Exam 4: Newborn Physiologic Adaptations Questions and Correct Solutions Rated A+

First period of reactivity Transition Period The newborn is alert, exhibits exploring activity, makes sucking sounds, and has a rapid heart rate and respiratory rate. Heart Rate: Can be as high as 160-180/min, but will stabilize at a baseline of 100-120/min during a period that lasts 30 minutes after birth Period of relative inactivity Transition Period The newborn will become quiet and begin to rest and sleep. The heart rate and respirations will decrease, and this period will last from 60-100 min after birth Second period of reactivity Transition Period The newborn reawakens, becomes responsive again, and often gags and chokes on mucus that has accumulated in the mouth. This period usually occurs 2-8 hours after birth and can last 10 min to several hours 160 to 180 Transition Period: First Phase The newborn heart rate increases rapidly to _____ to ______ beats per minute but gradually falls after 30 minutes to a baseline between 100 and 120 Irregular Transition Period: First Phase Respirations will be ________ and audible grunting, nasal flaring, and retractions of the chest may also be noted Meconium Transition Period: First Phase Bowel sounds are audible, and _________ may be passed Vaginal Respiratory System With a _________ birth, some lung fluid is squeezed from the newborn's trachea and lungs Cesarean Respiratory System With a ________ birth, some lung fluid may be retained within the alveoli 30-60 Respiratory System Once respirations are established, breaths are shallow and irregular, ranging from _____ to ____ breaths per minute. 20 Respiratory System Periods of brief apnea are normal, but apneic periods longer than _____ seconds are an indication of a pathological process Distress Respiratory System Signs of respiratory ________ may include nasal flaring, intercostal or subcostal retractions, or grunting with respirations Upper Respiratory System Suprasternal or subclavicular retractions with stridor or gasping most often represent an ______ airway obstruction Fluids Maintaining Oxygen Supply During the first hour of life the pulmonary lymphatics continue to remove large amounts of _______ 2,500 - 4,000 g Measurements The normal newborn weight is what? 33 - 35.5 cm Measurements The normal newborn head circumference is what? 48 - 53 cm Measurements The normal newborn length is what? 30.5-33 cm Maintaining Oxygen Supply The newborn's chest circumference is approximately ____ to ______ cm at birth Abdominal Maintaining Oxygen Supply Because neonatal respiratory function is largely a matter of diaphragmatic contraction, __________ breathing is characteristic of newborns Surfactant Maintaining Oxygen Supply This lowers surface tension, therefore reducing the pressure required to keep the alveoli open with inspiration, and prevents total alveolar collapse on exhalation, thereby maintaining alveolar stability Foramen ovale Cardiovascular System Increased pulmonary blood flow to the left side of the heart increases pressure in the left atrium, which causes a functional closure of this structure Arteriosus Cardiovascular System When the PO2 level in the arterial blood approximates 50, the ductus _________ constricts in response to increased oxygenation 120-160 Cardiovascular System The heart rate averages between _____ to _____ beats per minute 100 Cardiovascular System A normal variation of the heart rate while the infant is sleeping is ______ bpm 80 Cardiovascular System Sinus bradycardia, which is a heart rate less than ______, may be associated with cardiac anomalies, sepsis, and/or hypoxemia 180-200 Cardiovascular System Sinus tachycardia, which is a heart rate greater than _____ to ______, is usually related to activity that creates demands on the heart. Removal of the stimulus returns heart to baseline. Rarely requires treatment 200+ Cardiovascular System Supraventricular tachycardia (SVT) rates up to ______+ bpm cannot be tolerated by the newborn. It usually causes CHF within 48 hours 180 Cardiovascular System A normal variation of the heart rate while the infant is crying is ______ bpm Murmurs Cardiovascular System Most heart ________ heard during the first few days of life have no pathological significance, and more than 1/2 of them disappear by 6 months Innocent Cardiovascular System This type of murmur is NOT caused by underlying cardiovascular disease