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