1. Physiologic and Behavioral Adaptations of the Newborn
Chapter 22
Physiologic and Behavioral
Adaptations of the Newborn
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2. Transition to Extrauterine Life
First period of reactivity
Lasts up to 30 minutes after birth
Newborn’s heart rate increases to 160 to 180 beats/min
Decreases after 30 minutes to baseline
Infant is alert and has spontaneous startles, crying, and head movement
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3. Transition to Extrauterine Life (Cont.)
Period of decreased responsiveness
Lasts from 60 to 100 minutes
Infant is pink
Respirations are rapid and shallow up to 60 breaths per minute
Sleeps or has a marked decrease in motor activity
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4. Transition to Extrauterine Life (Cont.)
Second period of reactivity
Lasts from 10 minutes to several hours
Occurs between 2 and 8 hours after birth
Tachycardia, tachypnea occur
Meconium passed
Increased muscle tone, changes in skin color, and mucus production
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5. Physiologic Adaptations
Respiratory system
Initiation of breathing
Signs of respiratory distress
Cardiovascular system
Heart rate and sounds
Blood pressure
Blood volume
Signs of risk for cardiovascular problems
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6. Physiologic Adaptations (Cont.)
Hematopoietic system
Red blood cells and hemoglobin
Leukocytes
Platelets
Blood groups
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7. Physiologic Adaptations (Cont.)
Thermogenic system
Heat loss
Thermogenesis
Cold stress
Hyperthermia
Renal system
Fluid and electrolyte balance
Signs of risk for renal problems
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10. Physiologic Adaptations (Cont.)
Gastrointestinal system
Digestion
Stools
Meconium
Feeding behaviors
Signs of risk for gastrointestinal problems
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11. Physiologic Adaptations (Cont.)
Hepatic system
Iron storage
Carbohydrate metabolism
Contribution of bilirubin and newborn jaundice
Coagulation
Signs of risk for hepatic system problem
Immune system
Risk for infection
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13. Physiologic Adaptations (Cont.)
Integumentary system
Vernix caseosa
Acrocyanosis
Sweat glands
Desquamation
Mongolian spots
Nevi
Erythema toxicum
Signs at risk for integumentary problems
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17. Physiologic Adaptations (Cont.)
Reproductive system
Female
Male
Swelling of breast tissue
Signs of risk for reproductive system problems
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20. Physiologic Adaptations (Cont.)
Skeletal system
Caput succedaneum
Cephalhematoma
Subgaleal hematoma
Spine and extremities
Signs of risk for skeletal problems
Neuromuscular system
Newborn reflexes
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25. Behavioral Characteristics
Sleep-wake states
Other factors influencing behavior of newborns
Gestational age
Time
Stimuli
Medication
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27. Behavioral Characteristics (Cont.)
Sensory behaviors
Vision
Hearing
Smell
Taste
Touch
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28. Behavioral Characteristics (Cont.)
Response to environmental stimuli
Temperament
Habituation
Consolability
Cuddliness
Irritability
Crying
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29. Question
A newborn is placed under a radiant heat warmer. The nurse knows that thermoregulation presents a problem for newborns because:
their renal function is not fully developed, and heat is lost in the urine.
their small body surface area favors more rapid heat loss than does an adult’s body surface area.
ANS: C
Feedback
A Incorrect: Heat loss does not occur through urination.
B Incorrect: Newborns have a higher body surface–to–body weight ratio than adults.
C Correct: The newborn has little thermal insulation. Furthermore, the blood vessels are closer to the surface of the skin. Changes in environmental temperature alter the temperature of the blood, thereby influencing temperature regulation centers in the hypothalamus.
D Incorrect: The flexed position of the newborn helps guard against heat loss because it diminishes the amount of body surface exposed to the environment.
DIF: Cognitive Level: Comprehension
OBJ: Client Needs: Physiologic Integrity
TOP: Nursing Process: Planning
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30. Question (Cont.)
they have a relatively thin layer of subcutaneous fat that provides poor insulation.
their normal flexed posture favors heat loss through perspiration.
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