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N131-test 3

postpartum

QuestionAnswer
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