Nursing 209

N209: Reproductive Health Study Guide o Fatty acids are released from brown fat metabolism, which leads to metabolic acidosis o When fatty acids from brown fat are released into the blood stream, there is an increase in jaundice (transportation of bilirubin to the liver is hampered) • Newborns are also prone to overheating due to limited sweating ability and insulation; can lead to fluid loss, increased respiratory rate, and increased BMR • One of the most important steps in neonatal resuscitation is prevention of cold stress 5.9 Fetal Circulation, Breathing, and Oxygenation Foramen Ovale • Before birth: Allows blood flow of oxygenated blood from inferior vena cava to right atrium to left atrium • After birth: The first breath pushes air into the lungs, which triggers an increase in pulmonary blood flow and venous return to the right side of the heart o This increases left atrium pressure vs. right atrium; causes foramen ovale to close and output from right ventricle flows to the lungs o Oxygenated and non-oxygenated blood are separated and permanent closure occurs Ductus Arteriosus • Before birth: Ductus arteriosus (between aorta and pulmonary artery) shunted blood right to left into descending aorta, bypassing pulmonary circulation o Fluid-filled, high-pressure system • After birth: Oxygen is the most important factor in closure; increased oxygenation of blood from aeration of lungs o After first breath and clamping of cord there is an increase in P02 from the increase in pulmonary blood flow and oxygen exchange in the lungs o Air-filled, low-pressure system Hepatic System • Before birth: Waste products are transferred through placental to maternal circulation • After birth: The neonate’s liver takes over the functions of the placenta • Iron storage: RBCs are destroyed after birth; releases iron, which is then stored by the liver • Iron stores depend upon gestational age and hemoglobin; term neonate has 4-6 months of iron stores • Carbohydrate metabolism: With no placenta, there is no maternal glucose supply • Liver releases glycogen stores for glucose for 24 hours

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