Which is the most critical physiologic change required of the newborn?
a. Closure of fetal shunts in the heart
b. Stabilization of fluid and electrolytes
c. Body-temperature maintenance
d. Onset of breathing
ANS: D
The onset of breathing is the most immediate and critical physiologic change required for transition to extrauterine life. Factors that interfere with this normal transition increase fetal asphyxia, which is a condition of hypoxemia, hypercapnia, and acidosis. This affects the fetus's adjustment to extrauterine life. Closure of fetal shunts in the heart, stabilization of fluid and electrolytes, and body-temperature maintenance are important changes that must occur in the transition to extrauterine life, but breathing and the exchange of oxygen for carbon dioxide must come first.
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