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48 Cards in this Set

  • Front
  • Back
The transition period is the first ____ to ____ hours of life after delivery
6 to 10
Functions of the placenta
blood oxygenation
elimination of waste products
transfer of 02/C02
The transfer of 02 and C02 across the placenta is by
simple diffusion
What percentage of the fetal CO does the placenta receive
Name the three fetal shunts
Ductus arteriosus
Ductus venosus
Foramen ovale
Function and location of the ductus venosus
bypasses approximately 40 to 60% of umbilical venous blood through the liver to the IVC. located in the liver
Function and location of the ductus arteriosus
Shunts blood away from the fetal lungs into the descending aorta. Connects the pulmonary artery to the descending aorta
Function and location of the foramen ovale
Located between the right and left atrium. Blood enters the left atrium from the right atrium
Which vessel carries oxygenated blood to the fetus
umbilical vein
Which vessel carries deoxygenated from the fetus to the placenta
umbilical arteries
What is the P02 value of the umbilical venous blood
The SVC blood comes primarily from
unoxygenated blood fro the brain and upper extremities
Explain fetal circulation
See core curriculum book, page 81
Surfactant is secreted into the amniotic fluid at ___ weeks
Fetal blood glucose levels are ____ % of the maternal levels
70 to 80%
Glucose is exchanged via the placenta by
facilitated diffusion
Role of glycogen during transition
provide large energy stores to sustain the NB through the transition period
What is the difference between fetal and adult hemoglobin
Fetal hgb has an increased affinity for oxygen
Describe the major cardiopulmonary changes at birth
Increased SVR, decreased PVR
3 fetal shunts functionally close, transition of postnatal circulation
What is the most potent stimulant for DA closure
Rise in P02
What other factor contributes to the closure of the DA
Decreased prostaglandin levels
What causes the FO to close
Decrease in R atrial pressure and increased L atrial pressure
When does the FO close
during the first month of life
What causes the FO to reopen
Anything that increases right atrial pressure
What causes the DV to close
Absent umbilical venous return
When does the DV close. After closure, it becomes the
2-3 days
ligamentum venosum
What is the stimulus for breathing after delivery
Mild hypercapnia, hypoxia, and acidosis. Other stimulants include cold, light, noise, and touch
What does aeration of the lungs do to the fluid
displaces it into the interstitium, where it is absorbed through the lymphatics and pulmonary circulation
What causes the PVR to drop
Increase in P02 causes vasodilationq
What causes petechiae and facial bruising after delivery
vertex presentation
rapid 2nd stage of labor
tight nuchal cord
A soft systolic murmur immediately after delivery suggests
patency of the DA
The normal term neonate voids and passes meconium by
24 hours of life
Maintaining a NTE immediately after delivery prevents
increased 02 consumption
utilizing glucose stores
exceeding brown fat stores
Nonshivering thermogenesis is mediated by
norepinephrine released by cold stress
What medications can be used as eye prophylaxis against Neisseria gonorrhoeae
1% silver nitrate
0.5% erythromycin
1% tetracylcine
Eye prophylaxis against chlamydia trachomatis requires what medications
erythromycin or tetracycline
Purpose of Vitamin K injection
promotes the hepatic biosynthesis of vitamin K dependent clotting factors
Vitamin K deficiency can lead to
hemorrhagic disease of the newborn
3 types of hemorrhagic disease of the newborn
Which two variations of hemorrhagic disease are prevented with vitamin K injection
classic and late
When does classic HDN present
1-7 postnatal days
what causes early HDN
maternal exposure to medications, including warfarin, anticonvulsants, and anti TB drugs
When does late HDN present
1-3 months
What portion of infants born to HBsAg + mothers will be +
If a mother is HBsAg +, what treatment should be provided to the NB
Hep B vaccine and HBIG
0.5ml IM within 12 hours of delivery
Dose of Vitamin K for those less than 1.5kg and greater than 1.5kg
< 1.5kg 0.5mg
> 1.5kg 1mg
What is the AAPs current recommendation regarding HBV
all newborns should be vaccinated prior to discharge
Which infants should have their H/H checked after birh
IDMs, history of blood loss, plethoric/pale twin, and twin deliveries.