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Questions and Answers
What is the primary function of vernix produced from 18 weeks gestation?
What is the primary function of vernix produced from 18 weeks gestation?
At what week of gestation does IgG reach its maximum level in the fetus?
At what week of gestation does IgG reach its maximum level in the fetus?
Which hormone is released by the kidneys to facilitate urine production?
Which hormone is released by the kidneys to facilitate urine production?
What best describes the Neutral Thermal Environment (NTE) for infants?
What best describes the Neutral Thermal Environment (NTE) for infants?
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What effect does hyperthermia have on the body's metabolic processes?
What effect does hyperthermia have on the body's metabolic processes?
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What is the normal temperature range for neonates?
What is the normal temperature range for neonates?
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Which of the following describes the relationship between hypothermia and core temperature in neonates?
Which of the following describes the relationship between hypothermia and core temperature in neonates?
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What environmental temperature factors contribute to rapid heat loss in neonates immediately after birth?
What environmental temperature factors contribute to rapid heat loss in neonates immediately after birth?
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When maintaining neonatal thermoregulation, where should the temperature probe be placed?
When maintaining neonatal thermoregulation, where should the temperature probe be placed?
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What physiological mechanism is triggered by hypothalamic stimulation in response to cold temperatures in neonates?
What physiological mechanism is triggered by hypothalamic stimulation in response to cold temperatures in neonates?
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What sequence occurs after blood enters the right ventricle in a newborn?
What sequence occurs after blood enters the right ventricle in a newborn?
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What is the first event that occurs when a newborn takes its first breath?
What is the first event that occurs when a newborn takes its first breath?
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Where should pre-ductal oxygen saturations be collected in a newborn?
Where should pre-ductal oxygen saturations be collected in a newborn?
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How soon can a patent ductus arteriosus take to close in a newborn?
How soon can a patent ductus arteriosus take to close in a newborn?
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What condition can oxygen saturation screening help detect in newborns?
What condition can oxygen saturation screening help detect in newborns?
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What is the primary organ of gas exchange for the fetus before birth?
What is the primary organ of gas exchange for the fetus before birth?
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Which clinical sign indicates a compromised newborn with depressed respiratory effort?
Which clinical sign indicates a compromised newborn with depressed respiratory effort?
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What effect can using 100% oxygen for resuscitation on newborns have?
What effect can using 100% oxygen for resuscitation on newborns have?
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At what percentage of oxygen should ventilation begin for preterm infants under 35 weeks?
At what percentage of oxygen should ventilation begin for preterm infants under 35 weeks?
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How does the blood flow from the fetal heart primarily bypass the lungs before birth?
How does the blood flow from the fetal heart primarily bypass the lungs before birth?
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What could be a consequence of an imbalance between reactive oxygen species and antioxidant defenses in newborns?
What could be a consequence of an imbalance between reactive oxygen species and antioxidant defenses in newborns?
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What is the composition of blood entering the placenta from the fetus?
What is the composition of blood entering the placenta from the fetus?
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Which of the following is NOT a typical sign of a compromised newborn?
Which of the following is NOT a typical sign of a compromised newborn?
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What is the primary benefit of non-shivering thermogenesis in neonates during cold stress?
What is the primary benefit of non-shivering thermogenesis in neonates during cold stress?
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Which condition is likely to result from increased glucose utilization due to cold stress in neonates?
Which condition is likely to result from increased glucose utilization due to cold stress in neonates?
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Which practice can help with thermoregulation in a newborn?
Which practice can help with thermoregulation in a newborn?
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What effect does prolonged vasoconstriction during hypothermia have on blood flow?
What effect does prolonged vasoconstriction during hypothermia have on blood flow?
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Which of the following describes the immediate changes in fetal circulation after birth?
Which of the following describes the immediate changes in fetal circulation after birth?
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What is a potential consequence of acidosis in a neonate's physiology?
What is a potential consequence of acidosis in a neonate's physiology?
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What change occurs in the lungs of a neonate that is crucial for transition to breathing air?
What change occurs in the lungs of a neonate that is crucial for transition to breathing air?
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What physiological response is expected in neonates due to hypothermia?
What physiological response is expected in neonates due to hypothermia?
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How should a neonate be rewarmed after exposure to cold stress?
How should a neonate be rewarmed after exposure to cold stress?
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Which factor contributes to the development of hyperoxia in a neonate?
Which factor contributes to the development of hyperoxia in a neonate?
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What is the role of surfactant in the lungs of a neonate?
What is the role of surfactant in the lungs of a neonate?
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What may indicate the need to monitor blood glucose levels in a neonate?
What may indicate the need to monitor blood glucose levels in a neonate?
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What change occurs in the digestive system during the transition from fetal to neonatal life?
What change occurs in the digestive system during the transition from fetal to neonatal life?
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What significant circulatory change occurs shortly after birth related to the ductus arteriosus?
What significant circulatory change occurs shortly after birth related to the ductus arteriosus?
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Study Notes
Neonatal Thermoregulation
- Normal neonatal core temperature: 36.5°C to 37.4°C
- Homeostasis is the balance between the body’s ability to produce and lose heat.
- Sensors/receptors send messages to the control center (hypothalamus) if required, effectors make changes to maintain stability.
- Hypothermia: core temperature < 36.5°C
- Hyperthermia: core temperature > 37.4°C
- Brown adipose tissue (BAT) is found around the scapulae, kidneys, adrenals, neck, axillae, and aorta.
- BAT is important for non-shivering thermogenesis.
Effects of Cold Stress in the Neonate
- Cold stress activates non-shivering thermogenesis (metabolism of brown fat)
- Increased oxygen consumption and glucose use can lead to hypoglycemia, tissue hypoxia, and metabolic acidosis
- Rewarming should be done slowly, ideally 0.5°C per hour or setting the cot temperature 1-1.5°C above the core temperature.
Fetal Circulation
- Intrauterine circulation: fetal circulation with the placenta as the organ of gas exchange.
- Extrauterine circulation: normal circulation with the lungs as the organ of gas exchange.
- Patent foramen ovale (PFO): closes with the first breath.
- Patent ductus arteriosus (PDA): closes within 1-2 days once pulmonary vascular resistance (PVR) reduces.
Fetal Breathing Movements
- Intrauterine: alveoli filled with clear fluid, dependent on placenta for gas exchange, high PVR, blood flow diverted across the PFO and PDA.
- Birth: lungs expand with air, surfactant released, fetal lung fluid leaves the alveoli, PVR reduces, pulmonary blood flow increases, blood flows through the lungs to pick up oxygen.
Clinical Signs of the Compromised Newborn
- Apnoea
- Cyanosis
- Poor muscle tone
- Depressed respiratory effort
- Bradycardia
Oxygen Saturations
- Pre-ductal oxygen saturations are collected on the right hand.
- Post-ductal oxygen saturations are collected on the left or right foot.
- Infant should be settled and not crying or feeding.
- Waiting for at least 30 seconds for a good trace before reading the oximeter.
Medications
- Adrenaline: given if heart rate is low.
- Normal Saline: given for fluid resuscitation.
Neutral Thermal Environment (NTE) & Neutral Thermal Zone (NTZ)
- NTE: ideal environment where the infant can maintain normal body temperature with minimal metabolic rate, oxygen and glucose consumption.
- NTZ: environment created to manage the infant's temperature and minimize oxygen consumption and calorie expenditure.
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Hyperthermia can lead to:
- Increased metabolic rate and oxygen consumption
- Dehydration
- Peripheral vasodilation/ hypotension
- Fluid/electrolyte abnormalities
- Seizures
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Description
This quiz covers crucial concepts in neonatal thermoregulation, including normal temperature ranges, homeostasis, hypothermia, and hyperthermia. It also highlights the effects of cold stress on neonates, such as non-shivering thermogenesis and metabolic responses. Explore how fetal circulation impacts these processes.
