Physiological Adaptations to Birth

Physiological Adaptations to Birth

1. During this part of the orientation, the nurse will be able to

   • Identify normal and abnormal assessment findings in the newborn
   • Describe the changes required by each body system for successful adaptation to extrauterine life
   • Discuss the respiratory and cardiovascular changes that occur during the transition to extrauterine life and during stabilization
   • Understand the steps involved in excretion of bilirubin in the newborn and discuss the reasons a newborn may develop jaundice
   • Describe the functional ability of the newborn’s liver and gastrointestinal tract
   • Describe how various factors affect the newborn’s blood values

2. Physiology of the Respiratory System

   • The development of the respiratory system in utero begins with differentiation of structures into pulmonary, vascular, and lymphatic structures.
   • At 28 to 32 weeks, surfactant production significantly increases,
   • Fetal breathing movements, in utero practice respiratory movements, begin by 17 to 20 weeks.
   • Beginning at 20 weeks, alveolar ducts begin to develop.
   • By 24 to 28 weeks, alveoli differentiate into type I cells, which aid in gas exchange, and type II cells, which produce and store surfactant.

3. Indicators of Abnormal Functioning

   • Respiratory rate less than 30 or greater than 60 breaths/minute Irregular depth (persistently shallow) and irregular rhythm Nasal flaring Chest retractions Generalized cyanosis

4. Indicators of Initial Normal Functioning

   • Respiratory rate 30 to 60 breaths/minute Diaphragmatic breathing Initially shallow Irregular in depth and rhythm

5. Physiological Adaptations Following Birth

   • Initiation of neonatal breathing at birth
     • Lung expansion occurs at the time of birth.
     • Lung fluid production decreases 24 to 26 hours prior to birth.
     • Increase in pulmonary circulation occurs.
   • Mechanical stimuli
   • Chemical stimuli
   • Other stimuli

6. Cardiovascular System

   • Cardiovascular development begins to occur within 3 weeks of the last menstrual period (LMP), when circulation begins and the structure of the heart begins to form.
     • By 4 weeks, the tubular heart beats, beginning at 28 days (post-LMP), and circulation to the fetus and placenta occurs, although detection of the fetal heart rate typically does not occur until 6 to 7 weeks.

7. MEMBERS

   • PAULA VASQUEZ - ERIKA NOREÑA - CAMILO BENAVIDES - JORGE RODRIGUEZ Y SOFIA HERRERA

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