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West Coast University, Orange County - NURS 307OB prework week 4 latest 2020

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Week 4 PRE WORK Chapter 15 DURHAM: Physiological & Behavioral Responses of the Neonate Neonatal period • From birth through the first 28 days of life. • Nursing actions: protect and support n... eonates as they undergo numerous physiological changes and adapt to extrauterine life. o Maintaining body heat. o Maintaining respiratory function o Decreasing risk for infection ▪ At rx due to immature immune system o Assisting parents in providing appropriate nutrition and hydration. o Assisting parents in learning to care for their newborn. Transition to extrauterine life • Begins at birth when umbilical cord is clamped and neonate takes their first breath (initiation of physiological systems) • System changes: o Respiratory: compression of thorax, lung expansion, increase in alveolar oxygen concentration, vasodilation of pulmonary vessels. ▪ Mechanical and chemical stimuli are the primary factors that initiate extrauterine respirations. ▪ Sensory stimuli such as exposure to temperature changes, sounds, lights, and touch also influence respirations by stimulating the respiratory center of the medulla. ▪ In utero, the lungs are filled with amniotic fluid. Approximately 30 mL of amniotic fluid is forced out of the lungs during the delivery process. ▪ Surfactant, within the alveoli assists in the establishment of functional residual capacity which decrease the amount of pressure and energy required on inspiration ▪ Surfactant produced at wks 24-34. < 34 weeks give meds (Betamethasone) ▪ Two factors that negatively affect the transition to extrauterine respirations are: • Decreased surfactant levels r/t immature lungs • Persistent hypoxemia and acidosis that leads to constriction of pulmonary arteries ▪ 10% of neonates require some degree of assistance with respirations at time of delivery and 1% require extensive resuscitation o [Show More]

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