Final answer:
The NRP questions focus on assessing the immediate needs of the newborn at birth; however, the question provided does not directly address them. Instead, it discusses the administration of pitocin to induce labor in prolonged labor cases and the alterations in the circulatory pattern following the newborn's first breath.
Step-by-step explanation:
The four NRP (Neonatal Resuscitation Program) questions that are considered at birth to determine the immediate needs of the newborn are not directly listed within the question provided. However, it's important to address the other questions which infer key aspects of childbirth and neonatal care. When Janine, at 41 weeks pregnant, arrives at the birthing unit with a prolonged labor and only 2 cm of cervical dilation, she is administered an IV infusion of pitocin. Pitocin is a synthetic form of oxytocin, which is used to augment or induce labor as it stimulates uterine contractions. This can help progress labor when there have been signs of labor for an extended period with little advancement.
The newborn's first breath significantly alters the circulatory pattern from fetal circulation to newborn circulation. With the first breath, a decrease in pulmonary vascular resistance occurs, and increased pulmonary blood flow establishes functional residual capacity in the lungs. This change facilitates the closure of the fetal circulatory shunts and establishes normal neonatal circulation.