Adaptation To Extrauterine Life

Front 1

The transition period is the first ____ to ____ hours of life after delivery

Back 1

6 to 10

Front 2

Functions of the placenta

Back 2

blood oxygenation
elimination of waste products
transfer of 02/C02

Front 3

The transfer of 02 and C02 across the placenta is by

Back 3

simple diffusion

Front 4

What percentage of the fetal CO does the placenta receive

Back 4

50%

Front 5

Name the three fetal shunts

Back 5

Ductus arteriosus
Ductus venosus
Foramen ovale

Front 6

Function and location of the ductus venosus

Back 6

bypasses approximately 40 to 60% of umbilical venous blood through the liver to the IVC. located in the liver

Front 7

Function and location of the ductus arteriosus

Back 7

Shunts blood away from the fetal lungs into the descending aorta. Connects the pulmonary artery to the descending aorta

Front 8

Function and location of the foramen ovale

Back 8

Located between the right and left atrium. Blood enters the left atrium from the right atrium

Front 9

Which vessel carries oxygenated blood to the fetus

Back 9

umbilical vein

Front 10

Which vessel carries deoxygenated from the fetus to the placenta

Back 10

umbilical arteries

Front 11

What is the P02 value of the umbilical venous blood

Back 11

32-35mmHg

Front 12

The SVC blood comes primarily from

Back 12

unoxygenated blood fro the brain and upper extremities

Front 13

Explain fetal circulation

Back 13

See core curriculum book, page 81

Front 14

Surfactant is secreted into the amniotic fluid at ___ weeks

Back 14

20

Front 15

Fetal blood glucose levels are ____ % of the maternal levels

Back 15

70 to 80%

Front 16

Glucose is exchanged via the placenta by

Back 16

facilitated diffusion

Front 17

Role of glycogen during transition

Back 17

provide large energy stores to sustain the NB through the transition period

Front 18

What is the difference between fetal and adult hemoglobin

Back 18

Fetal hgb has an increased affinity for oxygen

Front 19

Describe the major cardiopulmonary changes at birth

Back 19

Increased SVR, decreased PVR
3 fetal shunts functionally close, transition of postnatal circulation

Front 20

What is the most potent stimulant for DA closure

Back 20

Rise in P02

Front 21

What other factor contributes to the closure of the DA

Back 21

Decreased prostaglandin levels

Front 22

What causes the FO to close

Back 22

Decrease in R atrial pressure and increased L atrial pressure

Front 23

When does the FO close

Back 23

during the first month of life

Front 24

What causes the FO to reopen

Back 24

Anything that increases right atrial pressure

Front 25

What causes the DV to close

Back 25

Absent umbilical venous return

Front 26

When does the DV close. After closure, it becomes the

Back 26

2-3 days
ligamentum venosum

Front 27

What is the stimulus for breathing after delivery

Back 27

Mild hypercapnia, hypoxia, and acidosis. Other stimulants include cold, light, noise, and touch

Front 28

What does aeration of the lungs do to the fluid

Back 28

displaces it into the interstitium, where it is absorbed through the lymphatics and pulmonary circulation

Front 29

What causes the PVR to drop

Back 29

Increase in P02 causes vasodilationq

Front 30

What causes petechiae and facial bruising after delivery

Back 30

vertex presentation
rapid 2nd stage of labor
tight nuchal cord

Front 31

A soft systolic murmur immediately after delivery suggests

Back 31

patency of the DA

Front 32

The normal term neonate voids and passes meconium by

Back 32

24 hours of life

Front 33

Maintaining a NTE immediately after delivery prevents

Back 33

increased 02 consumption
utilizing glucose stores
exceeding brown fat stores

Front 34

Nonshivering thermogenesis is mediated by

Back 34

norepinephrine released by cold stress

Front 35

What medications can be used as eye prophylaxis against Neisseria gonorrhoeae

Back 35

1% silver nitrate
0.5% erythromycin
1% tetracylcine

Front 36

Eye prophylaxis against chlamydia trachomatis requires what medications

Back 36

erythromycin or tetracycline

Front 37

Purpose of Vitamin K injection

Back 37

promotes the hepatic biosynthesis of vitamin K dependent clotting factors

Front 38

Vitamin K deficiency can lead to

Back 38

hemorrhagic disease of the newborn

Front 39

3 types of hemorrhagic disease of the newborn

Back 39

classic
early
late

Front 40

Which two variations of hemorrhagic disease are prevented with vitamin K injection

Back 40

classic and late

Front 41

When does classic HDN present

Back 41

1-7 postnatal days

Front 42

what causes early HDN

Back 42

maternal exposure to medications, including warfarin, anticonvulsants, and anti TB drugs

Front 43

When does late HDN present

Back 43

1-3 months

Front 44

What portion of infants born to HBsAg + mothers will be +

Back 44

1/3

Front 45

If a mother is HBsAg +, what treatment should be provided to the NB

Back 45

Hep B vaccine and HBIG
0.5ml IM within 12 hours of delivery

Front 46

Dose of Vitamin K for those less than 1.5kg and greater than 1.5kg

Back 46

< 1.5kg 0.5mg
> 1.5kg 1mg

Front 47

What is the AAPs current recommendation regarding HBV

Back 47

all newborns should be vaccinated prior to discharge

Front 48

Which infants should have their H/H checked after birh

Back 48

IDMs, history of blood loss, plethoric/pale twin, and twin deliveries.