Physiologic and Behavioral Adaptations of the Newborn

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Presentation transcript:

Physiologic and Behavioral Adaptations of the Newborn Chapter 22 Physiologic and Behavioral Adaptations of the Newborn All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

Transition to Extrauterine Life First period of reactivity Lasts up to 30 minutes after birth Newborn’s heart rate increases to 160 to 180 beats/min Decreases after 30 minutes to baseline Infant is alert and has spontaneous startles, crying, and head movement All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

Transition to Extrauterine Life (Cont.) Period of decreased responsiveness Lasts from 60 to 100 minutes Infant is pink Respirations are rapid and shallow up to 60 breaths per minute Sleeps or has a marked decrease in motor activity All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

Transition to Extrauterine Life (Cont.) Second period of reactivity Lasts from 10 minutes to several hours Occurs between 2 and 8 hours after birth Tachycardia, tachypnea occur Meconium passed Increased muscle tone, changes in skin color, and mucus production All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

Physiologic Adaptations Respiratory system Initiation of breathing Signs of respiratory distress Cardiovascular system Heart rate and sounds Blood pressure Blood volume Signs of risk for cardiovascular problems All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

Physiologic Adaptations (Cont.) Hematopoietic system Red blood cells and hemoglobin Leukocytes Platelets Blood groups All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

Physiologic Adaptations (Cont.) Thermogenic system Heat loss Thermogenesis Cold stress Hyperthermia Renal system Fluid and electrolyte balance Signs of risk for renal problems All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

Physiologic Adaptations (Cont.) Gastrointestinal system Digestion Stools Meconium Feeding behaviors Signs of risk for gastrointestinal problems All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

Physiologic Adaptations (Cont.) Hepatic system Iron storage Carbohydrate metabolism Contribution of bilirubin and newborn jaundice Coagulation Signs of risk for hepatic system problem Immune system Risk for infection All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

Physiologic Adaptations (Cont.) Integumentary system Vernix caseosa Acrocyanosis Sweat glands Desquamation Mongolian spots Nevi Erythema toxicum Signs at risk for integumentary problems All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

Physiologic Adaptations (Cont.) Reproductive system Female Male Swelling of breast tissue Signs of risk for reproductive system problems All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

Physiologic Adaptations (Cont.) Skeletal system Caput succedaneum Cephalhematoma Subgaleal hematoma Spine and extremities Signs of risk for skeletal problems Neuromuscular system Newborn reflexes All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

Behavioral Characteristics Sleep-wake states Other factors influencing behavior of newborns Gestational age Time Stimuli Medication All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

Behavioral Characteristics (Cont.) Sensory behaviors Vision Hearing Smell Taste Touch All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

Behavioral Characteristics (Cont.) Response to environmental stimuli Temperament Habituation Consolability Cuddliness Irritability Crying All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

Question A newborn is placed under a radiant heat warmer. The nurse knows that thermoregulation presents a problem for newborns because: their renal function is not fully developed, and heat is lost in the urine. their small body surface area favors more rapid heat loss than does an adult’s body surface area. ANS: C Feedback A Incorrect: Heat loss does not occur through urination. B Incorrect: Newborns have a higher body surface–to–body weight ratio than adults. C Correct: The newborn has little thermal insulation. Furthermore, the blood vessels are closer to the surface of the skin. Changes in environmental temperature alter the temperature of the blood, thereby influencing temperature regulation centers in the hypothalamus. D Incorrect: The flexed position of the newborn helps guard against heat loss because it diminishes the amount of body surface exposed to the environment. DIF: Cognitive Level: Comprehension OBJ: Client Needs: Physiologic Integrity TOP: Nursing Process: Planning All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

Question (Cont.) they have a relatively thin layer of subcutaneous fat that provides poor insulation. their normal flexed posture favors heat loss through perspiration. All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.