Heat Loss and Thermoregulation of the Newborn Flashcards

1
Q

Which TWO ways can heat be lost from the body and describe how

A

Internal gradient - heat is lost from the core to the surface
External gradient - heat is lost from the skin to the environment

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2
Q

Why do newborns struggle to maintain their own body temperature? (3 reasons)

A
  • Large surface area compared with body mass
  • Thin layer of subcutaneous fat
  • Cannot shiver to produce heat
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3
Q

If heat loss is not prevented, how many degrees can a newborn’s temperature drop by in 5 minutes?

A

4.5 degrees

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4
Q

How is heat lost through radiation?

A

Through cold objects in the rooms not in contact with baby, eg. windows

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5
Q

How is heat lost is through conduction?

A

Through contact with cold objects, eg. scales, resuscitiare

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6
Q

How is heat lost is through evaporation?

A

Through wet skin

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7
Q

How is heat lost through convection?

A

Through drafts

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8
Q

What is the principal source of heat production in a neonate?

A

Non-shivering thermogenesis (break down of brown fat)

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9
Q

What TWO substances does non-shivering thermogenesis require?

A

Oxygen
and
Glucose

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10
Q

Which areas can brown fat be found in?

A

Around the neck, axillae (underarms), behind the sternum (chestbone) and between the scapulae (shoulder blades)
Deep layers surrounding adrenal glands, kidneys, trachea and oesphagous

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11
Q

Name the SIX stages of cold stree

A
  • Increased metabolism of glucose and oxygen
  • Increase in use of glycogen and depletion of glycogen stores
  • Hypoglycaemia
  • Oxygen consumption increases and increase in respiratory rate
  • Requires more oxygen than is available leading to hypoxia and anaerobic respiration
  • Respiratory distress
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12
Q

What is the normal core body temperature of a newborn?

A

36.5 - 37.2 degrees celcius

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13
Q

What is the core body temperature range of a newborn with mild hypothermia or cold stress?

A

36-36.4 degrees celcius

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14
Q

What is the core body temperature range of a newborn with moderate hypothermia?

A

32-35.9 degrees celcius

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15
Q

What is the core body temperature range of a newborn with severe hypothermia?

A

Less than 32 degrees celcius

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16
Q

What is the core body temperature range of a newborn with severe hyperthermia?

A

Greater than 37.2 degrees celcius

17
Q

Name SEVEN signs that a newborn may have hypothermia

A
  • Shallow breathing
  • Lethargy
  • Hypotonia
  • Pale, mottled skin
  • Hardening of the skin
  • Weak sucking
  • Hypoglycaemia
18
Q

Name SEVEN signs that a newborn may have hyperthermia

A

-Tachycardia, tachypnoea
-Apnoea
-Hypotension
Warm extremeties
-Perspiration
-Hypotonia
-Poor feeding

19
Q

List the NINE points of the warm chain

A
  • Warm delivery room (25 - 28 degrees)
  • Immediate drying, remove wet towel
  • Skin to skin contact
  • Breast feeding
  • Bathing postponed
  • Appropriate clothing and bedding
  • Mother and baby together
  • Warm transportation
  • Warm resuscitation
20
Q

List the THIRTEEN steps to follow after the birth

A
  • Prepare for resuscitation (if expected)
  • Dry baby and remove wet towel
  • Assess - APGAR score
  • Skin to skin contact
  • Breast feeding
  • Early feeding
  • Weight - cover scales
  • Delay first bath
  • Identification - 2 x name bands
  • Examination of the newborn
  • Vitamin K prophylaxis
  • Document findings
  • Mother and baby to transfer together where possible