Newborn Adaptation

Chapter 17

Fetal Structures

• Foramen ovale closes with decrease pulmonary vascular resistance

• Increases pressure to left side of heart

• 4 chambers

• Ductus arteriosis closes due to increase of O2 to lungs

• Ductus venosus close and liver begins to fx

Physiological adaptation

• Heart rate- 120-180 fluctuations due to activity.

• Tachycardia vs. bradycardia

• Blood volume-r/t cord clamping

• Blood components- RBC’S short life

• WBC- stress of labor

• Variations in volume

Physiological Adaptation

• Respiratory-Initiation of breathing

• Surfactant production- reduces surface tension

• Compare C/S vs. NSVD

• Respiration- 30-60

• Periodic breathing is normal, not longer than 15 secs

Types of Heat Loss

• Convection- warm body to cool air currents

• Radiation-heated body to cooler object (no direct contact)

• Evaporation- water converts to vapor

• Conduction- heat loss by contact with cooler surface

Thermoregulation

• Regulates heat loss through O2 consumption and rate of metabolism

• Conservation= increasing metabolism, movement, vasoconstriction, positioning.

• Non shivering thermogenesis– breakdown of brown fat

• Prevention of cold stress- drying, blankets, warmer, skin to skin, assess temp

Physiological Adaptation

• Temperature regulation—IMPORTANT

• Do not chill

• Thermoregulation- newborn has very narrow range

• Vessels close to skin- not able to shiver-lg body surface area- lack fat- unable to conserve heat- Can’t ask for blanket

Liver function

• Bilirubin breakdown of RBC’s

• Liver is immature cannot excrete bilirubin

• Some jaundice normal

• Nsg.- forehead, nose, chin. No pink room

• Interventions- early frequent feedings

GI

• Benefits of Vitamin K and Breastfeeding

• Difficulty digesting fats

• Avoid overfeeding- Burp

• Fluid shift- lose 10% to 15% 0f weight

• Passage of meconium

Physiological Adaptation

• Kidneys-Cannot dispose or concentrate urine

• Immunity- Natural barriers- IgG and IgA

• Sensory- smell, taste, vision

• Reflexes- blinking, moving, startle, suck

Behavioral Adaptation

• First period of reactivity- birth to 30 minutes-initiate breastfeeding

• Sleeping or quiet- sleepy, good time to hold

• Second period- more alert, notice environment

Neurobehavioral

• Orientation- stare- follow objects

• Habituation- block out stimuli

• Motor maturity- able to control hands

• Self quieting- console self

• Social behavior- cuddliness, reciprocal relationship