Review Of System Pedia

16 17 5. Review of systems 18 a. cardiovascular system 19 In utero, oxygenation takes place in the placenta not in the fetal lungs. So pressure on the left side is less than the pressure in the right side of the heart

20 Fetal accessory structures: –

Foramen ovale- opening between the right and left atria

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Ductus arteriosus- connects pulmonary artery and aorta

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Ductus venosus- bypasses the liver

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Umbilical vein- carries oxygenated blood

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2 umbilical arteries- carries deoxygenated blood

21 A newborn’s blood volume is around 80 t0 110 ml/ kg of body weight or about 300 mL 22 RBC- 6 M/ cubic mm 23 Hgb- 17 to 18g/ 100 ml of blood 24 Hct- 45%- 50 % 25 Platelets- 100,000- 200,000 26 WBC- 15,000 to 30,000 cells mm₃ 27 b. respiratory system 28 Newborn’s first breath requires tremendous amount of energy to pull in. Once the alveoli have initially have been inflated, breathing becomes much easier for the baby requiring only about 6 to 8 cm H₂O pressure 29 Heart of the newborn takes more space than in an adult so the amount of lung expansion is limited. 30 gastrointestinal system 31 Usually sterile at birth 32 Stomach can hold about 60-90 ml

33 Has limited ability to digest fat and starch because pancreatic enzymes(lipase and amylase) are deficient during the few months of life 34 Regurgitates easily because of immature cardiac sphincters between the stomach and the esophagus 35 Usually has low glucose and protein serum level due to immature liver function 36

37 Stools 38 Meconium- 1st stool that is usually passed within 24 hours after birth; 39 Sticky, tarlike, blackish green, odorless material formed from mucus, vernix, lanugo, hormones, and carbohydrates that accumulated during intrauterine life

40 Transitional stool- 2nd or 3rd day of life which may resemble diarrhea to the untrained eye - Green, loose

41 Stool of breastfed infants- 4th day of life - Golden yellow, sweet smelling, mushy - pass three or four light yellow stools per day

42 Stool of formula fed infants- passes two or three bright yellow stools a day, noticeable odor

43 Bright green stools- those placed under photo therapy 44 Stool with mucus- milk allergy or other irritant should be suspected 45 Gray/ clay colored stool- bile duct obstruction (because the bile pigments do not enter the intestinal tract

46 Black or tarry stool- intestinal bleeding 47 d. urinary system 48 Newborns void within 24 hours after birth

49 Single voiding is about 15 ml 50 Daily urine output for the first 1 or 2 days is about 30- 60 ml total 51 After 1 week- 300 ml/day 52 Specific gravity- 1.008 to 1.010 53 Proteinuria is normal for the first few days of life until kidney glomeruli are more fully mature 54 Light in color and odorless because their kidneys do not concentrate urine well 55 Female newborns produce a steady stream when voiding 56 Male newborns void with enough force to produce a small projected arc 57 E. Autoimmune system 58 Maternal Antibody (IgG) cross placenta to the fetus during the last 2 weeks ( passive natural immunity) and serve as protection against childhood diseases: poliomyelitis, measles, diphtheria, pertussis, chickenpox, rubella and tetanus 59 There is little natural immunity transmitted against herpes simplex. 60 Newborns are routinely administered hepatitis B vaccine during the first 12 hours after birth 61 Due to the difficulty forming antibodies against invading antigens until they are about 2 months of age, the newborn is prone to infection. 62 This inability to form antibodies early also is the reason that most immunizations against childhood diseases are not given to infants younger than 2 months.