Newborn adaptation

1. Newborn Adaptation
Chapter 17

2. 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

3. 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

4. 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

5. 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

7. 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

8. 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

9. 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

10. GI
•Benefits of Vitamin K and Breastfeeding
•Difficulty digesting fats
•Avoid overfeeding- Burp
•Fluid shift- lose 10% to 15% 0f weight
•Passage of meconium

11. Physiological Adaptation
•Kidneys-Cannot dispose or concentrate
urine
•Immunity- Natural barriers- IgG and IgA
•Sensory- smell, taste, vision
•Reflexes- blinking, moving, startle, suck

12. 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

13. Neurobehavioral
•Orientation- stare- follow objects
•Habituation- block out stimuli
•Motor maturity- able to control hands
•Self quieting- console self
•Social behavior- cuddliness, reciprocal
relationship