Newborn Adaptation

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Newborn Adaptation

• Chapter 17

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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

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Physiological adaptation

• Heart rate- 120-180 fluctuations due to activity.
• Tachycardia vs. bradycardia
• Blood volume-r/t cord clamping
• Blood components- RBCS short life
• WBC- stress of labor
• Variations in volume

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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

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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

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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

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Physiological Adaptation

• Temperature regulationIMPORTANT
• 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-
  Cant ask for blanket

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Liver function

• Bilirubin breakdown of RBCs
• Liver is immature cannot excrete bilirubin
• Some jaundice normal
• Nsg.- forehead, nose, chin. No pink room
• Interventions- early frequent feedings

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GI

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

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Physiological Adaptation

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

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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

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Neurobehavioral

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