1 / 18

Physiological Transition of the Newborn: Thermoregulation, Respiratory, Cardiovascular, and Other Adaptations

This chapter discusses the challenges newborns face in thermoregulation and explores the adaptations of their respiratory, cardiovascular, hematopoietic, hepatic, gastrointestinal, genitourinary, immunological, and psychosocial systems.

gabrielaz
Download Presentation

Physiological Transition of the Newborn: Thermoregulation, Respiratory, Cardiovascular, and Other Adaptations

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. Question 1 • A newborn is placed under a radiant heat warmer. The nurse knows that thermoregulation presents a problem for newborns because: • a. Their renal function is not fully developed, and heat is lost in the urine. • b. Their small body surface area favors more rapid heat loss than does an adult’s body surface area. • c. They have a relatively thin layer of subcutaneous fat that provides poor insulation. • d. Their normal flexed posture favors heat loss through perspiration

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

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

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

  6. 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

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

  8. 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

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

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

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

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

  13. 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

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

  15. 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

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

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

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

More Related