When caring for the newborn after a vaginal delivery, the nurse needs to be able to identify the respiratory changes that occur during the transition of the fetus to extrauterine life

Question

Which factors does the nurse recognize as contributing to the changes in the newborn's lung function after birth? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Adequate lung development and production of surfactant
2. Marked decrease in pulmonary circulation
3. Inspiratory gasp triggered by the elevation in PCO2 and decrease in pH and PO2
4. Stimulation of skin nerve endings due to chilling
5. Chemical stimulator associated with transient asphyxia of the fetus

Answer 1

3,4,5
Rationale 1: These intrauterine factors support respiratory function, and need to be present prior to the delivery.
Rationale 2: A marked increase in pulmonary circulation must occur for the lungs to function after birth.
Rationale 3: This is the natural result of the cessation of placental gas exchange when the cord is clamped.
Rationale 4: A significant decrease in ambient temperature after birth results in sudden chilling of the moist newborn, which stimulates skin nerve endings. The newborn response is rhythmic breathing.
Rationale 5: The chemical stimulator acts on the aortic and carotid chemoreceptors, initiating impulses that trigger the brain's respiratory center.