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chapter 27 l&d

labor and delivery chapt 27

Define Acrocyanosis Infants hands and feet are slightly blue
Define circumcision (elective) surgical removal of foreskin
Define colostrum first substance of breast milk baby receives
Define diaphoresis secretion of sweat (Sweating)(accounts for most of fluid loss)
Define diuresis increased formation and secretion of urine
Define engorgement uncomfortable fullness of the breasts when milk supply initially comes in.
Define fontanelles babies have 2, anterior (closes at approx 18 months) and posterior (closes approx 2 months) soft spot
Define gynecomastia infant have enlarged breasts (due to mothers hormones and happens to both sexes)
Define Harlequin sign Half of the newborns body appears deep red and the other half appears pale as a result of vasomotor disturbance (some vessels contract while others are dialating)
Define Homans sign dorsiflexing foot will show pain in the calf, is positive for homans sign, it indicates inflammation of blood vessels of leg and possible thrombophlebitis.
Define lactation function of secreting milk or period during which milk is secreted
Define lochia consists of blood, tissue, and mucus has a fleshy smell
Define Lochia Rubra (first 2 days) bright red blood drainage
Define Lochia sorosa (next 5 days) becomes pink to brown
Define alba (after 7 days)drainage is yellow to white (goes for 10 days to 2 weeks)
Define pseudomenstration discharge blood tinged mucus from female babies (due to moms hormones)
An episiotomy should be free of _____ and should heal in _______ Edema, 2-3 weeks
S& SX of hypovolemic shock Skin feels cool and clammy Pulse rate increases Blood pressure declines
Interventions for Episiotomy Ice pack during the first 2 hours after birth (decrease edema) sitz bath
postpartum maternal danger signs fever w/ w/o chills, malodorous vaginal discharge, excessive vaginal discharge,bright red bleeding after pink stage, edema or painful area on legs,pain or burning when voiding, or unable to void, breast changes, perineal pain in pelvic area
postpartum danger signs for parent-newborn relationships passive or hostile reactions verbal or non verbal,doesnt touch or hold or examine baby or be affectionate, disappointment in sex of baby, lack of eye contact, non supportive between parents.
Engorgement resolves itself in ___ days and pain can be resolved by taking ______. 48 hours or 2-3 days, tylenol
After giving birth what is the estimated time for a new mother to void. 4-6 hours after birth.
What 2 medications are given to baby within the first hour after birth Erythromycin drops and vitamin K (helps clotting)
When mom is O- what is the shot she will rcv? RhoGAM (only mom gets shot mom and baby must have different blood types shot is not given if blood type is the same)
What 2 drugs can be taken for a short period of time after giving birth. Codeine and Oxycodone
Ibuprofen is good for craping and after birth pain also can aide with painful breasts from breast feeding
methylergonovine helps with bleeding
newborns head is disproportionately large for his or her body, what are adv weight respiratory and temp 7 lb 8 oz, respiratory 30-60 with brief periods of apnea, temp should be between 97.6 and 98.6 (first temp is rectal)
Define: milia small white spots on nose and chin, disappear within a few weeks, no interv required
Define: Newborn rash elevated hive like rash may have small white vesicles, no interv required
Define: Telangiectatic nevi (stork bites) flat pink or red marks often seen on eyelids nose or nape of neck disappear at 1-2 years of age, no intervention needed.
Define: Mongolian spots increased pigmentation of lumbar dorsal area, may appear bluish black, seen in darker skinned people, goes away on its own, no intervention needed
Port wine stain reddish purple discoloration often seen on face, medical intervention needed
strawberry birthmarks capillary hemangiomas, increase in size for several months but usually disappear in early childhood
Jaundice yellowish discoloration cause by deposits of bile pigments , if seen in babies, they are put under light to correct
molding overlapping of bones in skull
Caput succedaneum seen with molding, edema of soft tissue of scalp (disappears without treatment)
Cephalhematoma bleeding within the periosteum of cranial bone, confined to particular bone doesnt cross suture lines.
Moro reflex sudden jarring or change in equilibrium causes extension and abduction of extremities and fanning of fingers.
tonic neck reflex when infants head is quickly turned to one side, arm and leg will extend on that side and opposite arm and leg will flex (fencing position)
Babinski reflex when the sole of the foot is stroked along the side of sole begining at heal and then moving across ball of foot to big toe, toes will fan out with dorsiflexion of big toe.
grasp reflex place finger in palm of hand, infants fingers curl around your finger
Plantar place fingers at the base of the toes, toes curl downward.
pt teaching for Lochia first 3 days bright red, like menstural flow, 2-3 days after pinkish brown, flow continues for 3-4 weeks,report foul smelling or bright red discharge or large clots
pt teaching for breastfeeding colostrum till day 3, air dry, engorgement apply heat warm shower may pump to enable baby to latch on
pt teaching for episiotomy care sitz baths 2-3 times a day, cleanse from front to back, change pad frequently dont douche or tampons till after first dr visit.
pt teaching nutrition continue prenatal vitemins till gone, if nursing you need 500 kcal more then pregnant diet
pt teaching cesarean birth notify dr of any redness, drainage, separation of incision, temp greater than 100.4, dont lift anything heavier than baby, take pain meds
pt teaching: what to report to dr temp < 100.4, chills, change in lochia, calf pain, breast tenderness,urinary urgency severe depression
signs of mastitis engorged, fever chills malaise, flu like symptoms, red spot on breasts,
Engorgement for non breast feeding moms (treatment) compression with firm bra, ice packs analegsics
Engorgement for breastfeeding moms manual expressing, warm moist compress
Before checking the fundus the nurse asks the patient to do what? Void
Created by: CNEISTUD