Transcript Newborn Assessment

Chapter
24
Physiologic Adaptations
of the Newborn
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
– Decrease in motor activity after period
Transition to Extrauterine Life—
cont’d
• Second period of reactivity
– Occurs 4 to 8 hours after birth
– Tachycardia, tachypnea occur
– Meconium passed
– Increased muscle tone, changes in
skin color, and mucous production
Physiologic Adaptations
• Respiratory system
– Initiation of breathing
– Signs of respiratory distress
– Maintaining adequate oxygen supply
• Cardiovascular system
– Heart rate and sounds
– Blood pressure
– Blood volume
Physiologic Adaptations—cont’d
• Hematopoietic system
– Red blood cells and hemoglobin
– Leukocytes
– Platelets
– Blood groups
Physiologic Adaptations—cont’d
• Gastrointestinal system
– Digestion
– Stools
• Meconium
– Feeding behaviors
Physiologic Adaptations—cont’d
• Hepatic system
– Iron storage
– Carbohydrate metabolism
– Jaundice
– Coagulation
• Immune system
Physiologic Adaptations—cont’d
• Integumentary system
– Caput succedaneum
– Cephalhematoma
– Subgaleal hematoma
– Sweat glands
– Desquamation
– Mongolian spots
– Nevi
– Erythema toxicum
Physiologic Adaptations—cont’d
• Skeletal system
– At birth more cartilage then ossified bone
• Neuromuscular system
– Newborn reflexes
– Neurologic assessment
Physical Assessment
• General appearance
• Vital signs
• Baseline measurements of physical
growth
– Weight and length
– Head circumference
• Neurologic assessment
Behavioral Characteristics
• Sleep-wake states
• Other factors influencing behavior
of newborns
– Gestational age
– Time
– Stimuli
– Medication
Behavioral Characteristics—cont’d
• Sensory behaviors
– Vision
– Hearing
– Smell
– Taste
– Touch
Behavioral Characteristics—cont’d
• Response to environmental stimuli
– Temperament
– Habituation
– Consolability
– Cuddliness
– Irritability
– Crying
Key Points
• Term infant’s various anatomic and
physiologic systems have reached
development and function that
permits physical existence apart from
mother
• Infant has sensory capabilities that
indicate state of readiness for social
interaction
• Appearance of jaundice during first
day or persistence of jaundice for
Key Points—cont’d
• Heat loss in newborn may exceed capacity
to produce heat and lead to metabolic and
respiratory complications that threaten
newborn’s well-being
• Assessment of newborn requires data
from the prenatal, intrapartal, and
postpartal periods
• Assessment proceeds systematically so
each system is thoroughly evaluated
Key Points—cont’d
• Some reflex behaviors are important for
newborn’s survival
• Personalities and behavioral
characteristics of infants play major role
in the ultimate relationship between
infants and parents
• Each full-term newborn has
predisposed capacity to handle
multitude of stimuli in external world