Foundations 2 Maternal Child

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38. Lung expansion after birth stimulates the release of surfactant, a slippery, detergent-like lipoprotein. In which newborns would the neonatal nurse expect to find decreased surfactant production? SELECT ALL THAT APPLY. 1) An infant with a hemolytic disorder 2) An infant of a multiple gestation 3) An infant whose mother has diabetes Class C 4) An infant whose mother has hypertension 5) An infant whose mother abused heroin

1, 2, 3

The perinatal nurse is providing care to a postpartum woman during the first 24 hours following birth. For which reasons might the postpartum woman's temperature be slightly increased?SELECT ALL THAT APPLY. 1) Exertion of labor 2) Dehydration during labor 3) Increased breast vascularity 4) Infection 5) Breast feeding

1, 2, 3, 5

The postpartum nurse discusses the use of acetaminophen (Tylenol) and ibuprofen (Motrin) with a postpartum woman as part of a self-medication program. Why is information on and participation in a self-medication program beneficial to the postpartum woman?SELECT ALL THAT APPLY. 1) Increases the perception of control 2) Increases the amount of medication available and taken 3) Increases the satisfaction with her postpartum care 4) Increases the length of hospital stay 5) Increases the risk of side effects

1, 3

The nurse is providing care to a postpartum mother and her infant. When discussing safety with the patient, which is the priority? 1) Information provided to the mother about security risks and appropriate measures 2) Presence of an electronic security system 3) Transporting the infant in a bassinet 4) Ensuring that all personnel wear visible photo identification badges

1.

The perinatal nurse is assigned a G4 TPAL 2114 woman who gave birth to twins 2 hours ago. The patient's fundal height is palpated at 1 fingerbreadth above the umbilicus. Which information in the client's health history is most likely the cause of this assessment finding? 1) Multiple gestation 2) Status as a grand multiparous woman 3) Precipitous vaginal birth 4) Increased placental size

1.

The perinatal nurse is caring for a patient who is 1 day postpartum. When reviewing the client's medical record, the nurse notes that the client is Rh- and the baby is Rh+. Which intervention is the priority? 1) Administering Rho(D) immune globulin 2) Administering varicella 3) Administering an MMR 4) Administering oxytocin

1. A woman who is Rh- who gives birth to an Rh+ infant requires Rho(D) immune globulin within 72 hours of birth. Although the other medications may also be needed, this medication is the priority.

A nurse is preparing to administer a vitamin K (phytonadione) injection to a newborn. Which of the following responses should the nurse make to the newborn's parents regarding why this medication is given? A. It assists with blood clotting B. It promotes maturation of the bowel C. It is a preventative vaccine D. It provides immunity

A

41. The nurse is providing care to a postpartum client who delivered a healthy newborn by cesarean birth. Which finding in the medical record may indicate an increased risk for complications? 1) Blood loss of 1,200 mL 2) Temperature of 100.1°F 3) Blood pressure of 120/70 mm Hg 4) Heart rate of 88 beats/min

1. Normal blood loss during a cesarean birth is approximately 1,000 mL. The patient's blood loss exceeds this amount, and therefore could lead to complications. All of the other findings are considered normal.

During the physical examination, the perinatal nurse checks the newborn's heart rate. Which location is the most appropriate for the nurse to use when conducting this assessment? 1) Brachial area 2) At the base of the umbilical cord 3) In the area of the mid-sternum 4) In the upper clavicular area

2. Base of the umbilical chord

The perinatal nurse applies perineal ice packs to facilitate healing and decrease edema for optimal benefit during the first _________ hours after a vaginal delivery.

24

A nurse is assesses the urine of a newborn. Which normal laboratory value does the nurse anticipate for the term neonate?

3.

The clinic nurse uses the birth measurement to plot the infant's head circumference from birth to _________ months of age to assess growth and development.

36

The nurse is providing care to a postpartum patient whose antenatal blood work results indicate no immunity to rubella. Which action by the nurse is the most appropriate based on this data? 1) Encourage her to follow up with her family doctor prior to the next pregnancy. 2) Encourage her to stop breastfeeding for 24 hours to facilitate the rubella immunization. 3) Talk with her about having the rubella immunization at the 6 week follow-up. 4) Provide information about the risks/benefits of rubella immunization.

4) Provide information about the risks/benefits of rubella immunization.

The nurse is providing care to a newborn who is exhibiting jerky movements with intense crying. The newborn's mother asks what is wrong with her baby. Which response by the nurse is the most appropriate? 1) "Your baby is entering the drowsy alert state." 2) "Your baby is in the wide-awake state and this is normal behavior." 3) "Your baby is in the active alert state and is very hungry." 4) "Your baby is in the crying state and might be hungry."

4.

The postpartum nurse teaches the student nurse that normal spontaneous voiding efforts return for most women in ________hours following childbirth.

6 to 8 hrs

The perinatal nurse is teaching student nurses about neonatal respiratory transition. During this time, neonatal laboratory values of less than _______% oxygen saturation are concerning.

94% Cardiac insufficiency describes a condition that occurs when an infant cannot adequately oxygenate and circulate blood. This condition is characterized by pallor, rapid breathing, and cyanosis around the lips. Pulse oximetry readings should be obtained immediately. Readings of less than 94% oxygen saturation are of major concern, and if an infant's oxygen saturation drops below 90%, rapid transfer to an intensive care unit for continuous respiratory and cardiac monitoring should be accomplished.

A nurse is performing a fundal assessment for a client who is 2 days postpartum and observes the perineal pad for lochia. The pad is saturated approximately 12 cm with lochia that is bright red and contains small clots. Which of the following findings should the nurse document? A. Moderate lochia rubra B. Excessive lochia serosa C. light lochia rubra D. scant lochia serosa

A

A nurse is teaching a newly licensed nurse how to bathe a newborn and observes a blush brown marking across the newborn's lower back. The nurse should include which of the following information in the teaching? A. "This is more commonly seen in newborns who have dark skin." B. "This is a finding indicating hyperbilirubinemia." C. "This is a forceps mark from an operative delivery." D. "This is related to prolonged birth or trauma during delivery."

A

During the newborn assessment, the perinatal nurse observes the infant exhibit jitteriness. Based on this data, which condition does the nurse suspect the infant is experiencing? 1) Hypoglycemia 2) Respiratory distress 3) Septicemia 4) Hyperbilirubinemia

A Infants with a low blood glucose level (hypoglycemia) or those who exhibit signs and symptoms of hypoglycemia (jitteriness, apnea, seizures, or lethargy) require immediate attention to prevent brain cell damage. Signs of respiratory distress include flaring of the nares, retractions (in-drawing of tissues between the ribs, below the rib cage, or above the sternum and clavicles), and grunting with expirations. Septicemia is a systemic condition caused by multiplication of microorganisms in circulating blood. Hyperbilirubinemia presents with yellow coloring of the skin.

A nurse is caring for a newborn immediately following a circumcision using a Gomco procedure. Which of the following actions should the nurse implement? A. Apply Gelfoam powder to the site B. Place the newborn in the prone position C. Apply petroleum gauze to the site D. Avoid changing the diaper until the first voiding

C

The perinatal nurse is explaining to new parents about the eye ointment their infant will receive. Which medications are appropriate to include in the teaching session? SELECT ALL THAT APPLY. 1) Erythromycin ophthalmic 0.5% ointment (Ilotycin) 2) Tetracycline 1% ophthalmic ointment (Achromycin V; Tetracyn; Tetrex) 3) Penicillin G 1% ophthalmic ointment 4) Gentamicin 0.5% ophthalmic ointment 5) Vitamin K (Phytonadione)

A, B

A Korean couple is expecting a baby in 2 months. The couple attends birthing classes at a local clinic, where the instructor is describing the newborn transitions from in utero life to birth. Which newborn conditions might this neonate be predisposed to due to the ethnic background?SELECT ALL THAT APPLY. 1) Jaundice 2) Glucose-6-phosphate dehydrogenase (G6PD) 3) Pyruvate kinase deficiency 4) Respiratory distress syndrome 5) Type 1 diabetes mellitus

A, B, C

The perinatal nurse assesses a patient who is 2 hours postpartum and notes the presence of a hemorrhoid that has resulted from the birth. Which nursing actions are appropriate based on this data? SELECT ALL THAT APPLY. 1) Assisting the patient to ambulate within 2 to 4 hours 2) Encouraging the patient drink six to eight glasses of water per day 3) Providing information and care about hemorrhoids and their care to the patient 4) Providing a sitz bath three times a day to the patient 5) Encouraging the patient to strain during bowel movements

A, B, C

At approximately 1 hour following birth, the perinatal nurse is assessing the newborn's respiratory function. Which findings would be indicative of respiratory distress?SELECT ALL THAT APPLY. 1) RR of 72 breaths/minute 2) HR of 168 beats/minute 3) Flaring nostrils 4) Pallor 5) Intercostal retractions

A, B, C, E

The nurse is providing care to several postpartum patients. During the uterine assessment, which does the nurse include?SELECT ALL THAT APPLY. 1) Tone 2) Location 3) Color 4) Height 5) Odor

A, B, D The fundus is assessed for consistency (firm, soft, or boggy), location (should be midline), and height (measured in fingerbreadths). Lochia is assessed for color and odor.

A nurse is providing education to a client is who 2 hours postpartum and has perineal laceration. Which of the following information should the nurse include? (select all that apply) A. Use a perineal squeeze bottle to cleanse the perineum. B. Sit on the perineum while resting in bed C. Apply a topical anesthetic cream or spray to the perineum D. Wipe the perineum thoroughly with a back and forth motion E. Apply cold or ice packs to the perineum

A, C, E

A perinatal nurse auscultates the chest of a newborn at 23 hours post-childbirth. Which does the nurse consider as normal characteristics of the blood flow through the ductus arteriosus?SELECT ALL THAT APPLY. 1) In utero, most of the fetal blood flow occurs across the ductus arteriosus. 2) The ductus arteriosus functions as the pathway between the pulmonary artery and the ascending aorta. 3) Blood flow through the ductus arteriosus occurs in a left-to-right direction. 4) Once the umbilical cord is clamped, lungs oxygenate the blood, and increased PaO2 stimulates the closure of the ductus arteriosus. 5) After the cord is clamped, placental blood flow increases and there is an increase in the systemic blood pressure and vascular resistance.

A, D

A nurse is reviewing contraindications for circumcision with a newly hired nurse. Which of the following conditions are contraindications? (Select all the apply) A. Hypospadias B. Hydrocele C. Family history of hemophilia D. Hyperbilirubinemia E. Epispadias

A,C,E

The perinatal nurse is facilitating a class for new mothers who are interested in breastfeeding. Which hormone does the nurse include as one that is responsible for the system of milk-secreting glands and increased vascularity that prepares the breast for breastfeeding? 1) Estrogen 2) Progesterone 3) Relaxin

A. Estrogen stimulates the formation of additional ducts, the elongation of existing ducts, and the formation of a system of milk-secreting glands. These changes are associated with an increase in volume and elasticity of connective tissue, deposition of adipose tissue, and increased vascularity.

Two hours following birth, the perinatal nurse places the newborn in a radiant warmer and administers vitamin K. Which condition does this vitamin protect the newborn against? 1) Neonatal hemorrhage 2) Eye infection 3) Jaundice 4) Respiratory infection

A. The radiant warmer and probe provide a safe source for external heat as the infant is examined, and vitamin K is administered to prevent neonatal hemorrhage.

The perinatal nurse promotes ongoing attachment for the breastfeeding mother who is discharged before her infant. Which positive actions would the nurse encourage the mother to do in this situation? SELECT ALL THAT APPLY. 1) Make telephone calls for updates on her baby. 2) Touch the baby when visiting. 3) Pump the breast milk every 6 hours. 4) Rest for more than 6 hours at night. 5) Discontinue breastfeeding due to pain.

A. B

The nurse recognizes that __________ is caused by poor peripheral circulation in the newborn.

Acrocyanosis

A nurse is preparing to administer prophylactic eye ointment to a newborn to prevent ophthalmia neonatorum. Which of the following medications should the nurse anticipate administering? A. Ofloxacin B. Nystatin C. Erythromycin D. Ceftriaxone

C

A nurse is providing discharge teaching to the parents of a newborn regarding circumcision care. Which of the following statement made by a parents indicates an understanding of the teaching? A. The circumcision with heal within a couple of days B. I should remove the yellow mucus that will form C. I will clean the penis with each diaper change D. I will give him a tub bath within a couple of days

C

A nurse is reviewing car safety with the parents of a newborn. Which of the following instructions should the nurse include in the teaching regarding car seat position? A. Front seat; rear-facing B. Front seat; forward-facing C. Back seat; rear-facing D. Back seat; forward- facing

C

A nurse is assessing a postpartum client for fundal height, location, and consistency. The funds is noted to be displaced laterally to the right, and their is uterine atony. The nurse should identify which of the following conditions as the cause of the uterine atony? A. Poor involution B. Urinary retention C. Hemorrhage D. infection

B

A nurse is caring for a newborn. Which of the following actions by the newborn indicates readiness to feed? A. Spits up clear mucus B. Attempts to place their hand in their mouth C. Turns the head toward sounds D. Lies quietly with their eyes open

B

A nurse is completing postpartum discharge teaching to a client who had no immunity to varicella and was given the varicella vaccine. Which of the following statements by the client indicates understanding of the teaching? A. I will need to use contraception for 3 months before considering pregnancy B. I need a second vaccination at my postpartum visit C. I was given the vaccine because my baby is O positive D. I will be tested in 3 months to see if I have developed immunity

B

A newborn was not dried completely after birth. This places the infant at risk for which of the following types of heat loss? A. Conduction B. Convection C. Evaporation D. Radiation

C

A nurse is caring for a newborn who was born at 38 weeks of gestation, weighs 3,200g and is in the 60th percentile for weight. Based on the weight and gestational age, the nurse should classify this neonate as which of the following? a. Low birth weight b. appropriate for gestational age c. small for gestational age d. large for gestational age

B.

A healthy pregnant woman gives birth to a healthy boy at term. The physician holds the neonate below the level of the placenta and delays clamping of the cord. The nurse is aware that this practice may provide which advantage for the neonate? 1) Decreased risk of jaundice 2) Enhanced pulmonary perfusion 3) Decreased hemoglobin and hematocrit levels 4) Increased amount of adult hemoglobin replacing fetal hemoglobin

B. Holding the neonate below the level of the placenta and delaying the clamping of the cord may allow an increase of up to 100 milliliters per kilogram in the neonate's total blood volume. The increase in blood volume may facilitate an improved transition due to enhanced pulmonary perfusion and the gain of additional iron stores. A disadvantage of this practice is the increased risk of jaundice due to the higher volume of erythrocytes and possible resultant polycythemia.

The perinatal nurse includes palpation in the respiratory system assessment to identify the presence of ______ _________.

Birth Injuries During the assessment, the nurse should gently palpate the anterior lung field to identify birth injuries, such as fractures of the clavicle or ribs. These injuries can cause an increased respiratory rate due to pain.

Perinatal nurses carefully observe the neonate for asymmetry in body position during the first 24 hours following birth. The importance of this assessment is to detect the possibility of ________ _________.

Birth Trauma

The neonatal nurse is aware that during nonshivering thermogenesis, the newborn metabolizes ________ ___________, a process that increases the metabolic rate and oxygen consumption.

Brown Fat

A nurse is taking a newborn to a parents following a circumcision. Which of the following actions should the nurse take for security purposes? A. Ask the parent to state their full name B. Look at the name on the newborn bassinet C. Match the parent's identification brand with the newborn's band D. Compare name on the bassinet and the room number

C

A nurse is teaching a group of new parents about proper techniques for bottle feeding. Which of the following instructions should the nurse provide? A. Burp the newborn at the end of the feeding B. Hold the newborn close to a supine position C. Keep the nipple full of formula throughout the feeding D. Refrigerate any unused formula

C

During ambulation to the bathroom, a postpartum client experiences a gush of dark red blood that soon stops. On assessment, a nurse finds the uterus to be firm, midline, and at the level of the umbilicus. Which of the following findings should the nurse interpret this data as being? A. Evidence of a possible vaginal hematoma B. An indications of a cervical or perineal laceration C. A normal postural discharge of lochia D. Abnormally excessive lochia rubra flow

C

A nurse is completing an assessment. Which of the following data indicate the newborn is adapting to extrauterine life? (Select all that apply) A. Expiratory grunting B. Inspiratory nasal flaring C. Apnea for 10-second periods D. Crackles and wheezing

C, D

A nurse is reviewing formula preparations with parents who plan to bottle-feed their newborn. Which of the following information should the nurse include in the teaching? A. Use a disinfectant wipe to clean the lid of the formula can B. Store prepared formula in the refrigerator for up to 72 hours C. Place used bottles in the dishwasher D. Check the nipple for the appropriate flow of formula E. Use tap water to dilute concentrated formula

C,D,E

A postpartum woman who is breastfeeding her infant has returned to the clinic because of a "lump" that she describes in the upper quadrant of her right breast. Which question by the nurse is most appropriate in this situation? 1) "Do you have a history of breast cancer in your family?" 2) "Is the lump painful to touch?" 3) "Does the lump get smaller in size after breastfeeding?" 4) "Are you smoking or taking pain medications?"

C.

Forty-five minutes after a newborn's birth, the nurse is preparing to give 0.5 milligram of vitamin K1 (phytonadione [AquaMEPHYTON]) IM as ordered. The newborn's father asks about the purpose of this medication. Which response by the nurse is the most appropriate? 1) "Your baby's health-care provider has ordered it for your baby." 2) "This medication must be given to all babies within the first hour of birth." 3) "Babies need additional vitamin K to aid with blood clotting." 4) "Are you anxious about your baby receiving medication?"

C.

A pregnant woman who has been in labor for 23 hours is rushed to the operating room for an emergency cesarean section. The perinatal nurse is prepared for which newborn transitional difficulty related to the cesarean birth? 1) Cardiovascular transitions 2) Thermogenic transitions 3) Pulmonary transitions 4) Hematopoietic transitions

C. During a vaginal birth, approximately one-third of the fetal lung fluid is expelled due to the "thoracic squeeze" that occurs during passage through the birth canal. Infants of cesarean births are at a higher risk for pulmonary transitional difficulties because they do not receive the lung-compression benefits associated with a vaginal birth

A nurse assesses a newborn who is exhibiting brief periods of tachycardia, tachypnea, and rapid changes in color and muscle tone. In which stage of activity is this a normal finding? 1) The first period of reactivity 2) The period of inactivity and sleep 3) The second period of reactivity 4) The second period of inactivity and sleep

C. During the second period of reactivity, the newborn becomes increasingly more responsive to exogenous and endogenous stimulation, which can cause the heart rate to become labile. The infant may exhibit brief periods of tachycardia, tachypnea, and rapid changes in color and muscle tone. The nurse needs to be aware of normal newborn behaviors during this period that may last for minutes up to several hours and perform careful, ongoing assessment to differentiate between normal reactions and symptoms that signal difficulty with transition.

A physician orders a blood test for a healthy 2-day-old newborn to check bilirubin levels. When reading the results, the perinatal nurse is aware that which is a normal level of bilirubin in the peripheral blood for the newborn? 1) 1.5 mg/dL 2) 2.6 mg/dL 3) 6.5 mg/dL 4) 8.5 mg/dL

C. Normal bilirubin levels for a 2-day-old newborn are 6 to 7 mg/dL; for a newborn 0 to 1 day, 2.6 mg/dL; and for a newborn 3 to 5 days, 4 to 6 mg/dL.

1. The nurse is providing care to several newborns in the nursery. Which newborn is ready for the metabolic screening? 1) The newborn who is having the initial assessment 1 hour after birth 2) The newborn who is receiving phototherapy 20 hours after birth 3) The newborn who has been feeding for 28 hours after birth 4) The newborn who is NPO 12 hours after birth

C. Approximately 24 hours following birth, a small sample of blood is taken from the infant's heel and placed on special filter paper. A blood sample taken before 24 hours of age may be unreliable in detecting several conditions. However, if the newborn is discharged from the hospital or birthing center before completing the first 24 hours of life, a sample must be obtained, and the infant's parents must be instructed to contact the physician within 2 weeks to arrange to have another specimen drawn.

The perinatal nurse assesses the infant for nasal patency by carefully occluding one naris when the infant's mouth is closed and observing chest rise and fall. This assessment is critical in ruling out ______ ________.

Choanal atresia To assess for nasal patency, the nurse carefully occludes one naris while the infant's mouth is closed. A rise in the infant's chest confirms that the nasal passageway is open and air has been inhaled. The assessment may be repeated with the other naris. If the infant demonstrates difficulty with this maneuver, he or she may have a developmental anomaly known as choanal atresia. Choanal atresia is a malformation of the bucconasal membrane.

A nurse is caring for a newborn immediately following birth. Which of the following nursing interventions is the highest priority? A. Initiating breastfeeding B. Performing the initial bath C. Giving vitamin K injection D. Covering the newborn's head with a cap

D

A nurse is giving instructions to a parent about how to breastfeed their newborn. Which of the following actions by the parent indicated understanding of the teaching? A. The parent places a few drops of water on their nipple before feeding B. The parent gently removes their nipple from the infant's mouth to break the suction C. When they are ready to breastfeed, the parent gently strokes the newborn's neck with a finger D. When latched on, the infant's nose, cheek, and chin are touching the breast

D

A nurse is reviewing breastfeeding positions with the parent of a newborn. Which of the following positions should the nurse discuss? A. Over-the-shoulder B. Supine C. Chin-supported D. Cradle

D

A nurse is reviewing care of the umbilical cord with the parents of a newborn. Which of the following instructions should the nurse include in the teaching? A. Cover the cord with a small gauze square B. Trickle clean water over the cord with each diaper change C. Apply Hydrogen peroxide to the cord twice a day D. Keep the diaper folded below the cord

D

A nurse is assessing the reflexes of a newborn. In checking for the Moro reflex, the nurse should perform which of the following? A. Hold the newborn vertically under arms and allow one foot to touch table. B. Stimulate the pads of the newborn's hands with stroking or massage C. Stimulate the soles of the newborn's feet on the outer lateral surface of each foot D. Hold the newborn in a semi-sitting position, then allow the newborn's had and trunk to fall backwards

D.

A nurse is completing a newborn assessment and observes small pearly white nodules on the roof of the newborn's mouth. This finding is a characteristic of which of the following conditions? A. Mongolian Spots B. Milia spots C. Erythema toxic D. Epstein's pearls

D.

When assessing the newborn for cardiac functioning, the perinatal nurse explains to the mother that fibrosis occurs in the nonfunctional ductus venosus after birth, and the structure, which is termed the __________ ___________, usually closes by the end of the first week.

Fibrosis occurs in the nonfunctional ductus venosus, and the structure, which is termed the ligamentum venosum, usually closes by the end of the first week.

The optimal prenatal values that the perinatal nurse can use to compare with the blood pressure of a postpartum woman are her _________-trimester values.

First trimester

Upon examination of a newborn for respiratory functioning, the perinatal nurse recalls that _________causes a decreased surface tension within the alveoli, which allows for alveolar reexpansion following each exhalation.

Surfactant Lung expansion after birth stimulates the release of surfactant, a slippery, detergent-like lipoprotein. Surfactant causes a decreased surface tension within the alveoli, which allows for alveolar reexpansion following each exhalation. Under normal circumstances, by 34 to 36 weeks of gestation, surfactant is produced in sufficient amounts to maintain alveolar stability

The nurse assessing an infant for heat loss recalls that thermogenic adaptation is closely related to the infant's rate of ____________ consumption and metabolism.

Oxygen

A G1 TPAL 1001 postpartum woman is admitted to the mother/baby care unit experiencing perineal pain related to a third-degree tear and episiotomy. Her vital signs are T = 99.3°F (37.4°C), BP = 110/70, P 62, and RR = 22. Which vital sign requires continued priority assessment?

Respiratory Rate

The perinatal nurse uses the Neonatal Skin Condition Score in the neonatal intensive care unit. An infant score of 6 suggests that further assessment and application of __________ would be beneficial in maintaining skin integrity.

The Neonatal Skin Condition Score (NSCS) is an assessment tool developed by investigators involved in the Neonatal Skin Care Project, a clinical study designed to develop guidelines for the examination and evaluation of neonatal skin care. The NSCS consists of a 9-point scale that evaluates three broad categories: dryness, erythema, and breakdown/excoriation. A score ranging from 1 (normal) to 3 (extensive) is assigned to each category; a perfect score = 3 and the worst possible score = 9.

In assisting families with information concerning infant car seats, the perinatal nurse suggests that the infant be dressed in a(n) ________layer and that a rolled receiving blanket be used for head support.

The infant must be dressed in such a way that the clothing facilitates ease of positioning and strap placement. Head support is recommended and parents can use a commercially made product or a receiving blanket that can be rolled up and placed around the infant's head and neck area.

The student nurse learns that __________respiration is the exchange of gases (oxygen, carbon dioxide) between the alveoli and the blood through the alveolar-capillary membrane.

external respirations


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