RNSG 1412 (Ob/Pedi) - Exam 1 |Neonatal Assessment and
Adaptation Exam: Respiratory Transition, Surfactant Production,
Thermoregulation, Non-Shivering Thermogenesis, Cold Stress,
Hematologic Adaptation, Vitamin K Function, Polycythemia,
Bilirubin Metabolism, Physiologic and Pathologic Jaundice, Hepatic
Function, Blood Glucose Regulation, Gastrointestinal Maturation,
Meconium Passage, Enzymatic Digestion, Renal Function, Urinary
Output, Immune System Development, IgG Passive Immunity, IgA
Colostral Protection, Neurologic Reflexes, Moro Reflex, Rooting
Reflex, Sucking Reflex, Grasp Reflex, Stepping Reflex, Babinski
Reflex, Tonic Neck Reflex, Behavioral States, Bonding, Apgar
Scoring, Circumcision Care, Infection Identification, Thermoneutral
Environment Exam Questions Verified and Provided with
Complete A+ Graded Rationales Latest Updated 2026
Initiation of respirations: Development of the lungs
Surfactant (UNDERSTAND: purpose, production, influence of maternal complications)
24-25 weeks (DETECTABLE)
34-36 weeks (SUFFICIENT)
what accelerates surfactant production DURING PREGNANCY?
Labor, *****steroids, HTN, Placental insufficiency, maternal infection, ROM >48 hours.
what delays surfactant production DURING PREGNANCY?
Diabetes
,**steroids are given to the premature babies right before birth to increase surfactant levels
Initiation of respirations: Causes of respirations - Chemical factors
normal hypoxia associated with a normal birth (Increase in PCO2 (partial pressure of carbon dioxide) &
Decrease in po2 (partial pressure of oxygen) & Decrease in ph)
results in: stimulation of the respiratory center in the brain
which leads to: forceful diaphragm contraction
and causes: air to enter the lungs
prolonged hypoxia (complication):
•Cns depression & No stimulation of the respiratory center
Initiation of respirations: Causes of respirations - Mechanical factors
chest compression and chest recoil
fetal fluid forced out & some air enters with the recoil that follows. This reduces the amount of pressure
needed for the first breath
Initiation of respirations: Causes of respirations - thermal & sensory factors
Stimulation of skin sensors... (and auditory, visual, olfactory, and pain stimuli).
,Initiation of respirations: continuation of respirations
•Surfactant allows for less effort with subsequent breaths.
•Note: Pulmonary blood vessels dilate in response to increased oxygenation.
•Problems? Low levels of oxygen may constrict the pulmonary blood vessels
NEUROLOGIC ADAPTATION: THERMOREGULATION
Fetal thermoregulation in utero?
from mom
What characteristics predispose the newborn for heat loss? The skin is thin, blood vessels are close to
the surface, and there is little subcutaneous (white) fat to provide a barrier to loss of heat, can't shiver,
they lose heat 4x faster than adults.
What characteristics of the newborn prevent heat loss?
Newborns rely on brown fat, a flexed posture, skin-to-skin contact, and the vernix caseosa to minimize
heat loss.
NEUROLOGIC ADAPTATION: THERMOREGULATION methods of heat loss- conduction
Loss of heat to a cooler surface by direct skin contact
, NEUROLOGIC ADAPTATION: THERMOREGULATION methods of heat loss- convection
Loss of heat to cooler air currents
NEUROLOGIC ADAPTATION: THERMOREGULATION methods of heat loss- radiation
loss of heat to cooler surfaces and objects not directly in contact with the skin
NEUROLOGIC ADAPTATION: THERMOREGULATION methods of heat loss- evaporation
loss of heat when water is converted to a vapor
NEUROLOGIC ADAPTATION: THERMOREGULATION - nonshivering thermogenesis (NST)
A Cold newborn is flexed, acrocyantotic, restless and crying.
A Cold newborn has increased metabolism and an increased need for oxygen and glucose.
-NST can increase heat production by 100%
-Brown fat is metabolized when lower environmental temp is noted by thermal receptors in skin
-norrepinephrine is released in brown fat when thermal receptors are stimulated
-norepinephrine in the brown fat initiates its metabolism.
•As brown fat is metabolized, it generates more heat than other fats.
Adaptation Exam: Respiratory Transition, Surfactant Production,
Thermoregulation, Non-Shivering Thermogenesis, Cold Stress,
Hematologic Adaptation, Vitamin K Function, Polycythemia,
Bilirubin Metabolism, Physiologic and Pathologic Jaundice, Hepatic
Function, Blood Glucose Regulation, Gastrointestinal Maturation,
Meconium Passage, Enzymatic Digestion, Renal Function, Urinary
Output, Immune System Development, IgG Passive Immunity, IgA
Colostral Protection, Neurologic Reflexes, Moro Reflex, Rooting
Reflex, Sucking Reflex, Grasp Reflex, Stepping Reflex, Babinski
Reflex, Tonic Neck Reflex, Behavioral States, Bonding, Apgar
Scoring, Circumcision Care, Infection Identification, Thermoneutral
Environment Exam Questions Verified and Provided with
Complete A+ Graded Rationales Latest Updated 2026
Initiation of respirations: Development of the lungs
Surfactant (UNDERSTAND: purpose, production, influence of maternal complications)
24-25 weeks (DETECTABLE)
34-36 weeks (SUFFICIENT)
what accelerates surfactant production DURING PREGNANCY?
Labor, *****steroids, HTN, Placental insufficiency, maternal infection, ROM >48 hours.
what delays surfactant production DURING PREGNANCY?
Diabetes
,**steroids are given to the premature babies right before birth to increase surfactant levels
Initiation of respirations: Causes of respirations - Chemical factors
normal hypoxia associated with a normal birth (Increase in PCO2 (partial pressure of carbon dioxide) &
Decrease in po2 (partial pressure of oxygen) & Decrease in ph)
results in: stimulation of the respiratory center in the brain
which leads to: forceful diaphragm contraction
and causes: air to enter the lungs
prolonged hypoxia (complication):
•Cns depression & No stimulation of the respiratory center
Initiation of respirations: Causes of respirations - Mechanical factors
chest compression and chest recoil
fetal fluid forced out & some air enters with the recoil that follows. This reduces the amount of pressure
needed for the first breath
Initiation of respirations: Causes of respirations - thermal & sensory factors
Stimulation of skin sensors... (and auditory, visual, olfactory, and pain stimuli).
,Initiation of respirations: continuation of respirations
•Surfactant allows for less effort with subsequent breaths.
•Note: Pulmonary blood vessels dilate in response to increased oxygenation.
•Problems? Low levels of oxygen may constrict the pulmonary blood vessels
NEUROLOGIC ADAPTATION: THERMOREGULATION
Fetal thermoregulation in utero?
from mom
What characteristics predispose the newborn for heat loss? The skin is thin, blood vessels are close to
the surface, and there is little subcutaneous (white) fat to provide a barrier to loss of heat, can't shiver,
they lose heat 4x faster than adults.
What characteristics of the newborn prevent heat loss?
Newborns rely on brown fat, a flexed posture, skin-to-skin contact, and the vernix caseosa to minimize
heat loss.
NEUROLOGIC ADAPTATION: THERMOREGULATION methods of heat loss- conduction
Loss of heat to a cooler surface by direct skin contact
, NEUROLOGIC ADAPTATION: THERMOREGULATION methods of heat loss- convection
Loss of heat to cooler air currents
NEUROLOGIC ADAPTATION: THERMOREGULATION methods of heat loss- radiation
loss of heat to cooler surfaces and objects not directly in contact with the skin
NEUROLOGIC ADAPTATION: THERMOREGULATION methods of heat loss- evaporation
loss of heat when water is converted to a vapor
NEUROLOGIC ADAPTATION: THERMOREGULATION - nonshivering thermogenesis (NST)
A Cold newborn is flexed, acrocyantotic, restless and crying.
A Cold newborn has increased metabolism and an increased need for oxygen and glucose.
-NST can increase heat production by 100%
-Brown fat is metabolized when lower environmental temp is noted by thermal receptors in skin
-norrepinephrine is released in brown fat when thermal receptors are stimulated
-norepinephrine in the brown fat initiates its metabolism.
•As brown fat is metabolized, it generates more heat than other fats.
