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INTRODUCTION. http://www.youtube.com/watch?v=ylGrQVL774k. Neonatal Nursing Care Part 1 Physiological Adaptation of the Newborn to birth. Developed by D. Ann Currie, RN, MSN 2012. Physiological Responses of the Newborn to Birth. Respiratory Adaptations: Mechanical changes - PowerPoint PPT Presentation

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Page 1: INTRODUCTION

INTRODUCTIONhttp://www.youtube.com/watch?v=ylGrQVL77

4k

http://www.youtube.com/watch?v=ylGrQVL774k
http://www.youtube.com/watch?v=ylGrQVL774k
Page 2: INTRODUCTION

Developed by D. Ann Currie, RN, MSN2012

Page 3: INTRODUCTION

Physiological Responses of the Newborn to BirthRespiratory Adaptations: Mechanical changes Chemical changes Thermal changes Sensory changes

Page 4: INTRODUCTION

Fetal and Neonatal Circulation

Page 5: INTRODUCTION

Normal Term Newborn Cord Blood

Page 6: INTRODUCTION

Neutral Thermal Environmental Temperatures

Page 7: INTRODUCTION

Physiologic Adaptations to Extrauterine Life

Page 8: INTRODUCTION

Newborn Urinalysis Values

Page 9: INTRODUCTION

Cardiovascular Adaptations Decreased pulmonary vascular resistance and

increased blood flowIncreased systemic pressure and closure of

ductus venosusIncreased left atrium and decreased right

atrium pressureClosure of foramen ovale

Reversal of blood flow through ductus arteriosus and increased PO2Closure of ductus arteriosus

Page 10: INTRODUCTION

Transitional circulation: conversion from fetal to neonatal circulation.

Page 11: INTRODUCTION

Fetal-neonatal circulation. A, Pattern of blood flow and oxygenation in fetal circulation. B, Pattern of blood flow and oxygenation in transitional circulation of the newborn. C, Pattern of blood flow and oxygenation in neonatal circulation.

Page 12: INTRODUCTION

Fetal Laboratory Value ChangesDecreased erythropoietin productionRise of hemoglobin concentrationPhysiologic anemia of infancyLeukocytosisDecreased percentage of neutrophils

Page 13: INTRODUCTION

Thermogenesis in the NewbornLarge body surface area compared to massTypes of heat loss

ConvectionRadiationEvaporationConduction

Page 14: INTRODUCTION

Convection

Page 15: INTRODUCTION

Radiation

Page 16: INTRODUCTION

Evaporation

Page 17: INTRODUCTION

Conduction

Page 18: INTRODUCTION

Types of Bilirubin Unconjugated bilirubinConjugated bilirubinTotal bilirubin

Page 19: INTRODUCTION

Conjugation and Excretion of Bilirubin Bilirubin is transported in blood via albuminBilirubin is transferred into the hepatocytesAttachment of unconjugated bilirubin to

glucuronic acidExcreted into bile ducts, then into the

common duct and duodenumBacteria transform it into urobilinogen and

stercobilinogenBilirubin is excreted in urine and stool

Page 20: INTRODUCTION

Jaundice

Page 21: INTRODUCTION

Physiologic Jaundice Accelerated destruction of fetal RBCs

Increased amounts of bilirubin delivered to liver

Inadequate hepatic circulationImpaired conjugation of bilirubin

Defective uptake of bilirubin from the plasma

Defective conjugation of the bilirubin

Page 22: INTRODUCTION

Physiologic Jaundice (continued) Increased bilirubin reabsorption

Defect in bilirubin excretionIncreased reabsorption of bilirubin from the

intestine

Page 23: INTRODUCTION

Liver Adaptations Iron content stored in liverLow carbohydrate reservesMain source of energy is glucoseLiver begins to conjugate bilirubinLack of intestinal flora results in low levels of

vitamin K

Page 24: INTRODUCTION

GI Adaptations Sufficient enzymes except for amylaseDigests and absorbs fats less efficientlySalivary glands are immatureStomach has capacity of 50-60 mLCardiac sphincter is immature

Page 25: INTRODUCTION

Fluid and Electrolyte Balance

Less able to concentrate urineLimited tubular reabsorption of waterLimited excretion of solutesLimited dilutional capabilities

Page 26: INTRODUCTION

Immunologic Responses in the Newborn

IgG – passive acquired immunity via placentaIgM – usually not passively transferred

Elevated levels may indicate fetal antigenic activity in utero

IgA – passive acquired immunity via colostrum

Page 27: INTRODUCTION

Periods of Reactivity First period of reactivitySleep phaseSecond period of reactivity

Page 28: INTRODUCTION

Mother and baby gaze at each other. This quiet alert state is the optimal state for interaction

Page 29: INTRODUCTION

Behavioral and Sensory Capabilities

HabituationOrientationAuditoryOlfactoryTasting and SuckingTactile

Page 30: INTRODUCTION

End of Part 1

Page 31: INTRODUCTION

QUESTIONS

Page 32: INTRODUCTION

Thank youhttp://www.youtube.com/watch?v=ylGrQVL77

4k

http://www.youtube.com/watch?v=ylGrQVL774k
http://www.youtube.com/watch?v=ylGrQVL774k

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