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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

– Ductus arteriosus- connects pulmonary artery and aorta

– Ductus venosus- bypasses the liver

– Umbilical vein- carries oxygenated blood

– 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.

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