Ch. 15- Physiological + Behavioral Response to Neona NEONATAL PERIOD 4 first 28 days of life 4 transition begins when umbilical cord is cut + neonate takes first breath 4 Nurse's Role- protect + support neonate 4 Families support infant transition Nurses Focus . maintain respirations . maintain heat . decrease risk of infection . provide adequate nutrition + hydration . assist parents in caring for baby RESPIRATORY CHANGES establishment of respirations is most important physiologica change to occur chemical + mechanical stimuli mitate process MECHANICAL · loss of ampione fluid in lungs . net . pressure in lunas courses CHEMICAL · cessation of placental flow leads to hypoxic
passive inspiration auclosis results from returned CO2 this stims, respiratory · air enters alveoli · lymph system absorbs extra fluid . crying > pos. pressure · lungs remain open center . Breathing occurs - TWO FACTORS NEGATIVELY AFFECTING RESPIRATIONS 1) Low surfactant levels 2) Persistent hypoxemia + acidosis + 10% infants need assistance w/ respirations SIGNS OF RESPIRATORY DISTRESS . Cyanosis - ( central ) bluish- gray mucous membranes . Acrocyanosis - bluish tinge to hands/ feet - 1st 24hr = normal most common 2- 6 hrs. after birth . Abnormal pattern - Apnea ( stop breathing - 20sec.) or tachypnea . Nasal Franny . Grunting . Intercostal / subcostal retractions . hypotonic LD >60 breaths / min
TRANSITION TO NEONATAL CIRCULATION 1) Ductus Venosus Foramen Ovale 3 Ductus Arteriosus THERMOREGULATION . amniotic fluid helps regulate temperature in utero . adapt to changes in the environment once born . at risk for cold stress . neutral thermal environment . HOW DOES BABY RESPOND TO COLD? Lo A metabolic rate 4 + muscle activity 4 peripheral vascular construction 4 metabolism of brown fat METHODS OF HEAT LOSS Evaporation: . loss of heat when - Convection . loss of heat from a