4/4/25, 6:04
PM
NR 327 EXAM 3 EXAM QUESTIONS AND ANSWERS WITH COMPLETE SOLUTIONS
VERIFIED GRADED A++
Terms in this set (106)
• Lack of muscle tone that results in failure of the uterine muscle fibers to
contract firmly around blood vessels when the placenta separates. The
relaxed muscles allow rapid bleeding from the endometrial arteries at the
placental sire, bleeding continues until the uterine muscle fibers contract to
stop the flow of blood.
• Risks: overdistention of the uterus from any cause (multiple gestations,
large infant, or
hydramnios) makes it more difficult for the uterus to contract with enough firmness
to prevent excessive bleeding. Multiparity results in muscle fibers that have been
Atony stretched repeatedly and these flaccid muscle fibers may not remain
contracted after birth. Intrapartum factors include contractions that were barley
effective, resulting in prolonged labor, contractions that were excessively
vigorous, resulting in precipitate labor and labor that was induced or
augmented with oxytocin. Retention of a large segment of the placenta does
not allow the uterus to contract firmly and therefore can result in uterine
atony
• Manifestations: uterine fundus that is difficult to locate, soft or boggy feel
when the fundus is located, uterus that becomes form as it is massaged but
loses its tone when massage is stopped, fundus that is located above the
expected level, excessive lochia especially if it is bright red, excessive clots
expelled with or without massage, saturation of one peripad in 15 minutes.
1/17
,4/4/25, 6:04
PM
Surfactant is a complex substance containing phospholipids and a number of
apoproteins. This fluid is produced by the Type II alveolar cells, and lines the
alveoli and smallest bronchioles. Surfactant reduces surface tension throughout
the lung. It is also important because it stabilizes the alveoli.That is, at a
constant surface tension, small alveoli will generate bigger pressures within
them than will large alveoli. Smaller alveoli would therefore be expected to
empty into larger alveoli as lung volume decreases. This does not occur,
Surfactant
however, because surfactant differentiallyreduces surface tension, leading to
alveolar stability and reducing the likelihood of alveolar collapse. If the lungs
did not secrete surfactant, this surface tension would be much higher and it
would not be able to inflate normally.Surfactant is formed relatively late in fetal
life; thus premature infants born without adequate amounts experience
respiratory distress syndrome which is caused by lack of surfactant and may die.
It is commonly suffered by premature babies born before 28-32 weeks of
gestation.
With a normal delivery and healthy baby - At birth and again at five minutes
how often should APGAR scores be
taken?
What does APGAR assess? COLOUR, HEARTRATE, GRIMACE, ACTIVITY, RESPIRATIONS
*Thin Skin
*Blood vessels close to the surface
Little subcutaneous fat so little insulation Preterms even less
Newborn Characteristics that lead to
*Newborns have 3x more body surface area vs. their weight compared with adults
Heat Loss
*Lose heat 4x faster than adults
*Cannot shiver like adults
Term newborns flex to conserve heat Preterms can't flex so lose heat
Evaporation
Conduction
Methods of Heat Loss
Convection
Radiation
Definition:
Wet surfaces exposed to air
Occurs:
*Immediately p birth
Methods of Heat
*During baths
Loss Evaporation
Prevention:
*Dry quickly, wrap, and place hat on baby at birth
*During baths wrap baby while washing head
*Wrap and hat baby p bath to allow baby temperature to stabalize
Definition:
Loss of heat via direct contact with cold surface
Occurs:
Methods of Heat *Scales, NIC Bed, Warmer not preheated at birth, Cold stethoscopes, Cold hands
Loss Conduction
Prevention:
*Prewarm Warmer Unit at birth
*Place blanket on cold scale and zero out
*Warm Stethoscope and hands
2/17
, 4/4/25, 6:04
PM
Definition:
Loss of heat from body surface to cooler air currents
Occurs:
*Removal from incubator for procedures
Methods of Heat
*Ceiling air vents, drafty doorways or windows
Loss Convection
*Oxygen unheated or moisturized
Prevention:
Perform necessary procedures efficiently, Keep baby well wrapped & capped,
Moisturize & heat O2
Definition:
Loss of heat via transfer of heat from body surface to cooler surfaces and objects
not in direct contact with the body
Methods of Heat Occurs:
Loss Radiation *Walls of a room, a window, even an incubator, ice for blood draws
Prevention:
*Line incubator with blanket to insulate from incubator side
*Keep away from drafts and walls
brown color
principal function
special features of brown fat (5) sympathetic innervation
use of uncoupling protien
1
found more in newborns than in adults
Why is a preterm or sick newborn at risk Preterm infant has less of a brown fat reserve.
for heat loss/cold sure?
How does brown fat help maintain Brown fat had a richer vascular and nerve supply than ordinary fat. A preterm
body temperature? Under what infant can have less of a reserve of brown fat at birth.
circumstance can newborns have
inadequate brown fat and why.
Thin skin; blood vessels near the surface; little insulating subcutaneous white fat;
List characteristics that
heat readily transferred from internal organs to skin; greater ratio of surface area
predispose newborns to heat
to body mass
loss
All methods except evaporation can also be sources of heat gain, such as contact
Which methods can also be promote heat
with warm blankets or exposure to warmed air currents or heat from a radiant
gain?
warmer.
How does brown fat hel neworn maintain Brown fat is metabolized to generate heat, which is transferred to the blood
body temp? vessels running through it and then circulated to the rest of the body
Infants who may have inadequate brown fat include preterm infants who may not
Under what circumstances can newborms have accumulated brown fat, those with intrauterine growth restriction whose
have inadequate brown fat & why? stores were depleted, and those exposed to prolonged cold stress who use up
their brown fat.
Heat production requires oxygen for metabolism, which can exceed the
infant's capacity to supply the oxygen. Cold stress decreases production of
surfactant, which can cause respiratory difficulty. Glucose use is accelerated
Explain relationship between
when the metabolic rate rises to produce heat, possibly depleting these stores
oxygenation, body temp, glucose stores
and resulting in hypoglycemia. Metabolism of glucose and brown fat without
& bilirubin levels in newborn.
adequate oxygen causes increased production of acids. These acids may
cause jaundice because they interfere with transport of bilirubin to the liver,
where it can be conjugated and excreted.
3/17
PM
NR 327 EXAM 3 EXAM QUESTIONS AND ANSWERS WITH COMPLETE SOLUTIONS
VERIFIED GRADED A++
Terms in this set (106)
• Lack of muscle tone that results in failure of the uterine muscle fibers to
contract firmly around blood vessels when the placenta separates. The
relaxed muscles allow rapid bleeding from the endometrial arteries at the
placental sire, bleeding continues until the uterine muscle fibers contract to
stop the flow of blood.
• Risks: overdistention of the uterus from any cause (multiple gestations,
large infant, or
hydramnios) makes it more difficult for the uterus to contract with enough firmness
to prevent excessive bleeding. Multiparity results in muscle fibers that have been
Atony stretched repeatedly and these flaccid muscle fibers may not remain
contracted after birth. Intrapartum factors include contractions that were barley
effective, resulting in prolonged labor, contractions that were excessively
vigorous, resulting in precipitate labor and labor that was induced or
augmented with oxytocin. Retention of a large segment of the placenta does
not allow the uterus to contract firmly and therefore can result in uterine
atony
• Manifestations: uterine fundus that is difficult to locate, soft or boggy feel
when the fundus is located, uterus that becomes form as it is massaged but
loses its tone when massage is stopped, fundus that is located above the
expected level, excessive lochia especially if it is bright red, excessive clots
expelled with or without massage, saturation of one peripad in 15 minutes.
1/17
,4/4/25, 6:04
PM
Surfactant is a complex substance containing phospholipids and a number of
apoproteins. This fluid is produced by the Type II alveolar cells, and lines the
alveoli and smallest bronchioles. Surfactant reduces surface tension throughout
the lung. It is also important because it stabilizes the alveoli.That is, at a
constant surface tension, small alveoli will generate bigger pressures within
them than will large alveoli. Smaller alveoli would therefore be expected to
empty into larger alveoli as lung volume decreases. This does not occur,
Surfactant
however, because surfactant differentiallyreduces surface tension, leading to
alveolar stability and reducing the likelihood of alveolar collapse. If the lungs
did not secrete surfactant, this surface tension would be much higher and it
would not be able to inflate normally.Surfactant is formed relatively late in fetal
life; thus premature infants born without adequate amounts experience
respiratory distress syndrome which is caused by lack of surfactant and may die.
It is commonly suffered by premature babies born before 28-32 weeks of
gestation.
With a normal delivery and healthy baby - At birth and again at five minutes
how often should APGAR scores be
taken?
What does APGAR assess? COLOUR, HEARTRATE, GRIMACE, ACTIVITY, RESPIRATIONS
*Thin Skin
*Blood vessels close to the surface
Little subcutaneous fat so little insulation Preterms even less
Newborn Characteristics that lead to
*Newborns have 3x more body surface area vs. their weight compared with adults
Heat Loss
*Lose heat 4x faster than adults
*Cannot shiver like adults
Term newborns flex to conserve heat Preterms can't flex so lose heat
Evaporation
Conduction
Methods of Heat Loss
Convection
Radiation
Definition:
Wet surfaces exposed to air
Occurs:
*Immediately p birth
Methods of Heat
*During baths
Loss Evaporation
Prevention:
*Dry quickly, wrap, and place hat on baby at birth
*During baths wrap baby while washing head
*Wrap and hat baby p bath to allow baby temperature to stabalize
Definition:
Loss of heat via direct contact with cold surface
Occurs:
Methods of Heat *Scales, NIC Bed, Warmer not preheated at birth, Cold stethoscopes, Cold hands
Loss Conduction
Prevention:
*Prewarm Warmer Unit at birth
*Place blanket on cold scale and zero out
*Warm Stethoscope and hands
2/17
, 4/4/25, 6:04
PM
Definition:
Loss of heat from body surface to cooler air currents
Occurs:
*Removal from incubator for procedures
Methods of Heat
*Ceiling air vents, drafty doorways or windows
Loss Convection
*Oxygen unheated or moisturized
Prevention:
Perform necessary procedures efficiently, Keep baby well wrapped & capped,
Moisturize & heat O2
Definition:
Loss of heat via transfer of heat from body surface to cooler surfaces and objects
not in direct contact with the body
Methods of Heat Occurs:
Loss Radiation *Walls of a room, a window, even an incubator, ice for blood draws
Prevention:
*Line incubator with blanket to insulate from incubator side
*Keep away from drafts and walls
brown color
principal function
special features of brown fat (5) sympathetic innervation
use of uncoupling protien
1
found more in newborns than in adults
Why is a preterm or sick newborn at risk Preterm infant has less of a brown fat reserve.
for heat loss/cold sure?
How does brown fat help maintain Brown fat had a richer vascular and nerve supply than ordinary fat. A preterm
body temperature? Under what infant can have less of a reserve of brown fat at birth.
circumstance can newborns have
inadequate brown fat and why.
Thin skin; blood vessels near the surface; little insulating subcutaneous white fat;
List characteristics that
heat readily transferred from internal organs to skin; greater ratio of surface area
predispose newborns to heat
to body mass
loss
All methods except evaporation can also be sources of heat gain, such as contact
Which methods can also be promote heat
with warm blankets or exposure to warmed air currents or heat from a radiant
gain?
warmer.
How does brown fat hel neworn maintain Brown fat is metabolized to generate heat, which is transferred to the blood
body temp? vessels running through it and then circulated to the rest of the body
Infants who may have inadequate brown fat include preterm infants who may not
Under what circumstances can newborms have accumulated brown fat, those with intrauterine growth restriction whose
have inadequate brown fat & why? stores were depleted, and those exposed to prolonged cold stress who use up
their brown fat.
Heat production requires oxygen for metabolism, which can exceed the
infant's capacity to supply the oxygen. Cold stress decreases production of
surfactant, which can cause respiratory difficulty. Glucose use is accelerated
Explain relationship between
when the metabolic rate rises to produce heat, possibly depleting these stores
oxygenation, body temp, glucose stores
and resulting in hypoglycemia. Metabolism of glucose and brown fat without
& bilirubin levels in newborn.
adequate oxygen causes increased production of acids. These acids may
cause jaundice because they interfere with transport of bilirubin to the liver,
where it can be conjugated and excreted.
3/17
