NM705 MODULE 1 EXAM QUESTIONS AND ANSWERS
WITH COMPLETE SOLUTIONS VERIFIED LATEST UPDATE
With NB birth, when is used of bulb syringe necessary?
‣ newborns who are exhausted and compromised by the birth process may need
assistance in clearing the fluid and mucus from the upper airway.
‣ Use of a suctioning device should be limited to situations in which the newborn's
respiratory efforts are diminished.
Why is the use of a bulb syringe or other device to suction the mouth or nares of
a vigorous newborn unnecessary?
‣ W/birth of head, mucus drains from the nares & mouth.
‣ some NB's gasp or cry.
‣ The first few breaths require some pressure because room air is flowing into a fluid-
filled space
‣ suctioning of the oropharynx and nasopharynx on the perineum does not prevent
meconium aspiration
Developments during gestation, that provide the infrastructure for the onset of
NB respiration.
‣ development of the musculature needed to breathe
‣ breathing movements throughout 2nd & 3rd trimesters which may have circadian
properties & change in response to maternal meals & caffeine intake.
‣ alveoli development throughout gestation
,‣ fetal ability to produce surfactant.
‣ interstitial space between the alveoli markedly thins
‣ decrease in lung fluid in the days before labor, w/ increased activity of epithelial
sodium channels (ENaC) that transport fluid away from the alveoli.
‣ Fetal plasma levels of catecholamines & glucocorticoids increase during normal labor.
which cause reabsorption of lung fluid during labor.
‣ the constricted fetal posture during labor causes increased transpulmonary pressure
and a significant release of lung fluid from the airways during the first stage of labor,
long before the final thoracic squeeze of second-stage labor.
Disadvantage to Neonates who experience a cesarean section birth
especially in the absence of labor,
‣ do not receive the benefit of the diminution of lung fluid
‣ have an increased risk for transient tachypnea of the newborn (TTN) or respiratory
distress syndrome (RDS).
biochemical phenomena that stimulate the neonate to take the first breath
‣ relative hypoxia
, of the end of labor
‣ subjection of neonate to physical stimuli, such as cold, gravity, pain, light, & noise,
cause excitation of the respiratory center.
‣ release of the thoracic pressure at birth may help stimulate a breath.
‣ Thoracic squeeze in the last minutes of labor helps extrude some upper airway fluid.
Significance of Sodium Channel (ENaC) activation to gestational age
Activation of ENaC is correlated with gestational age, so preterm and near-term infants
are born with lower activation in their ENaC, which accentuates the possibility of
respiratory distress.
Importance of thinning of interstitial space between the alveoli
allows for maximum contact between the capillaries and the alveoli for air exchange.
surfactant
the phospholipid that becomes available by 34 weeks' gestation and reduces surface
tension at the alveolar-air interface.
4 mechanisms through which newborns lose heat
• convection
• conduction
• radiation
• evaporation
pathway of fetal circulation from the placenta to the left atrium
→Umbilical Vein
→→Ductus Venosus
→→→Inferior Vena Cava
WITH COMPLETE SOLUTIONS VERIFIED LATEST UPDATE
With NB birth, when is used of bulb syringe necessary?
‣ newborns who are exhausted and compromised by the birth process may need
assistance in clearing the fluid and mucus from the upper airway.
‣ Use of a suctioning device should be limited to situations in which the newborn's
respiratory efforts are diminished.
Why is the use of a bulb syringe or other device to suction the mouth or nares of
a vigorous newborn unnecessary?
‣ W/birth of head, mucus drains from the nares & mouth.
‣ some NB's gasp or cry.
‣ The first few breaths require some pressure because room air is flowing into a fluid-
filled space
‣ suctioning of the oropharynx and nasopharynx on the perineum does not prevent
meconium aspiration
Developments during gestation, that provide the infrastructure for the onset of
NB respiration.
‣ development of the musculature needed to breathe
‣ breathing movements throughout 2nd & 3rd trimesters which may have circadian
properties & change in response to maternal meals & caffeine intake.
‣ alveoli development throughout gestation
,‣ fetal ability to produce surfactant.
‣ interstitial space between the alveoli markedly thins
‣ decrease in lung fluid in the days before labor, w/ increased activity of epithelial
sodium channels (ENaC) that transport fluid away from the alveoli.
‣ Fetal plasma levels of catecholamines & glucocorticoids increase during normal labor.
which cause reabsorption of lung fluid during labor.
‣ the constricted fetal posture during labor causes increased transpulmonary pressure
and a significant release of lung fluid from the airways during the first stage of labor,
long before the final thoracic squeeze of second-stage labor.
Disadvantage to Neonates who experience a cesarean section birth
especially in the absence of labor,
‣ do not receive the benefit of the diminution of lung fluid
‣ have an increased risk for transient tachypnea of the newborn (TTN) or respiratory
distress syndrome (RDS).
biochemical phenomena that stimulate the neonate to take the first breath
‣ relative hypoxia
, of the end of labor
‣ subjection of neonate to physical stimuli, such as cold, gravity, pain, light, & noise,
cause excitation of the respiratory center.
‣ release of the thoracic pressure at birth may help stimulate a breath.
‣ Thoracic squeeze in the last minutes of labor helps extrude some upper airway fluid.
Significance of Sodium Channel (ENaC) activation to gestational age
Activation of ENaC is correlated with gestational age, so preterm and near-term infants
are born with lower activation in their ENaC, which accentuates the possibility of
respiratory distress.
Importance of thinning of interstitial space between the alveoli
allows for maximum contact between the capillaries and the alveoli for air exchange.
surfactant
the phospholipid that becomes available by 34 weeks' gestation and reduces surface
tension at the alveolar-air interface.
4 mechanisms through which newborns lose heat
• convection
• conduction
• radiation
• evaporation
pathway of fetal circulation from the placenta to the left atrium
→Umbilical Vein
→→Ductus Venosus
→→→Inferior Vena Cava
