Newborn

Neonatal period

• From birth → 1st 28 days of life

• Neonate transitions from intrauterine → extrauterine life

• Adapts to new environment

• Focus of nursing care is to protect & support the neonate during the physiological changes by:

• Maintaining airway, breathing, circulation (ABCs)

• Maintaining thermoregulation

• Decreasing risk for respiratory difficulties, hypothermia, hypoglycemia, infection, & hyperbilirubinemia

Fetal Circulation

• In utero, the placenta serves as the fetal lungs; oxygen & carbon dioxide exchange, nutrition & waste removal

• Alveoli filled with amniotic fluid

• Pulmonary arterioles constricted

• Pulmonary blood flow diminished

• Blood flow diverted across ductus arteriosus

Lungs & Circulation After Delivery

• Transitions from fetal to neonatal circulation

• 1st breath & Clamping Cord stimulates a series of cardiopulmonary changes

• Amniotic fluid leaves alveoli

• Expansion of lungs-pulmonary circulation

• Decrease in pulmonary vascular resistance

• Closing of 3 shunts

• Ductus arteriosus*

• Ductus venosus

• Foramen ovale

Acrocyanosis vs. central cyanosis —> signs of respiratory distress

• Acrocyanosis is the normal finding of blue coloring of hands and feet post birth

• Central Cyanosis is ABNORMAL —> blue color of full body

• • Signs of Respiratory Distress

  • Cyanosis

  • Abnormal respiratory pattern such as apnea

  and tachypnea

  • Retractions of the chest wall

  • Grunting

  • Flaring of nostrils

  • Hypotonia