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VN153 Maternity Fina
VN153 Maternity Finals
| Question | Answer |
|---|---|
| S/S oF HYPOGLYCEMIA IN NEWBORN | jitteriness, poor muscle tone, sweating, resp difficulty, low temp, poor sucking, high pitched cry, lethargy, seizures. Sugar less than 40 |
| FUNDUS CHECK - LEVELS POST PARTUM PER DAY | location: can be felt midline @ or below the level of umbilicus. Consistency: firm mass (abt size of grapefruit). 1cm per day |
| LOCHIA RUBIA | 1st stage; red; 3 days after birth |
| LOCHIA SEROSA | 2ND stage; pink, 3-10th day after birth |
| LOCHIA ALBA | 3rd stage; clear or mucus; 10th - 21st day after birth |
| BREASTFEEDING HELP/TIPS FOR NEW MOMS | position of mom's hands, latch on, suckling patterns, removing infant from breast |
| EVAPORATION | moisture from newborn's wet body surface disipates heat along w moisture. My keeping newborn dry, evap is prevented. |
| CONDUCTION | occurs when newborn is on a cold surface, such as a cold pad or mattress. |
| CONVECTION | occurs as air moves across the newborn's skin from an open door & heat is transferred to the air. |
| RADIATION | occurs when heat from the newborn radiates to a colder surface. |
| S/S OF POST PARTUM HEMORRHAGE - HYPOVOLEMIC SHOCK | reduced blood volume w increased heart & resp rates. TACHYCARDIA is 1st sign of inadequate blood volume. 1st bp = falling systolic pressure & rising diastolic pressure. Pale, cold clammy skin. LOC change, dec urinary output. Pulse rate = 100 bpm or higher |
| TREATMENT OF MASTITIS | prescribed antibiotics, mild analgesics. Cont breastfeed or pump & discard milk. Heat promotes blood flow. Both breasts shld be emptied reg to prevent stasis. Massage area of inflammation to improve milk flow. Encourage fluid intake. Wear support bra. |
| S/S POST PARTUM DVT | pain, calf tenderness, leg edema, color changes, pain when walking & + homan's sign (pain when foot is dorsiflexed). |
| CAPUT SUCCEDANEUM | may have swelling of the soft tissues of the scalp |
| CEPHALHEMATOMA | a collection of blood beneath the periosteum of the cranial bone. It does not cross the suture lines. |
| S/S RESPIRATORY DISTRESS IN NEWBORN | Respirations increased to 60 bpm or more. Tachypnea accompanied by gruntlike sounds, nasal flaring, cyanosis & intercoastal & sternal retractions. Edema, lassitude & apnea occur as condition becomes more severe. |
| NORMAL FINDINGS OF A HEALTHY NEWBORN | has moro reflex, rooting, tonic neck, dancing, head lag |
| NORMAL STOOL FINDINGS OF A NEWBORN - HOW DOES IT CHANGE | 1st meconium is dark, black & tarry. It gradually changes to greenish yellow transitional stool. Breastfed infant's "milk" stool is golden yellow, bottle fed is pale yellow. Green waterry stool is indicative of diarrhea |
| NORMAL SKIN CHANGES IN NEWBORN | body covered with Lanugo, vernix caseosa, may have physiological jaundice |
| LANUGO | body usually covered with fine hair |
| VERNIX CASEOSA | made of cells & glandular secretions; thought to protect skin from irritation & effects of a watery environment. |
| ICTERUS NEONATORUM | physiological jaundice; seen as a yellow tinge to the skin. Caused by rapid destruction of excess red blood cells |
| JAUNDICE | immature liver contributes to condition called ICTERUS. Causes skin & white of eyes to assume a yellow-orange cast. Liver unable to clear blood of bile pigments w/c rsult from normal postnatal destruction of RBcs. |
| JAUNDICE - FYI | an increase of 5mg/dl in 24 hrs or a bilirubin level above 12.9 mg/dl requires careful investigation. Breastfed infants can show s/s about 4 days after birth. |
| KERNICTERUS | Rising bilirubin levels staining the basal nuclei of brain. |
| JAUNDICE-NI | observe skin, sclera & mucus membrane for s/s. report progression from face to abdomen & feet. Monitor abnormal lab reports. Response to phototherapy. Feed them so they can poop it out. If breastfed, need formula. |
| RDS - SURFACTANT | result of immature lungs. This is a fatty protein necessary for lungs to absorb O2. BEGINS TO FORM @ 24 WLS GESTATION & BY 34 WKS, IF FETUS IS DELIVERED, SHOULD BE ABLE TO BREATHE ADEQUATELY. |
| APNEA IN PRETERM INFANT | cessation of breathing for 20 sec or longer. May be r/t immaturity of nervous system. May be accompanied by bradycardia (HR <100 beats/min) & cyanosis |
| WHAT CAN BE GIVEN TO MOM IN PRETERM LABOR TO HELP DEVELOP LUNG OF FETUS | may be given corticosteroids to stimulate lung maturity 1-2 days before delivery. |
| NORMAL URINE OUTPUT OF PRETERM INFANT | should be between 1 & 3 ml/kg/hr |
| PREVENTION OF RETINOPATHY OF THE PRETERM INFANT | damage to immature retinal blood vessels throught to be caused by high o2 levels in arterial blood. Maintain sufficient levels of vit E & avoiding excessively high concentrations of o2. cryosurgery may reduce long term complications |
| WHY PRETERM NEEDS TO BE IN INCUBATOR | provide a neutral thermal environment. Temp, air, radiating surface temp & humidity are controlled to maintain the infant's tem w/in a normal range w minimal O2 consumption req. provides isolation & protection from infection. |
| HYPOGLYCEMIA IN POST TERM NEWBORN OR NB OF DIABETIC MOM | fetus gets large amt of glucose causing it to be hyperglycemic . Causing fetus to get big. AFTER BIRTH - glucose level below 40 mg/dl can result in brain damage. |
| NORMAL FINDINGS OF POST TERM NEW BORN - SKIN/NAILS/HAIR ETC | long & thin - wt may have been lost. Skin is loose (esp around butt & thighs). Little lanugo or verniz caseosa. Skin is dry, crackles & peels. Nails are long & may be stained from meconium. Thick head of hair & looks alert. |
| BULGING FONTANELLE | may indicate hydrocephalus or increased intracranial pressure. |
| SUNKEN FONTANELLE | may indicate dehydration |
| CHEILOPLASTY | initial repair of cleft lip. occurs in 3 month of age. |
| CHEILOPLASTY - NI | may have elbow restraints to prevent the infant from scratching the lip. Prevent infant from sucking and crying (LOGAN BOW). Careful positioning : head up. Prevent infection by cleaning suture line. |
| CHEILOPLASTY - feeding | special syringe or bottle is needed to assist in feeding. Med dropper untl wound is completely healed ( 1-2 wks). Clean mouth by giving smal amt of sterile water at end of each feeding session |
| BARLOW'S TEST | upon adduction & extension of the hips (w health care providing stabilization to the pelvis), may "feel" the dislocation actually occur. |
| ORTOLANI'S SIGN | CLICK. Where health care provider can actually feel & hear the femoral head slip back into the acetabulum under gentle pressure |
| S/S HIP DYSPLACIA IN NEWBORN | limited abduction of leg on affected side. Knee on side of dislocation is lower. Skin folds of thigh are deeper & often assymetrical. When in prone position, one buttock appears higher than the other. |
| PKU-PHYLKETONURIA DIET | must avoid the sweetener aspartame (nutrasweet) because it is a converted to phenylalanine in the body |
| PKU | faulty metabolism of phenylalanine, an amino acid essential to life & found in all protein foods. Infant unable to digest this essential acid & it accumulates in blood & found in urine w/in 1st wk of life. Results in severe metal retardation. |
| CARE OF DOWNSYNDROM INFANT - HOW TO DEAL WITH HYPOTONICITY | it makes positioning & holding more difficult & contributes to heat loss from exposed surface areas. infant should be warmly wrapped to prevent chilling. It causes resp problems & excess mucus accumulation. Bulb suctioning before feedings |
| RH NEG MOM - WHAT DOES SHE NEED | administer RHOGAM w/in 72 hrs of delivery or at 28 wks gestation |
| PATHOLOGICAL JAUNDICE | occurs w/in 24 hours of delivery |
Created by:
jekjes
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