transition and physiology
The major physiologic adaptations occur during this time after birth
the first 6-8 hours
normal newborn respiratory rate
30-60 bpm
TTN is caused by failure to clear this
Fetal lung fluid
2:1
continuous positive pressure
CPAP
gas exchange before birth occurs through this
Placenta --> transplancental gas exchange
normal oxygen saturation
95-100%
RDS is caused by deficiency of this
Surfactant
Phospholipid indicating maturity
Phosphatidylglycerol
oxygenation device if ventilation not needed
Oxygen hood
This event increases lung perfusion after birth
umbilical cord clamping
Apnea > this is abnormal
20 seconds
TTN resolves in
24-72 hours
Surfactant begins at
24 weeks
intervention to help lungs expand
positioning
4 factors that initiate respirations
chemical, mechanical, thermal and sensory
Late sign of respiratory distress
Cyanosis
Biggest risk factor for RDS
Prematurity
Medication to accelerate lungs
Betamethasone
keep airway clear
suctioning
why is crying important?
expands alveoli and keeps them open
signs of respiratory distress
retractions, grunting, nasal flaring, tachypnea
ET tube medication for RDS
Surfactant replacement
Test used to assess maturity
Amniocentesis
key monitoring
pulse ox and blood gases