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Foundations of Neonatal Care
Cardiac
Objectives
Describe the anatomic and physiologic
transition from fetal to neonatal circulation.
List the diagnostic tests to be ordered for an
infant with a cardiac condition.
Describe three clinical presentations of cardiac
conditions.
Explain the nursing care required for an infant
with a cardiac condition.
Describe post–cardiac surgery nursing care.
Identify nursing considerations for the
administration of common cardiac medications.
Physiology
Cardiac tube
develops; primitive
heart structures form
Weeks gestation
Corrected
transposition,
dextrocardia
Atrial and ventricular
septa form; endocardial
cushions form the
atrioventricular valves
4 weeks
Ventricular septal defect,
atrial septal defect;
endocardial cushion defect;
stenosis, atresia, absence, or
deformation of the tricuspid
and mitral valves
Embryology of Cardiac
Conditions
Great vessels
including aorta and
branches, septum, and
semilunar valves form
8 weeks
Truncus arteriosus,
tetralogy of Fallot,
pulmonary/aorta valve
atresia or stenosis,
transposition of great
vessels
Fetal Circulation
Reprinted with permission of greystone.net.
Neonatal Circulation
Reprinted with permission of greystone.net.
Foundations of Neonatal Care
Nutritional &
Metabolic
Objectives
List the normal values for blood pH, carbon
dioxide (CO2), and bicarbonate (HCO3) for
interpreting blood gases.
Write the formula for calculating total fluid
intake.
Explain the nursing considerations for oral
and enteral feeding.
Explain the nursing care for an infant with a
fluid or electrolyte imbalance.
Physiology
Electrolyte Physiology
Ca+
Ca+
Na+
Na+
Na+
Na+
K+
Mg+
K+
Na+
K+
Na+
Mg+
Ca+
Na+
K+
K+
K+
Na+
Na+
K+
K+
Inside cell
K+
Mg+
Outside cell
Acid-Base Balance
Acid-base regulation
Chemical buffering
Respiratory system
Kidneys
Acid-base imbalances
Acidosis pH <7.35
Alkalosis pH >7.45
Compensation
Minimize pH changes
Acid-Base Balance
pH
pCO2 / HCO3
Acid-base disorder
Compensation
low
high pCO2
respiratory acidosis
high HCO3
high
low pCO2
respiratory alkalosis
low HCO3
low
low HCO3
metabolic acidosis
low pCO2
high
high HCO3
metabolic alkalosis
high pCO2
pH 7.20
Acidic
7.40
Alkalotic
pH 7.60