REM • Alert • Drowsy/semidozing • Wide awake • Active awake • Crying

More Related