The nurse is assessing the cardiovascular status of a newborn. ...

[lak]

The nurse is assessing the cardiovascular status of a newborn. Which of the following findings indicates adequate systemic circulation?
 
  A.
  Capillary refill 2 seconds
  B.
  Capillary refill 4 seconds
  C.
  Pale mucous membranes in a dark-skinned baby
  D.
  Truncal cyanosis

Question 2

The perinatal nurse explains the cardiopulmonary adaptations that occur in the neonate to a student nurse. Which of the following statements accurately describes the sequence of these changes?
 
  A.
  As air enters the lungs, the PO2 rises in the alveoli, which causes pulmonary artery relaxation and results in an increase in pulmonary vascular resistance.
  B.
  As the pulmonary vascular resistance increases, pulmonary blood flow increases, reaching 100 by the first 24 hours of life.
  C.
  Decreased pulmonary blood volume contributes to the conversion from fetal to newborn circulation.
  D.
  Once the pulmonary circulation has been functionally established, blood is distributed throughout the lungs.

[6ana001]

Answer to Question 1

ANS: A
On assessment, the systemic circulation is deemed adequate if the newborn exhibits a brisk capillary refill and stable blood pressure. Capillary refill in less than 3 seconds is considered adequate. A refill time greater than 4 seconds may be indicative of an underlying condition, such as sepsis, hypoxia, or cardiovascular or central nervous system compromise. A dark-skinned baby should have pink mucous membranes. Acrocyanosis is normal, but a cyanotic trunk is not.

Answer to Question 2

ANS: D
As air enters the lungs, the PO2 rises in the alveoli. This normal physiological response causes pulmonary artery relaxation and results in a decrease in pulmonary vascular resistance. As the pulmonary vascular resistance decreases, pulmonary blood flow increases, reaching 100 by the first 24 hours of life. The increased pulmonary blood volume contributes to the conversion from fetal to newborn circulation. Once the pulmonary circulation has been functionally established, blood is distributed throughout the lungs. The other explanations are inaccurate.