Nursing 209

N209: Reproductive Health Study Guide • Along with thyroid hormones, this “surge” triggers the sodium pump for clearance of lung fluid, along with surfactant production (for lung maturity) • During the last weeks of gestation, conversion of T4 and T3 increase, and catecholamine releases from adrenals increase • Glucose metabolic pathways in liver matur • Digestive capacity in the gut (enzyme induction) increase • Cortisol level rises and peaks shortly after delivery • C-section delivery interferes with this rise in cortisol • Preterm delivery may result in decreased cortisol levels • Interference of cortisol production can affect newborn transition of: o Lung maturity and fluid clearance o Gut function o Thyroid maturation o Release and regulation of catecholamine o Glucose metabolism Catecholamines • Drive adaptive responses (regulated by cortisol); levels increase in labor • Catecholamine “surge” is responsible for: o Increase in blood pressure after birth o Energy metabolism o Initiation of thermogenesis o Enhanced surfactant secretion o C-section delivery: No labor, catecholamine release is depressed; may also be influenced by maternal anesthesia Thermoregulation • Normal temperature is between 97.7 F (36.5 C) and 98.6 F (37 C) • Essential for physiologic adaptation • Depends upon external environment and internal physiologic processes • Newborns are homeothermic, meaning they attempt to regulate temperature regardless of environmental factors Neutral Thermal Environment • Affected by size and gestational age • Temperature range where body temperature can be maintained with minimal basal metabolic rate and oxygen consumption

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