Changes in the cardiovascular systems
- Ductus arteriosus =ligamentum arteriosum
- Foramen ovale – closes and becomes fossa ovalis
- Ductus venosus constricts and becomes ligamentum venosum
- Umbilical vein – becomes ligamentum teres
- Proximal portions of the umbilical arteries persist.
- indicative of low blood O2
- a blue hue to the lips, tongue and central trunk.
blue hue to the hands and feet related to perfusion.
Cold stress of the newborn?
hypothermia can lead to increased respirations causing increased need for O2, glucose, acidemia and surfactant production is impaired
New born medications
- erythromycin ophthalmic ointment-prophylactic treatment for ophthalmia neonatorum=one time dose
- vitamin K=stimulates liver formation clotting factors. Eye prophylaxis and vitamin K are required by law in most states
- Hep B vaccine administered within 12 hours of birth.
Baby heat loss
- maintain warm environment
newborn screening for metabolic disorders
- Cystic fibrosis
- Congenital hypothyroidism
- Sickle cell trait
- in oregon newborns are screened for 36 disorders.
- Unconjugated bilirubin-by product of RBC breakdown-not in an excretable form-must be converted by liver.
- Kernicterus-bilirubin encephalopathy
- Total bilirubin serum is checked on newborns
- caused by too much bilirubin in the newborn
- jaundice can appear 24 hours or more after birth. caused by RBC breakdown and the inability of the liver to process, lack of intestinal bacteria, hydration
Treatment: phototherapy and hydration
Hemolytic disease of the newborn
- seen at birth or up to 24 hours after
- Mom with blood type O (ABO Incompatibility)
- Rh negative mom and a positive baby
Treatment: exchange transfusion
Breast milk jaundice
- bilirubin levels rise in the first week of life of the newborn
- breast milk is high in free fatty acids-bilirubin will drop in 24-48 hours after cessation of breastfeeding.
- glucose less than 40mg/dl
- feeding will reverse this or possible D10 IV infusion
- baby S&S-poor feeding, irritability, tremors, apnea, seizures, hypothermia, hypotonia-floppy baby syndrome
Alert stages of neonate
- quit alert-most cooperative
- active alert