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N131-test 3
postpartum
| Question | Answer |
|---|---|
| What are normal head circumferences? | 13-14 inches |
| What are normal chest circumferences? | 12-13 inches |
| What is normal heat to heel length? | 19-21 inches |
| What is normal birth weight? | 6-9 pounds |
| What is a normal temperature? | 97.9*-100.4* rectal - anything below or above is considered abnormal. If temp is low |
| What is a normal heart rate? | 120-140 beats per minute |
| What are normal respiration? | 30-60 breaths per minute |
| What posture should a newborn have? | Flexion of head and extremities |
| How is a frank breech different? | Extended legs |
| How should the skin look in a newborn? | Bright red |
| What is acrocyanosis? | Cyanosis of the hands and feet. |
| What is milia? | Distended sebaceous glands that appear as tiny white papules on cheeks |
| How should the anterior fontanel appear? | Should be diamond shaped |
| How should the posterior fontanel appear? | Should be triangular |
| What is caput succedaneum? | Swelling that crosses the midline of the cranium |
| What is cephalhematoma? | Hemorrhage of blood between the periosteum & skull bone - doesn't cross midline |
| What is the pilonidal cyst or sinus? | Small dimple near tailbone. Make sure its not an actual opening. |
| What can quivering or momentary tremors indicate? | Can be sign of low blood sugar or something more serious. |
| What are the important reflexes? | Sucking |
| What is the sucking reflex? | Sucking movements in response to stimulation |
| What is the rooting reflex? | Stroking the cheek causes infant to turn head toward that side and begins to suck. Should disappear around 3-4 months |
| What is the grasp reflex? | Touching palms of hand or soles of feet causes digits to flex |
| What is the babinski reflex? | When stroking the sole of the foot causes toes to hyper extend - disappears after age of 1 |
| What is the moro reflex? | Sudden jarring or change in equilibrium causes sudden extension & abduction of extremities and fanning of fingers |
| What is the startle reflex? | A sudden loud noise causes abduction of the arms with flexion of the elbows |
| What is the aysmmetric tonic neck? | When infant's head is turned to one side |
| What are the neonatal signs of low blood sugar? | Jitteriness |
| What is routine circumcision care? | Post-circumcision |
| What is the recommended way to breast feed? | Chest to chest |
| How do you know the baby is getting enough to eat? | 6 to 10 wet diapers & 1 bm per day |
| How is LATCH used in charting breastfeeding? | L - latch |
| What teaching should be given for non-breastfeeding mothers? | Do not stimulate or manipulate breasts |
| What should the mother do when the milk comes in? | Use breast binder |
| What are some warning signs for a newborn? | No urine in first 24 hours |
| Postpartum | From the delivery of the placenta & membranes to the return of a woman's reproductive system to its non-pregnant state - approx 6 weeks. |
| Involution | the process by which the uterus returns to its normal size. |
| Satisfactory involution | Firmness of uterus |
| Normal rate of involution | 1st day postpartum - at or slightly above umbilicus |
| Delayed involution causes | A prolonged labor |
| #1 postpartum concern | Hemorrhage |
| S/S of hemorrhage | Increase pulse rate |
| Critical levels for H&H | Hb <5.0g/dl & Hct of <20% |
| Early or immediate causes of hemorrhage | blood loss greater than 500 ml in first 24 hrs caused by uterine atony |
| Late causes of hemorrhage | Retained placenta and infection are the most common causes. |
| Lochia | the decidua (lining) which is cast off down to myometrium |
| Lochia rubra | Bright red |
| Lochia serosa | Dark red (or pinkish) to brond |
| Lochia alba | Whitish/yellowish discharge - lasts 10-14 days |
| Diastasis abdominis | Separation of the rectus abdominis muscles may occur leaving part of abdominal wall with no support except skin |
| Postpartum bathing | There is an increased risk for infection during postpartum. |
| Episiotomy | A surgical incision of the perineal body - assess using REEDA - redness |
| Laceration | A tear in the perineal body which occurs in varying degrees. |
| 1st degree laceration | tear through skin & structures that are superficial to muscle |
| 2nd degree laceration | extends through perineal muscles - much like an episiotomy |
| 3rd degree laceration | continues through anal sphincter muscle |
| 4th degree laceration | involves anterior rectal wall |
| Sulcus tear | tear into the tissue of the vagina |
| Bladder function after delivery | Pt should void within 6-8 hours following delivery |
| Bowel dysfunction | Delay in bowel function can be due to loss of abdominal muscle tone |
| Dietary recommendations | Vaginal deliveries can have normal diet |
| Vital sign monitoring after delivery | Q15 minutes for 1st hour |
| Standard vital signs | Temp |
| BUBBLE PEC | Breasts |
| Breast assessment | Are they soft |
| Uterine assessment | Is it firm? Is it descending? Location & position in abdomen |
| Bladder assessment | Assess for position and size. Teach S/S of infection |
| Bowel assessment | Check for flatus/bowel sounds |
| Lochia assessment | Assess for amount: scant |
| Episiotomy or laceration assessment | Assess for redness |
| Emotional assessment | Is the mother dependent or independent? Is she depressed |
| Antepartum | The time between conception and onset of labor |
| Intrapartum | The time between the beginning of labor and the birth of the infant. |
| Puerperium or postpartum | Time from birth of infant until woman's body returns to essentially prepregnant state. |
| Para | The number of pregnancies in which the fetus has reached 20 or more weeks gestation when they are born regardless of live or still born. |
| Abortion/miscarriage | Birth that occurs prior to the 20 weeks |
| Preterm/premature labor | Labor that occurs after 20 weeks but before completion of 37 weeks. |
| Term pregnancy length | A pregnancy from the beginning of 38 weeks of gestation to the end of 42 weeks |
| TPAL | TPAL replaces para & gives more information. T = term infants |
| Still birth | A baby born dead at 20 or more weeks gestation. |
| Neonate | First 28 days after birth. |
| Viability | Capacity to live outside the uterus - about 22-25 weeks gestation. |
| Placenta accreta | Slight penetration of placenta into the myometrium |
| Placenta increta | Deep penetration of the placenta into the myometrium |
| Placenta percreta | Perforation of the uterus by the placenta. |
| Hydroamios & macrosomia | Hydraminos is too much amnionic fluid |
| Hematoma cause | There is an injury to a blood vessel |
| S/S of a hematoma | Vulvar - most common & most can be seen |
| 1st sign of infection | Presence of a fever of 100.4 |
| Neonate & infection | Leading cause of newborn sepsis & meningitis |
| Metritis | Infection of the muscle of the uterus |
| Endometritis | Infection at the placental site |
| Parametritis | Infection of the pelvic connective tissue. |
| Salpingitis & ooporitis | Infection of the tubes & ovaries. |
| Thrombophelpitis | An infection of the lining of a vessel in which a clot attaches to the vessel wall. |
| Pulmonary emboli symptoms | Sudden onset of SOB |
| Amniotic fluid embolism | A small tear in the amnion or chorion high in the uterus allows fluid to enter maternal circulation. |
| Disseminated intravascular coagulation - DIC | The coagulation sequence is activated by injury to the epithelium |
| Psychological adjustment stages | Taking in |
| Taking in | Consists of days 1-3 |
| Taking hold | Consists of days 3 to 2 weeks. Pts resume control of life |
| Letting go | Accept and realize the physical separation of infant and relinquish role of childless individual. Challenge - extreme exhaustion of night time care and sleep deprivation |
| Postpartum or baby blues | Can occur 1-2 weeks after birth |
| Postpartum depression | Symptoms persist longer than 2 weeks and intensify. |
| Elevated temp causes | A temp elevated to 100.4* in the 1st 24 hours post delivery can be due to exertion & dehydration. |
| Mastitis | An infection of the breast tissue. More common in breast feeding mothers. |
| Fundus position after delivery | 2cm below umbilicus |
| Fundus position after 12 hours | 1 cm/fingerbreadth above umbilicus *decreases 1 fb per day |
| Fundus position end of 1 week | uterus lies in the true pelvis |
| Fundus position prepregnant size | 5-6 weeks |
| combining form ossicul/o means: | Ossicle |
| The snail-shaped tube in the inner ear is the: | Cochlea |
| membrane between the middle and inner ears is the | Oval window |
| The structures of the ear involved in maintaining equilibrium are found in the vestibule and the: | Semicircular canals |
| A chronic disorder of the labyrinth of the inner ear is | Ménière's disease |
| he medical term for dizziness is | Vertigo |
| Inflammation of the middle ear is | Otitis media |
| The suffix -cusis in the term presbycusis means | Hearing |
Created by:
aanderson14
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