Chapter 17 NB Transitioning
-air-filled, low pressure encourages blood flow thru lungs for gas exchange
-increase O2 content of blood in lungs contributes to the closing of the ductus arterious
respiratory system neonatal
Site of gas exchange in neonatal
lungs
pressures in the left atrium are greater than the right atrium, causing the foramen ovale to close
circulation thru heart for neonatal
ductus venousus closes; hepatic portal circulation begins
hepatic portal circulation
Thermoregulation
body temp is maintained thru flexed posture and brown fat
Temp (NB)
97.7-99.5 F (36.5-37.5 C)
HR NB
110-160 bpm; can increase to 180 during crying
respirations NB
30-60 breaths/min at rest; will increase when crying
BP NB
50-70 mmHg systolic; 30-45 mmHg dialstolic
-Stimulate and dry infant
-assess ABC's
-Assign APGAR scores
-NB ID
-Keep mom, baby, and partner together as much as possible
Initial NB assessment
Initial NB assessment
Give eye px and vit k
-maintain airway
-ensure proper ID
-Never walk w/babies
-maintain thermoregulation
-administer eye px/ vit K
Nurse interventions w/ immediate NB
Initial NB assessment cont...
-lenght/wt
-VS
-Gestational age assessement
-physical maturity (skin texture, lanugo, plantar creases, brst tissue, eyes and ears)
-neuromuscular maturity (posture, arm recoil, popliteal angle, heal to ear, square window, scarf sign)
Appearance (color), Pulse, Grimace (reflex irrability), Activity (muscle tone), Respiratory
APGAR
done at 1 min and 5 min, if less than 7 also at 10 mins
APGAR scoring
inspection of trunk/extremities w/ appropriate color appearing within minutes after birth
Appearance (color)
cyanotic/pale (appearance)
0pts
appropriate body color; blue extremities (acrocyanosis) (appearance)
1pt
completely appropriate color (appearance)
2pts