A woman gives birth to a healthy baby boy at 35 weeks' gestation. What factor regarding the development of the normal respiratory system should the nurse consider when performing an assessment of the neonate?
A.
As the fetus approaches term, secretion of intrapulmonary fluid increases.
B.
Lung expansion after birth suppresses the further release of surfactant.
C.
Surfactant increases alveolar surface tension, allowing re-expansion after exhalation.
D.
Surfactant production is sufficient to maintain alveolar stability by about 34 weeks.
ANS: D
As the fetus approaches term, there is a decrease in the secretion of intrapulmonary fluid, which assists in reducing the pulmonary resistance to blood flow and facilitates the initiation of air breathing. Lung expansion after birth stimulates the release of surfactantâ€"a slippery, detergent-like lipoprotein. Surfactant causes decreased surface tension within the alveoli, which allows for alveolar re-expansion following each exhalation. Under normal circumstances, by the 34th to 36th week of gestation, surfactant is produced in sufficient amounts to maintain alveolar stability.
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