Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Adjustments to Extrauterine Life By : Mohammad Abuadas RN, MSN What after birth??? • The most important physiologic change required of the neonate is the transition from fetal or placental circulation to independent respiration out of the uterus. • “Fetal Asphyxia” is considered to be the most fatal abnormal stressor after labor . Immediate adjustments after birth • Respiratory system: Chemical factors in the blood (low pH , high CO2), which stimulate the presence of impulses that excite the respiratory center in the medulla . The production of the “surfactant” by the alveoli epithelium that facilitate breathing . The circulatory system: The changes in the circulatory system occurs gradually due to the pressure in the lungs, heart and vessels. The closure of the fetal shunts which are : foramen ovale, ducus arteriosus, and the ductus venosus. Thermoregulation : “”HEAT LOSS”” is the most critical event in the thermoregulation process, the factors behind that heat loss are : 1- the newborn’s large surface area facilitates heat loss to the environment by Convection , conduction, radiation , and evaporation . Thermoregulation 2- the newborn’s thin layer of subcutaneous fat provides poor insulation for conservation of heat. 3- the newborn’s nonshivering thermogenesis. “” brown adipose tissue or brown fat, from mitochondria is the main heat producer in the newborn infant. The hemopoietic system • The fetal blood volume depends on the amount of blood transferred from placenta. • The blood of the full term infant is about 80 to 85 ml/kg of body weight. • After birth , the blood volume averages 300 cc. added to 100 from placental circulation. Fluid and electrolyte balance • At birth , the total weight of the infant is 73% fluids, as compared with 58% in the adult. • The infant rate of metabolism is twice greater than that in adults, leading to acidosis. Gastrointestinal system • Digestion of only monosaccharide (simple carbohydrates ) in the early stages . • The immature liver causes conjugation of billirubin , causes physiologic jaundice. • Salivary gland don’t function till 2 to 3 months of age, when drooling become frequent. • Infant’s stomach capacity is about 90cc. • Infant’s intestine is longer than adult’s in relation to their sizes. Integumentary system • At birth, all skin structures are present but found immature . • The “sebaceous glands” are very active late in fetal life and early infancy related to the androgens , they are present in the face, scalp, and genitalia producing greasy “vernix caseosa” that covers the infant at birth. • The eccrine (sweat) glands are functiong. • The apocrine gland remain immature till puberty. • The newborn colors are lighter at birth because melanin is low at birth.