North American Registry of Midwives (NARM) Practice Exam

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What are three effects of hypoxia in the newborn?

  1. Increased heart rate, increased blood pressure, and metabolic alkalosis

  2. Persistent fetal circulation, CO2 buildup, and metabolic acidosis

  3. Decreased oxygen saturation, increased respiratory rate, and metabolic acidosis

  4. Increased temperature, metabolic alkalosis, and increased heart rate

The correct answer is: Persistent fetal circulation, CO2 buildup, and metabolic acidosis

Hypoxia in the newborn can lead to several critical physiological responses, primarily affecting the cardiovascular and respiratory systems, as well as acid-base balance. When a newborn experiences hypoxia, the body responds in ways that attempt to compensate for the lack of oxygen. One significant effect is persistent fetal circulation, where the newborn's circulation patterns do not transition as they should after birth. Instead of the normal shift to newborn pulmonary circulation, the blood continues to bypass the lungs due to a combination of poor oxygenation and vasoconstriction of pulmonary vessels, resulting from elevated levels of carbon dioxide (CO2) in the body. Additionally, CO2 buildup occurs because the body is unable to adequately exchange gases, leading to respiratory distress. This buildup can lead to metabolic acidosis as the body attempts to compensate for changes in acid-base balance due to hypoxia and inadequate oxygen supply, resulting in an accumulation of acids in the bloodstream. Understanding these physiological responses to hypoxia is crucial for managing newborns at risk and providing timely intervention to prevent further complications.