Beruflich Dokumente
Kultur Dokumente
HUMAN DEVELOPMENT
Vanessa M. Manila, RN
UP Manila College of Nursing
1
OBJECTIVES
1. Describe the newborn’s transition to
extrauterine life.
a. Intrauterine Life
b. Physiologic Adaptations
2. Describe the neonatal physical
characteristics
3. Describe the neonate’s behavioral
responses and developmental tasks
4. Discuss appropriate nursing care of
the newborn
2
Transition from intrauterine
to
extrauterine life 3
I. Intrauterine Life
Placental Function:
- transfer of gases (lungs)
- transport of nutrients (gastrointestinal
tract)
- excretion of wastes (kidneys)
- transfer of heat (skin)
4
I. Intrauterine Life
Placental Function:
- conjugation of drugs and hormones
(liver)
- production of various protein and
steroid hormones (endocrine
gland)
5
II. Physiologic
Adaptations
“ The most
profound
physiologic
change required
of the neonate is
transition from
fetal or placental
circulation to
independent
respiration…”
(Whaley and 6
Wong, 1989)
II. Physiologic
Adaptations
A. Respiratory adaptations
B. Cardiovascular adaptations
C. Temperature regulation
D. Urinary Adaptations
E. Gastrointestinal Adaptation
F. Hepatic Adaptation
G. Immunologic System
H. Neurologic and Sensory/ Perceptual
Functioning
7
II. Physiologic
Adaptations
– most critical: first 24 hours
– the most critical and immediate
physiologic change required of the
newborn is the onset of
breathing
slapping the infant’s feet/
buttocks has no beneficial
effect
8
II. Physiologic
Adaptations
A. Respiratory adaptations
Characteristics:
- Normal rate: 30- 60
breaths per minute
- shallow and irregular depth and rhythm
- Primarily abdominal and synchronus with
the chest mov’t
- Short periods of apnea are to be expected
- Pauses lasting 5- 15 secs, called periodic
breathing, may occur
9
II. Physiologic
Adaptations
B. Circulatory adaptations
Characteristics:
- Heart rate: 100 bpm when asleep;
120- 150 when awake
- Rates as high as 180 while crying may
be normal
- Apical pulse rates should be obtained
by auscultation for a full minute
- BP: resting: 74/47 mmHg
- Crying may cause elevation
10
II. Physiologic
Adaptations
C. Thermogenic Adaptations
Thermogenesis in newborn:
- increased muscular activity and
positional changes
- chemical thermogenesis (non-shivering
thermogenesis); increased basal
metabolic rate
- vasomotor control
12
II. Physiologic
Adaptations
D. Renal System
13
II. Physiologic
Adaptations
15
II. Physiologic
Adaptations
E. Gastrointestinal System
A special mechanism coordinates
breathing, sucking, and swallowing
reflexes necessary for oral feeding
Sucking in newborn takes place in
small bursts of 3- 8 sucks at a time
Unable to move food
from the lips to the
pharynx
16
III. Physiologic
Adaptations
F. Hepatic Regulation
Liver is immature
17
II. Physiologic
Adaptations
G. Immunologic System
18
III. Physiologic
Adaptations
G. Immunologic System
19
II. Physiologic
Adaptations
H. Neurologic and Sensory/
Perceptual Functioning
Vision
- the least mature at
term
- development
continues for the first
6 months
21
II. Physiologic
Adaptations
H. Neurologic and Sensory/
Perceptual Functioning
Hearing
- as soon as amniotic fluid is drained
from the ear, hearing is similar as to
that of an adult
- react to high frequency sound with a
startle
- reacts to low- frequency sound by
decreasing motor activity or stopping
crying 22
II. Physiologic
Adaptations
H. Neurologic and Sensory/
Perceptual Functioning
Smell
- highly developed
- by the 5th day, can recognize
mother’s smell
- breastfed infants are able to smell
breastmilk and can differentiate their
mother from other lactating women
23
II. Physiologic
Adaptations
H. Neurologic and Sensory/
Perceptual Functioning
Taste
- tasteless solution: no response
- sweet: eager sucking
- sour: puckering of lips
- bitter: grimace
- newborns prefer
glucose water to plain
water
24
II. Physiologic
Adaptations
H. Neurologic and Sensory/
Perceptual Functioning
Touch
- responsive to all
parts of the body
- face, hands, and soles
of the feet appear to be
the most sensitive
- touch and motion are
essential to normal
growth and
development 25