Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
UTA NURS 4441 Exam 2
UTA NURS 4441 OB Exam 2
| Question | Answer |
|---|---|
| Puerperium | interval between birth of the newborn and the return of the reproductive organs to their normal nonpregnant state; also called the fourth trimester of pregnancy or the postpartum period. Lasting usually about 3 to 6 weeks. |
| Involution | Return of the uterus to its non-pregnant state after birth after expulsion of the placenta with contraction of the uterine muscle. It begins immediately after the placenta is born and is complete in approximately 6 weeks. |
| Breast feeding affect in fourth stage of labor | prevents maternal hemorrhage by aiding the contraction of the uterus through oxytocin release. |
| Location of fundus after third stage of labor | Midline, 2 cm below the umbilicus, the fundus resting on the sacral promontory |
| Location of fundus 12 hours after birth | At the level of the umbilicus |
| Amount fundus descends each postpartum day | 1-2 cm/ day. |
| When uterus is unpalpable | 10-14 days |
| Changes to size of uterus with each pregnancy | There is a slight increase in uterine size after each pregnancy. |
| Subinvolution | Failure of the uterus to return to non-pregnancy state. |
| Subinvolution causes | Retained placental fragments and infection. |
| Achievement of postpartum hemostasis | Primarily by compression of intramyometrial blood vessels as the uterus contracts. |
| Hormone administered to enhance uterine contractility | Pitocin (oxytocin). |
| Afterpains | Painful uterine cramps that occur intermittently for approximately 2 or 3 days after birth and that result from contractile efforts of the uterus to return to its normal involuted condition. Also called afterbirth pains. |
| Cause of more noticeable afterpains | births in which the uterus was overdistended (e.g., large baby, multifetal gestation, polyhydramnios) |
| Afterpain intensifiers | Breastfeeding and exogenous oxytocic medication usually intensify these afterpains, because both stimulate uterine contractions |
| Lochia | Uterine/vaginal discharge after childbirth (during the puerperium) consisting of blood, tissue, and mucus. Varieties include rubra, serosa, and alba. |
| Lochia rubra | Red, distinctly blood-tinged vaginal flow that follows birth and lasts 3 to 4 days; consists mainly of blood and decidual and trophoblastic debris. |
| Lochia serosa | Serous, pinkish brown, watery vaginal discharge that follows lochia rubra until about the tenth day after birth; consists of old blood, serum, leukocytes, and tissue debris. |
| Lochia alba | Thin, yellowish to white, vaginal discharge that follows lochia serosa on about the tenth day after birth and that may last up to 8 weeks; consists primarily of leukocytes and decidual cells but also contains epithelial cells, mucus, serum, and bacteria. |
| Lochia changes after C/S | lochia is less |
| Lochia rubra reoccurrence at 7-14 days postpartum indication | bleeding from the healing placental site. |
| Postpartum endometritis manifestations | Continued lochia with fever, pain with abdominal tenderness. |
| Normal lochia odor | Normal menstrual flow odor. |
| Length of time it takes for episiotomy to heal | 2- 3 weeks for initial healing, 4-6 months for complete. |
| Exercises recommended after childbirth to strengthen perineal muscles | Kegel exercises |
| Hormone that inhibits ovulation | Prolactin |
| Ovulation occurrence in non-lactating vs. lactating women | 70-75 days (non-breastfeeding) vs. 6 months (breastfeeding). Average times, may range from 2.5 months to 6 months and can occur before or after first menses |
| First menses postpartum vs. normal | Heavier than normal |
| Time it takes distended abdominal muscles to return to prepregnancy state | 6 weeks |
| Diastasis recti abdominis | Separation of the two rectus muscles along the median line of the abdominal wall. This is often seen in women with repeated childbirths or with a multiple gestation (e.g., triplets). In the newborn it is usually attributable to incomplete development. |
| BUN and proteinuria changes postpartum | BUN increases as autolysis of the involuting uterus occurs. The breakdown of excess protein in the uterine muscle cells also contributes to proteinuria, which resolves by 6 weeks postpartum |
| Method of eliminating accumulated fluids postpartum | Profuse diaphoresis occurs within 12 hours of birth, especially at night, for the first 2-3 days |
| Postpartal diuresis causes | decreased estrogen levels, removal of increased venous pressure in the lower extremities, and loss of the remaining pregnancy-induced increase in blood volume |
| Affect of not emptying bladder when full immediately postpartum | Immediately after birth excessive bleeding can occur if the bladder becomes distended because it pushes the uterus up and to the side and prevents it from contracting firmly |
| Postpartal constipation causes | Decreased tone in intestines during labor, prelabor diarrhea, lack of food during labor and dehydration, perineal tenderness causing mom to resist urge to defecate, and sometimes anal lacerations. |
| Postpartal anal incontinence causes | Operative vaginal birth (forceps or vacuum) and anal lacerations. |
| When real milk comes in (vs. colostrum) | 72-96 hours (3-4 days) |
| When lactation stops | If suckling or expression of milk (pumping) is never begun (or is discontinued), lactation ceases within a few days to a week. |
| Blood loss during SVD | 300 - 500 ml |
| Blood loss during C/S | 500 - 1000 ml |
| Changes in WBC postpartum | During the first 10 to 12 days after childbirth, Increases to 20,000 to 25,000/mm3. |
| Clotting factor changes postpartum | Clotting factors and fibrinogen are normally increased during pregnancy and remain elevated in the immediate puerperium |
| Varicosity changes postpartum | They begin to regress immediately after childbirth |
| Carpal tunnel syndrome changes postpartum | Postpartum diuresis relieves carpal tunnel syndrome. |
| Minimal time women can stay in hospital after delivery | 48 hours for vaginal births and 96 for C/S. |
| Charge associated with allowing patient to be discharged before her condition has stabilized | Abandonment |
| Postpartal infection prevention | wiping front-to-back, applying the peri pad from front-to-back, and changing frequently (each time she uses the bathroom) |
| Fundal assessment initial nursing action | ask mother to urinate and empty bladder |
| Most frequent cause of excessive bleeding after birth | Uterine atony—failure of the uterus to contract firmly. |
| Uterine atony | most frequent cause of excessive bleeding after birth; failure of the uterus to contract firmly |
| Signs of excessive bleeding | Saturating a pad in 15 minutes |
| Intervention to assist with good fundal tone and firm contracting uterus | Fundal massage |
| Primary responsibility when woman is hemorrhaging severely | Remain with the woman and call for help |
| Non-pharmacological interventions for perineal pain | Use a pillow when sitting, ice packs, topical application, dry heat, cleansing with a squeeze bottle, shower, tub bath or sitz bath |
| Non-pharmacological interventions for breast pain | Application of ice, heat, cabbage leaves and wearing a well fitted support bra |
| Opiod affect on intestinal system | Decreased intestinal motility |
| Thrombophlebitis manifestations | leg redness, tenderness, pain, and positive Homans sign (Pain in the calf of the leg upon dorsiflexion of the foot with the leg extended) |
| Homans sign | Pain in the calf of the leg upon dorsiflexion of the foot with the leg extended; early sign of phlebothrombosis of the deep veins of the calf (deep vein thrombosis). |
| Thromboembolism prevention | Early ambulation |
| Preeclampsia | A pregnancy-specific condition in which HTN and proteinuria develop after 20 weeks of gestation or early in the puerperium in a previously normotensive woman; a vasospastic disease process characterized by increasing HTN, proteinuria, & hemoconcentration. |
| Expected time to first void postpartum and minimum amount | Within 6-8 hours (usually 6 is the limit) and it must be 150 ml |
| Engorgement | Swelling of breast tissue caused by increased blood and lymph supply to the breasts as the body produces milk, occurring at about 72 – 96 hours after birth |
| Timing of rubella vaccination | A SQ injection in the immediate PP period |
| Rubella vaccination teaching | She should not get pregnant for at least a month |
| RhoGAM action | Suppression of immune response in nonsensitized women with Rh-negative blood who receive Rh-positive blood cells because of fetomaternal hemorrhage, transfusion, or accident |
| RhoGAM indications | Routine antepartum prevention at 28 weeks of gestation in women with Rh-negative blood; suppress antibody formation |
| RhoGAM dosage and route | 1 vial (300 mcg) IM in deltoid or gluteal muscle |
| RhoGAM adverse effects | Myalgia, lethargy, localized tenderness and stiffness at injection site, mild and transient fever, malaise, headache; rarely nausea, vomiting, hypotension, tachycardia, possible allergic response |
| RhoGAM nursing considerations | Given at 28 weeks of gestation AND within 72 hours after birth if baby is Rh positive |
| Coombs test | a screening tool for Rh incompatibility. |
| Timing of first postpartum check-up | 6 weeks for vaginal births, 2 weeks for C/S |
| Attachment | The process by which parents come to love and accept a child and a child comes to love and accept a parent. |
| Mutuality | Component of parent-infant attachment; the infant's behaviors and characteristics elicit a corresponding set of parental behaviors and characteristics. |
| Synchrony | Fit between an infant's cues and the parent's response. |
| Claiming process | Process by which the parents identify their new baby in terms of likeness to other family members, differences, and uniqueness; the unique newcomer is thus incorporated into the family. |
| Reciprocity | Type of body movement or behavior that provides the observer with cues, such as the behavioral cues infants provide to parents and parents’ responses to cues. |
| Parental behaviors that facilitate infant attachment | Looks, gazes; takes in physical characteristics of infant; assumes en face position; eye contact |
| Percentage of women who experience postpartum blues | 50-80% |
| Postpartum blues peak | 5th – 10th day PP |
| Postpartum blues manifestations | Emotional liability, crying, depression, let-down feeling, restlessness, fatigue, insomnia, headache, anxiety, sadness and anger. |
| Adolescent trains that may interfere with ability to parent effectively | Egocentricity and concrete thinking. |
| PPH | Loss of > 500 ml of blood with a SVD and > 1000 ml of blood with a C/S. Also, a 10% change in hematocrit. |
| Early PPH timing | within 24 hours of birth |
| Late PPH timing | after 24 and up to 6-12 weeks PP |
| PPH causes | uterine atony, lacerations of the birth canal, and formation of a hematoma |
| Iatrogenic | Caused by a health care provider's words, actions, or treatment |
| Iatrogenic cause of excessive bleeding between separation of the placenta and its expulsion | Undue manipulation of the fundus or excessive traction on the cord. |
| Signs of placental separation | lengthening of the cord, the separation gush of blood, and the uterus assuming a globular shape |
| Cause of persistent blood loss once placenta is out | Uterine atony or prolapse |
| Late PPH cause | Subinvolution, endometritis or retained placental fragments.. |
| Uterine atony | Relaxation of uterus; leads to postpartum hemorrhage. Failure of the uterine muscle to contract firmly. |
| Leading cause of PPH | Uterine atony. |
| Uterine atony risk factors | high parity, hydramnios, a macrosomic fetus, multifetal gestation; traumatic birth, use of halogenated anesthesia (e.g., halothane) or magnesium sulfate, rapid or prolonged labor, chorioamnionitis, and use of oxytocin for labor induction or augmentation |
| Genital tract lacerations risk factors | operative birth, precipitate birth, congenital abnormalities of the maternal soft parts, and contracted pelvis; size, abnormal presentation, & position of fetus; relative size of the presenting part and the birth canal; previous scarring; and varicosities |
| Genital tract lacerations manifestations | lots of bright red blood on peripad, and it is increasing rapidly, but the uterus is firm and contracted well into a ball, with the fundus exactly where it should be |
| Max time placenta has to be born after birth of the baby | 1 hour |
| Non-adherent retained placenta management | It is manually removed, i.e., separating the placenta by pulling the edges loose with the fingers and gradually getting the entire placenta out. |
| Adherent retained placenta management | hysterectomy |
| Uterine inversion seriousness | It is potentially life-threatening.. |
| Uterine inversion contributing factors | A. fundal implantation B. manual extraction of the placenta. C. short umbilical cord. D. Uterine atony. E. leimyomas. F. abnormally adherent placenta. |
| Uterine inversion presenting manifestations | Hemorrhage, shock and pain in the absence of a palpable fundus abdominally. |
| Uterine inversion prevention | The umbilical cord should not be pulled on strongly unless the placenta has definitely separated. |
| Subinvolution of the uterus manifestations | A larger-than-normal uterus that may be boggy, also prolonged lochial discharge, excessive bleeding. |
| Oxytocin (Pitocin) action | Contraction of uterus; decreases bleeding |
| Oxytocin (Pitocin) side effects | Oxytocin (Pitocin) |
| Oxytocin (Pitocin) dosage and route | 10 to 40 units/L diluted in lactated Ringer's solution or normal saline at 125 to 200 milliunits/min IV; or 10 to 20 units IM |
| Oxytocin (Pitocin) nursing considerations | Continue to monitor vaginal bleeding and uterine tone |
| Methylergonovine (Methergine) action | Contraction of uterus |
| Methylergonovine (Methergine) side effects | Hypertension, nausea, vomiting, headache |
| Methylergonovine (Methergine) contraindications | Hypertension, cardiac disease |
| Methylergonovine (Methergine) dosage and route | 0.2 mg IM every 2 to 4 hr up to five doses; may also be given intrauterine or orally |
| Methylergonovine (Methergine) nursing considerations | Check blood pressure before giving, and do not give if >140/90 mm Hg; continue monitoring vaginal bleeding and uterine tone |
| 15-Methylprostaglandin F2α (Prostin/15 m; Carboprost, Hemabate) action | Contraction of uterus |
| 15-Methylprostaglandin F2α (Prostin/15 m; Carboprost, Hemabate) side effects | Headache, nausea and vomiting, fever, tachycardia, hypertension, diarrhea |
| 15-Methylprostaglandin F2α (Prostin/15 m; Carboprost, Hemabate) contraindications | asthma or hypertension |
| 15-Methylprostaglandin F2α (Prostin/15 m; Carboprost, Hemabate) dosage and route | 0.25 mg IM or intrauterine every 15 to 90 min up to eight doses |
| 15-Methylprostaglandin F2α (Prostin/15 m; Carboprost, Hemabate) nursing considerations | Continue to monitor vaginal bleeding and uterine tone |
| Dinoprostone (Prostin E2) action | Contraction of uterus |
| Dinoprostone (Prostin E2) side effects | Headache, nausea and vomiting, fever, chills, diarrhea |
| Dinoprostone (Prostin E2) contraindications | Avoid with asthma or hypotension |
| Dinoprostone (Prostin E2) dosage and route | 20 mg vaginal or rectal suppository every 2 hr |
| Dinoprostone (Prostin E2) nursing considerations | Continue to monitor vaginal bleeding and uterine tone |
| Misoprostol (Cytotec) action | Contraction of uterus |
| Misoprostol (Cytotec) side effects | Headache, nausea and vomiting, diarrhea |
| Misoprostol (Cytotec) contraindications | History of allergy to prostaglandins |
| Misoprostol (Cytotec) dosage and route | 800 to 1000 mcg rectally once |
| Misoprostol (Cytotec) nursing considerations | Continue to monitor vaginal bleeding and uterine tone |
| Bimanual compression | inserting a fist into the vagina and pressing the knuckles against the anterior side of the uterus, and then placing the other hand on the abdomen and massaging the posterior uterus with it. |
| Type of shock most likely to be seen postpartum | Hemorrhagic (hypovolemic) shock |
| The most objective and least invasive assessment of adequate organ perfusion and oxygenation | urinary output of at least 30 ml/hr |
| disseminated intravascular coagulation (DIC) | Clotting that consumes large amounts of clotting factors, causing widespread bleeding and clotting; associated with abruptio placentae, eclampsia, intrauterine fetal demise, amniotic fluid embolism, and hemorrhage. |
| DIC manifestations | oozing at the sites of incisions or injections and the presence of petechiae or ecchymosis in areas not associated with surgery or trauma |
| Percentage of blood loss before postpartum woman demonstrates classic signs of shock | 30-40%. |
| Thromboembolic disease causes | Venous stasis, and hypercoagulation |
| Cause of decreased incidence of thromboembolic disease | early ambulation |
| Non-invasive diagnostic method used to identify a thromboembolus | Real-time and color doppler |
| superficial venous thrombosis management | analgesia (NSAID, not Aspirin); rest with elevation of the affected leg, and elastic stockings; local application of moist heat. |
| idiopathic thrombocytopenic purpura (ITP) | An autoimmune disorder in which antiplatelet antibodies decrease the life span of the platelets. Thrombocytopenia, capillary fragility, and increased bleeding time are diagnostic findings. Also called immune thrombocytopenic purpura (ITP). |
| ITP management | corticosteroids or IV immunoglobulin, platelet transfusions, and possibly splenectomy |
| von Willebrand disease (vWD) | A type of hemophilia; probably the most common of all hereditary bleeding disorders. |
| vWD management | administration of desmopressin, which promotes the release of vWF and factor VIII or Transfusion therapy with plasma products that have been treated for viruses and contain factor VIII and vWF (e.g., Humate-P, Alphanate) |
| puerperal infection | infection of the genital canal that occurs within 28 days after miscarriage, induced abortion, or childbirth; presence of a fever of 38° C or more on 2 successive days of the first 10 postpartum days (not counting the first 24 hours). |
| Most common postpartum infection | endometritis |
| Endometritis manifestations | Fever, increased pulse, chills, anorexia, nausea, fatigue, lethargy, pelvic pain, uterine tenderness, foul smelling profuse lochia, increased RBC sed. Rate, leukocytosis, anemia. Pg 834. |
| Incidence of UTIs in postpartum women | 2-4 % |
| Mastitis manifestations | Chills, fever, malaise local tenderness, pain swelling redness, swelling of lymph nodes in the axilla |
| Mastitis management | Heat or cold, adequate support, hydration analgesics and antibiotics. |
| DVT management | anticoagulant therapy, bed rest with the affected leg elevated, and analgesia; elastic stockings. |
| PE management | IV heparin followed by SQ heparin |
| newborn’s first period of reactivity | lasts up to 30 minutes after birth |
| respiratory rate of the newborn | breaths are shallow and irregular, ranging from 30 to 60 breaths/min, with periods of breathing that include pauses in respirations lasting less than 20 seconds. |
| Apneic periods that should be evaluated | lasting longer than 20 seconds |
| signs of respiratory distress in the immediate newborn period | Nasal flaring; retractions; grunting with exhalation; increased use intercostal muscles, see-saw respiration, rate less than 30 or more than 60. |
| Apneic episode contributing factors | Rapid increase in body temperature, hypothermia, hypocalcemia or sepsis. |
| mL of blood in the average newborn | 300 ml of blood. |
| Amount blood can be increased if “placental transfusion” is allowed to occur | 100 mL |
| Placental transfusion | the cord is not cut immediately and the blood in the cord and placenta is allowed to flow into the baby |
| Persistent tachycardia indicates | anemia, hypovolemia, hyperthermia, or sepsis |
| Persistent bradycardia indicates | congenital heart block or hypoxemia |
| Four modes of heat loss | convection, radiation, evaporation, conduction |
| Convection mode of heat loss | flow of heat from body surface to cooler air, |
| radiation mode of heat loss | loss of heat from body surface to cooler solid surface in relative proximity (not direct contact) |
| evaporation mode of heat loss | loss of heat that occurs when liquid is converted to vapor |
| conduction | loss of heat from body surface to cooler surfaces in direct contact |
| Expected time infant must void after birth | within 24 hours |
| source of bilirubin | Breakdown of RBCs and the newborn liver’s inability to process this |
| intervention that reduces serum bilirubin | Feeding stimulates peristalsis, which then causes less bilirubin to be reabsorbed by the gut |
| age infants should be able to concentrate their urine | Approximately 3 months |
| Epstein’s pearls | Small whitish areas found on the gum margins at the juncture of the hard and soft palate |
| 3 vitamins newborns need to synthesize once bacteria is established in the intestine | Vitamin K, folate, and biotin |
| capacity of the stomach of the newborn | Less than 30 mL on day 1 to more than 90 mL on day 3 (p. 535 ) |
| color of meconium | Greenish black |
| stools of breast-fed babies | Yellow to golden in color; pasty in consistency, resembles mixture of mustard and cottage cheese and has odor similar to sour milk |
| stools of bottle-fed babies | Pale yellow to light brown in color, firmer in consistency, with a more offensive odor than breast-fed babies |
| when normal, term infants pass meconium | within first 12 to 24 hours |
| length of time iron stores last in a full-term breast-fed infant vs. in a preterm infant | 4-6 months vs. 2-3 months |
| normal blood glucose level for a newborn in the first several hours after birth | 50-60 |
| normal blood glucose level by the third day of life | 60-70 |
| pathologic jaundice criteria | appears within 24 hours of birth, if total serum bilirubin levels increase by more than 5 mg/dl in 24 hours, and if the serum bilirubin level exceeds 15 mg/dl at any time |
| worst long-term disorders involving hyperbilirubinemia | Kernicterus |
| kernicterus | Bilirubin encephalopathy involving the deposit of unconjugated bilirubin in brain cells, resulting in death or impaired intellectual, perceptive, or motor function and adaptive behavior. |
| Signs of infection in newborns | Do not have fevers; Lethargy, irritability, poor feeding, vomiting or diarrhea, decreased reflexes, and pale or mottled skin color, apnea, tachypnea, grunting or retracting |
| vernix caseosa | A cheese-like substance that is fused with the epidermis and serves as a protective covering. The amount of vernix decreases with age and is shed into the amniotic fluid. |
| Acrocyanosis | Peripheral cyanosis; blue color of hands and feet in most infants at birth that may persist for 7 to 10 days. |
| Lanugo | Downy, fine hair on fetus between 20 weeks of gestation and birth that is most noticeable over the shoulder, forehead, and cheeks but is found on nearly all parts of the body except the palms of the hands, soles of the feet, and the scalp. |
| telangiectatic nevi (stork bites) | Clusters of small, red, localized areas of capillary dilation frequently seen in neonates at the nape of the neck or lower occiput, upper eyelids, and nasal bridge that can be blanched with pressure of a finger and usually fades by second year of life. |
| erythema toxicum | Innocuous pink papular neonatal rash of unknown cause, with superimposed vesicles appearing within 24 to 48 hours after birth and resolving spontaneously within a few days. Also called erythema neonatorum, newborn rash, or flea bite dermatitis. |
| hormone responsible for mucoid vaginal discharge and pseudo menstruation in neonatal girls and breast swelling and “witches milk” in either gender | Estrogen, from the mother’s blood |
| scrotum of a term male vs. preterm male | By 28 to 36 weeks of gestation, the testes can be palpated in the inguinal canal, and a few rugae appear on the scrotum. At 36 to 40 weeks of gestation, the testes are palpable in the upper scrotum, and rugae appear on the anterior portion. |
| caput succaneum vs. cephal hematoma | Caput succedaneum: edema of the scalp noted at birth; crosses suture lines. Cephalhematoma: bleeding between periosteum and skull bone appearing within first 2 days- does not cross suture lines |
| tests for hip dysplasia | Barlow test and Ortolani’s maneuver |
| age crying peaks | Crying peaks in the second month and then decreases |
| Source of contamination on newborn | blood and amniotic fluid, vernix and vaginal bacteria on the skin until bathed |
| Apgar score | Numeric expression of the condition of a newborn obtained by rapid assessment at 1 and 5 minutes of age; developed by Dr. Virginia Apgar |
| 5 areas assessed in generating an Apgar Score | Heart rate, respiratory effort, muscle tone, reflex irritability and color |
| Alarming ID bracelet placement | Before mom and baby are separated after birth |
| assessment done to determine gestational age | New Ballard Score |
| New Ballard Score | assessment done to determine gestation age that can be used with newborns as young as 20 weeks of gestation. The tool has the same physical and neuromuscular sections but includes −1 to −2 scores that reflect signs of extremely premature infants |
| signs of extremely premature infants | fused eyelids; imperceptible breast tissue; sticky, friable, transparent skin; no lanugo; and square-window (flexion of wrist) angle greater than 90 degrees |
| medications used to prevent ophthalmia neonatorum | Erythromycin Ophthalmic Ointment, 0.5% and Tetracycline Ophthalmic Ointment 1% |
| ophthalmia neonatorum | Infection in the neonate's eyes usually resulting from gonorrheal or other infection contracted when the fetus passes through the birth canal (vagina). |
| delivery techniques that can cause injury to the baby | Forceps-assisted births, vacuum extractors, version and extraction, cesarean sections |
| TcB monitor correlation with the serum bilirubin levels | The new monitors provide accurate measurements within 2-3 mg/dl in most neonatal populations at serum levels below 15 mg/dl. |
| total serum bilirubin normal | 1 – 12 mg/dl |
| glucose measurements in a neonate that indicate hypoglycemia | less than 40-50 mg/dl |
| hypoglycemia manifestations | Jitteriness, lethargy, poor feeding, hypotonia, temperature instability (hypothermia), respiratory distress, apnea, and seizures |
| hypocalcemia manifestations | Jitteriness, high-pitched cry, irritability, apnea, intermittent cyanosis, abdominal distention, and laryngospasm |
| best treatment for both hypoglycemia and hypocalcemia | feeding, as early as possible |
| heel stick location | Outer aspect of the heel |
| 2 injections all infants in the NN receive | Hep B vaccine and vitamin K |
| size needle used for IM injections in newborns | 25 gauge, 5/8 inch |
| muscle used for injections in newborns | Vastus lateralis |
| Hyperbilirubinemia treatment | early feeding and, if that doesn’t work, phototherapy or exchange blood transfusion – rare |
| methods of circumcision that requires use of Vaseline for post care | Gomco or Yellen |
| when plastic ring falls off when the plastibell method of circumcision has been used | 5-7 days |
| length of time yellow exudate on the glans after circumcision last | 2-3 days |
| bathing before cord has fallen off | Sponge baths are usually used until the infant's umbilical cord falls off and the umbilicus is healed. |
| position for sleeping is currently recommended | Supine position |
| cord care recommendations | cleaning the cord with sterile water initially and subsequently with plain water |
| occurs before each spurt in development | Immediately before each spurt in development is a predictable short period of disorganization in the baby |
| suction order | mouth first, then nose |
| Times/day infant should breastfeed | Latch and feed effectively at least eight times per 24 hr (every 1.5 to 3 hours) |
| Oz of formula/day | 3-4 oz every 3-4 hrs (24 oz day) |
| Number of diapers/day | two to six wet diapers per 24 hr until the fourth day of life and then six to eight wet diapers and at least three bowel movements every 24 hours (breastfeeding) or one every 48 hours (formula-fed) |
| Vital sign normals for newborns | HR: 120-160 when awake; RR: 30-55 without retractions, grunting, or nasal flaring; temp: 36.5 to 37.2 axillary |
| Length of time infants should be breastfed exclusively | 6 months |
| contraindications to breastfeeding | Infants with galactosemia, mothers with HIV or TB or Human T-cell lymphotrophic virus type I or II; mothers receiving radiation or chemotherapy, and mothers using street drugs and certain other meds |
| galactosemia | Inherited, autosomal recessive disorder of galactose metabolism, characterized by a deficiency of the enzyme galactose-1-phosphate uridyltransferase. |
| Calories human milk contains | 67 kcal/100 ml or 20 kcal/oz |
| Problem associated with cow’s milk | Although cow’s milk is high in calcium, the calcium/phosophorus ratio is low, resulting in decreased absorption |
| weeks gestation the breast begin making colostrum | Around week 16 of gestation |
| How the body “knows” when to make more milk | As more milk is removed from the breast, more is produced |
| postpartum complications with decreased risk when breastfeeding | Postpartum hemorrhage |
| breastfeeding affect on afterpains | causes increased afterpains d/t Increased release of oxytocin with breastfeeding causing more uterine contractions |
| hormones that affect women’s emotions | Prolactin and Oxytocin |
| When real milk (as opposed to colostrum) “comes in” | Day 3 to 5 |
| Foremilk | initial milk: bluish with milk that is part skim milk (approximately 60% of the volume) and part whole milk (approximately 35% of the volume). It provides primarily lactose, protein, and water-soluble vitamins. |
| Hindmilk | relased 10-20 minutes into feeding; contains the denser calories from fat necessary for ensuring optimal growth and contentment between feedings. |
| breastfeeding positions | Football hold, cradle, modified cradle or across lap, and side-lying |
| amount of areola baby’s mouth should cover if properly “latched on” | the mouth should cover the nipple and an areolar radius of 2-3 cm around the nipple. |
| demand feeding | The infant determines the frequency of feeding by exhibiting feeding cues. |
| Length of feedings on each breast once lactation is established | 15-20 mins per breast |
| nipple confusion prevention | Avoid bottle feeding and pacifiers until breastfeeding is well established, after 3-4 weeks. |
| benefits of breast milk for preterm infants | Higher concentrations of energy, fat, protein, sodium, chloride, potassium, iron, and magnesium. Enhances retinal maturation and improves neurocognitive outcomes; decreases the risk of necrotizing entercolitis. |
| Length of time breast milk can be stored | Room Temperature: up to 8 hours; Refrigerator: up to 8 days; Frozen up to 6 months; Deep Freeze: up to 12 months |
| Breast milk thawing | In the refrigerator for gradual thawing, or in warm water for faster thawing. |
| Breast milk use after thawing | use within 24 hours and it should not be refrozen. |
| Microwave dangers r/t breast milk | should not be used for thawing since it does not heat evenly and can cause burns to the mouth, throat, and upper GI tract. It also decreases the effectiveness of Vitamin C and antiinfective properties. |
| additional Kcal needed by breastfeeding woman | 300-500 calories per day |
| product that helps women with flat or inverted nipples | Breast shells |
| oral contraceptive not likely to interfere with milk supply | POPs (Progesterone-only pills) and other progesterone-based contraceptives. |
| breast augmentation affect on breast feeding | usually no affect |
| engorgement manifestations | Painful overfilling of breast; breast are firm, tender, hot, shiny, taut, nipples may flatten |
| When engorgement is likely to occur | 3-5 days after birth when milk has come in |
| How often mother with engorgement should breastfeed | Frequently, q2 hours |
| interventions recommended for engorgement | Feed every 2 hours, massage breasts, use breast pump if infant not emptying breast, cold compresses, raw cabbage leaves. |
| causes of sore nipples | Poor positioning, incorrect latch-on, improper suck, monolial infection. |
| Mastitis manifestations | Flu-like signs and symptoms like fever, chills aches, headache, along with localized redness and swelling, especially in one quadrant of the breast. |
| Mastitis management | Antibiotics, analgesics, antireptics, frequent feeding/pumping, warm compresses, rest. |
| implications/risks of propping a baby bottle | They can choke and it deprives them of parental interaction. |
Created by:
camellia
Popular Nursing sets