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BSNC 5000 OB Module 4 questions with correct answers
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BSNC 5000 OB Module 4 questions with correct answers
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BSNC 5000 OB Module 4 questions with correctanswers
What triggers the transition from intrauterine to extrauterine life?
Correct Answer-This is due to the cessation of placental blood flow
coupled with thermal and tactile stimuli necessary to initiate the steps
essential to transition
What is the definition of successful immediate transition to extrauterine
life? Correct Answer-This is a successful transition to air breathing,
cardiovascular remodeling, and independent glucose or energy
management. This requires oxygenation, hemodynamic stability, thyroid
hormones, insulin, epinephrine, and cortisol
What initiates respirations for a newborn during the transitional period?
Correct Answer-This is triggered by cessation of blood flow from the
placenta and subsequent removal of circulating prostaglandins, tactile
and thermal stimulation, changes in partial pressure of oxygen and
carbon dioxide
How is fetal lung fluid balance controlled during respiratory transition to
extrauterine life? Correct Answer-At birth this is cleared from the lungs
and is likely connected with increased expulsion of fluid via trachea and
absorption of remaining lung fluid into interstitial lung tissue through
sodium channels. After birth inspirations, crying, grunting, and braking
maneuvers are thought to establish and maintain functional residual
capacity
,What are the characteristics of the first few breathes after birth for a
newborn? Correct Answer-The first breath is generally the longest and
deepest while the additional next two or three require the most
inspiratory work to clear fluid out of the lung and establish functional
residual capacity. Maternal administration of nitrous oxide may have an
effect.
What is the respiratory rate and pattern immediately after birth? Correct
Answer-During the 10 to 90 minutes after birth there are deep breathes
combined with short periods of breath holding to increase functional
residual capacity which increases over the first 30 minutes of life. It
takes 4 to 11 breathes before adequate gas exchange is established
What is the definition of a successful respiratory transition to
extrauterine life? Correct Answer-This is considered successful if there
is an oxygen saturation levels more than 90% within the first 10 minutes
of life and demonstrate adequate gas exchange, respiratory patterns, and
respiratory rate within the first 90 minutes of life
What are the triggers for the cardiovascular transition to extrauterine
life? Correct Answer-The pulmonary vascular resistance decreases while
systemic vascular resistance increases followed by remodeling of fetal
circulation into postnatal circulation through closure of fetal shunts
(ductus arteriosus, foramen ovale, ductus venosus)
What is the division of blood flow from the placenta throughout the
fetus? Correct Answer-About 50% of the oxygenated fetal blood
returning to fetus from placenta flows past the fetal liver and through
inferior vena cava into right atrium. Deoxygenated blood returned from
,fetal head and extremities enters right atrium through superior vena cava
but flow patterns within the atrium prevent from completely mixing.
About two thirds in the atrium that is mainly oxygenated is shunted
through foramen ovale to left atrium and ventricle to perfuse coronary
arteries and brain. Remaining blood flows into right ventricle where it is
ejected toward the lungs; flows through ductus arteriosus into
descending aorta, circumventing the lungs
What is the role of the ductus arteriosus and foramen ovale? Correct
Answer-These guide blood away from the lungs through the heart to
brain and back to the placenta
What mediates the closure of the ductus arteriosus during the
extrauterine transition? Correct Answer-This is mediated by an increase
in oxygenation and withdrawal of prostaglandin E2 and begins shortly
after birth with significant decreases in patency in 2-5 minutes but may
be patent for 4 hours
What causes closure of the foramen ovale? Correct Answer-Blood flow
through this structure decreases immediately after birth due to an
increase in left atrial volume caused by an increase in pulmonary venous
return. This is occasionally patent at 1 year of age without hemodynamic
consequences
What are the changes with respect to workload of the ventricles during
the extrauterine transition? Correct Answer-Workload of the left
ventricle increases immediately after birth within 2-5 minutes while
workload of the right ventricle decreases as right ventricular afterload
lessens due to decrease in pulmonary vascular resistance. Cardiac output
, peaks around 1 hour of life with left ventricular output stabilizing and
decreasing between 8 to 24 hours after having peaked at about 1 hour of
life
What determines the heart rate of a neonate? Correct Answer-This is
affected by gestational age, mode of delivery, maternal anesthesia, and
timing of cord clamping. A heart rate of 100 beats per minutes is
considered the threshold for successful transition but may take several
minutes to achieve
What is the relationship between glucose or energy management and
temperature as a sign of successful extrauterine transition? Correct
Answer-To maintain body temperature neonates depend on outside
factors such as room temperature or maternal skin temperature, and
ability to mobilize internal energy sources such as glucose, lactate, and
brown fat
What are the impacts of hypoglycemia at birth? Correct Answer-This
may affect neurological and motor development and levels at birth are
associated with maternal glucose levels at time of birth
What determines the amount of energy needed to maintain homeostasis
for a newborn? Correct Answer-This is different for each neonate and
depends on a variety of factors including birth weight, gestational age,
and energy usage during labour
What are the signs of hypoglycemia and difficulty with energy
homeostasis during the transition to extrauterine life? Correct Answer-
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