Which is the most critical physiologic change required of the ...

[awywial]

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

Question 2

A patient on an intravenous opioid analgesic has become apneic. The nurse should implement which interventions? Place the interventions in order from the highest priority (first intervention) to the lowest priority (last intervention).
 
  Provide your answer using lowercase letters separated by commas (e.g., a, b, c, d).
  a. Place the patient on continuous pulse oximetry to assess SaO2.
  b. Administer the prescribed naloxone (Narcan) dose by slow IV push.
  c. Ensure oxygen is available.
  d. Prepare to calm the child as analgesia is reversed.

[Jayson]

Answer to Question 1

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.

Answer to Question 2

ANS:
b, a, c, d
The Narcan prescribed dose should be given, first by slow IV push every 2 minutes until effect is obtained. The second intervention should be assessment of the patient's SaO2 status. Oxygen should be made available and administered if the SaO2 status indicates hypoxemia. Last, the child should be calmed as the analgesia is reversed.