Neonatal Nursing Care Part 1 Physiological Adaptation of the Newborn to birth - PowerPoint PPT Presentation

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Neonatal Nursing Care Part 1 Physiological Adaptation of the Newborn to birth

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Developed by D. Ann Currie, RN, MSN * Physiological Responses of the Newborn to Birth Respiratory Adaptations: Mechanical changes Chemical changes ... – PowerPoint PPT presentation

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Title: Neonatal Nursing Care Part 1 Physiological Adaptation of the Newborn to birth


1
Neonatal Nursing Care Part 1 Physiological
Adaptation of the Newborn to birth
  • Developed by D. Ann Currie, RN, MSN

2
Physiological Responses of the Newborn to Birth
  • Respiratory Adaptations
  • Mechanical changes
  • Chemical changes
  • Thermal changes
  • Sensory changes

3
Fetal and Neonatal Circulation
4
Normal Term Newborn Cord Blood
5
Neutral Thermal Environmental Temperatures
6
Physiologic Adaptations to Extrauterine Life
7
Newborn Urinalysis Values
8
Cardiovascular Adaptations
  • Decreased pulmonary vascular resistance and
    increased blood flow
  • Increased systemic pressure and closure of ductus
    venosus
  • Increased left atrium and decreased right atrium
    pressure
  • Closure of foramen ovale
  • Reversal of blood flow through ductus arteriosus
    and increased PO2
  • Closure of ductus arteriosus

9
Transitional circulation conversion from fetal
to neonatal circulation.
10
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.
11
Fetal Laboratory Value Changes
  • Decreased erythropoietin production
  • Rise of hemoglobin concentration
  • Physiologic anemia of infancy
  • Leukocytosis
  • Decreased percentage of neutrophils

12
Thermogenesis in the Newborn
  • Large body surface area compared to mass
  • Types of heat loss
  • Convection
  • Radiation
  • Evaporation
  • Conduction

13
Convection
14
Radiation
15
Evaporation
16
Conduction
17
Types of Bilirubin
  • Unconjugated bilirubin
  • Conjugated bilirubin
  • Total bilirubin

18
Conjugation and Excretion of Bilirubin
  • Bilirubin is transported in blood via albumin
  • Bilirubin is transferred into the hepatocytes
  • Attachment of unconjugated bilirubin to
    glucuronic acid
  • Excreted into bile ducts, then into the common
    duct and duodenum
  • Bacteria transform it into urobilinogen and
    stercobilinogen
  • Bilirubin is excreted in urine and stool

19
Jaundice
20
Physiologic Jaundice
  • Accelerated destruction of fetal RBCs
  • Increased amounts of bilirubin delivered to liver
  • Inadequate hepatic circulation
  • Impaired conjugation of bilirubin
  • Defective uptake of bilirubin from the plasma
  • Defective conjugation of the bilirubin

21
Physiologic Jaundice (continued)
  • Increased bilirubin reabsorption
  • Defect in bilirubin excretion
  • Increased reabsorption of bilirubin from the
    intestine

22
Liver Adaptations
  • Iron content stored in liver
  • Low carbohydrate reserves
  • Main source of energy is glucose
  • Liver begins to conjugate bilirubin
  • Lack of intestinal flora results in low levels of
    vitamin K

23
GI Adaptations
  • Sufficient enzymes except for amylase
  • Digests and absorbs fats less efficiently
  • Salivary glands are immature
  • Stomach has capacity of 50-60 mL
  • Cardiac sphincter is immature

24
Fluid and Electrolyte Balance
  • Less able to concentrate urine
  • Limited tubular reabsorption of water
  • Limited excretion of solutes
  • Limited dilutional capabilities

25
Immunologic Responses in the Newborn
  • IgG passive acquired immunity via placenta
  • IgM usually not passively transferred
  • Elevated levels may indicate fetal antigenic
    activity in utero
  • IgA passive acquired immunity via colostrum

26
Periods of Reactivity
  • First period of reactivity
  • Sleep phase
  • Second period of reactivity

27
Mother and baby gaze at each other. This quiet
alert state is the optimal state for interaction
28
Behavioral and Sensory Capabilities
  • Habituation
  • Orientation
  • Auditory
  • Olfactory
  • Tasting and Sucking
  • Tactile

29
End of Part 1
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