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