1. Foundations of Neonatal Care
Cardiac

2. 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.

3. Physiology

4. Embryology of Cardiac Conditions
Cardiac tube develops; primitive heart structures form
Atrial and ventricular septa form; endocardial cushions form the atrioventricular valves
Great vessels including aorta and branches, septum, and semilunar valves form
Weeks gestation
4 weeks
8 weeks
Ventricular septal defect, atrial septal defect; endocardial cushion defect; stenosis, atresia, absence, or deformation of the tricuspid and mitral valves
Truncus arteriosus, tetralogy of Fallot, pulmonary/aorta valve atresia or stenosis, transposition of great vessels
Corrected transposition, dextrocardia
Embryology of Cardiac Conditions

5. Fetal Circulation
Reprinted with permission of greystone.net.

6. Neonatal Circulation
Reprinted with permission of greystone.net.

7. Nutritional & Metabolic
Foundations of Neonatal Care
Nutritional & Metabolic

8. 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.

9. Physiology

10. Electrolyte Physiology
Ca+
Ca+
Na+
Na+
Na+
Na+ K+
Mg+
Na+
Na+
Mg+ K+ K+
Ca+
Na+ K+ K+ K+
Na+
Na+ K+ K+ K+
Mg+
Inside cell
Outside cell

11. Acid-Base Balance Acid-base regulation Acid-base imbalances
Chemical buffering
Respiratory system
Kidneys
Acid-base imbalances
Acidosis pH <7.35
Alkalosis pH >7.45
Compensation
Minimize pH changes

12. respiratory alkalosis
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 pH 7.60
Acidic
Alkalotic