OB Test 4 BP
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| 1 What is involution? | The process in which the uterus, cervix and vagina shrink or return to the nonpregnant state.
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| 1 How do you feel the uterus for a vaginal birth and c-section birth? | 1 hour after delivery the uterus should be contracted firmly with the fiundus midline at the level of the umbilicus. Day after delivery the fundus is found 1 cm below the umbilicus Normal is the uterus descends 1 fingerbreath/day until below pubic bone.
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| 2 How does a full bladder affect the uterus? | Impedes uterine contraction pushes upward on the uterus and displaces it.
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| 2 What are signs of hypoglcemia in newborn? | Jiterryness, poor feeding, listlessness, irritability, decreased temp, weak, or highpitched cry, hypotonia, respiratory distress, apnea, seizures and coma relate signs.
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| What is colostrum? | thin yellowish milky fluid secreted by the breast during pregnancy or just after delivery. (2nd trimester). Increased antibodies and protein. Decreased fat. 2-20mL per feeding.
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| Soft and boggy uterus interventions | Fundal Massage to stimulate contractions
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| Medications given with soft and boggy uterus | oxytocin
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| Lochia Steps 1: Rubra | 3-4 days long, small to mod amount, mostly dark red blood. fleshy odor
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| Lochia Steps 2: Serosa | 4-10 days small amount brown/pink color
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| Lochia Steps 3: Alba | After day 10, white or pale yellow bc bleeding has stopped. discharge is composed mostly of WBCs
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| When should mom report lochia? | When it is malodorous, or smells rotten, suspect infection or large amounts with clots, saturated pads.
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| How should mom clean? | No tub baths. Can do sitz baths or spray bottle or shower.
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| When is the menstural cycle expected to return after birth? | 6-10 weeks or even longer if breast feeding.
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| What are ways a baby can lose heat? | conductive heat loss, heat loss by convection, evaporative and radiation
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| Cold stress is | exposure to temps cooler than normal, body temp so that the newborn must use energy to maintain heat.
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| What are Pyschological stages the mother goes through? | 1. begin attachment and prep for baby. 2. increased attachment, learn to care, physical restoration during postpartum. 3. moving toward new normal (4 mos) 4. Achieve maternal identity
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| What hormones are responsible for breastfeeding? | Prolactin, oxytocin
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| What are signs of hemorrhage in postpartum state? | decreased hgb and hematocrit levels by 1-1.5 g/dL and 2% - 4 %. Underyling coagulation defect with increased clotting times and decreased platelet and prothrombin lvls. Boggy or soft uterus. Steady stream of bright red blood. Fatigue.
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| What is uterine atony? | Uterus does not contract as it should.
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| Uterine atony interventions? | Fundal massage is initiated. Compress blood vessels and decrease bleeding. Drug therapy consists of oxytocin or ergonovine; bimanual uterus compression; if all else fails - hysterectomy (take it all out!)
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| Bottle Teaching: Different Formulas | Powder - cheapest - add water; Concentrate - more expensive, add water; Ready to feed - most expensive
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| Bottle Teaching: Mix formula properly | make as much needed wfor the next 24 hours. Refrigerate it. Warm in a pan with water not in the microwave!
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| Bottle Teaching: Supplements | Primary physician - fluoride or multiVs. 4-6 months infant ceral. 6-8 months Solid foods. 12 mos. Wean from formula.
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| Bottle Teaching: Contact doctor | Baby refusing to eat. Lost of emesis or diarrhea
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| Bottle Teaching: Dental caries | develop from prolonged sucking on milk or juice bottles. Do not leave baby with bottle overnight. High incidence of aspiration and otitis media.
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| Breast Feeding Teaching: Sore nipples | occur due to incorrect latch.. Rub a few drops of expressed milk onto nipples after nursing.
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| Breast Feeding Teaching: Engorgement | is swelling in the breast that occurs when the breast begins to produce milk. Frequent breast feeding is the best way to prevent/treat this.
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| Breast Feeding Teaching: Plugged milk ducts | Continue nursing - position baby with chin by lump to facilitate drainage. Avoid constricting clothes.
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| Breast Feeding Teaching: Mastitis | infection of the breast tissue. Report immediately to Doctor. Treatment consists of antibiotics, analgesics, bedrest and fluids. Continue breastfeeding.
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| Breast Feeding Teaching: Signs the newborn is not feeding well. | Dry mouth, not enough wet diapers per day, fdifficulty rousing to feed. Not enough feedings. Difficulty latching. Contact doctor!!
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| Breast Feeding Teaching: Growth spurts | Are normal. Your body will produce enough milk for the baby with extended feedings. Do not worry.
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| Breast Feeding Teaching: Available resorces | Breastfeeding support groups - la leche league
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| Breast Feeding Teaching: Breastfeeding Amenorrhea | Menstrual cycle returns 6-10 weeks after birth or no period at all while breastfeeding. BUT you can still ovulate.
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| Breast Feeding Teaching: Contraception | Needs to be non-hormonal.
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| Breast Feeding Teaching: Pumping and storing breast milk | Wash hands before you pump and clean equipment. Teach let down techniques massage, and apply warm packs. Fridgerate feed or freeze milk immediately. Store in a hard plastic bottle or breast milk bag.
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| What is a hematoma | collection of blood that can lead to blood loss
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| 23What are the vital signs on a normal new born? | heart rate 110-160bpm. during sleep as low as 100bpm and as high as 180bpm when crying. Respiratory 30-60 breath/min axillary temp 97.7-98.6 BP 60-80/40-45
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| 23Anterior and Posterior Fontanelles | are palpable
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| 28What is milia | Normal pearly white cysts over the bridge of the nose, chins and cheeks of newborn.
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| 31Pathologic Jaundice | serum levels 4-6 mg/dL and >, appears on head and face first as bilirubin levels increase. Jaundice moves to the trunk and extremities.
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| 31Physiogic jaundice | occurs after the 1st 24hrs of life on days 2 or 3 of life. bilirubin lvls peak bw days 3 and 5 lvls that do not increase rapidly no > than 5 mg/dL/ Day.
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| 35. When is Rhogam Given | within 72 hours of giving birth to an Rh+ infant.
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| 32 what is meconium | A thick, pasty, greenish black substance that is present in the fetal bowel as early as 10wks gestation.
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| 27 What is cephalohematoma | swelling that occurs from bleeding under the periosteum of the skull, usually over 1 of the parietel bones, caused by birth trauma.
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| What is caput succadaneuam | molding. molding is an elongated ead shape caused by overlapping of the cranial bones ats the fetus moves through the birth canal.
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| what is Caput | swelling of soft tissue of the scalp caused by pressure of the presenting part on a partially dilated cervix or trauma from a vacuum assisted delivery.
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| 37 What dietary restrictions are given in an infant that has PKU | recessive hereditary defect of metabolism that results in a congenital disease caused by a defect in the enzyme that normally changes the essential amino acid, phenyalanine into tyrosine. If untreated leads to MR.
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| 38 What is brown Fat? | Heat producing tissue found only in fetuses and newborns.
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| 40 What is necrotizing enterocolitis | acute inflammatory diserase of the intestine
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| 41 what is down's symdrome | most common chromosomal abnormality a result in chromosomal nondisjunction with an extra chromosome on chromose 21. trisomy 21.
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| 43 What is a hemolytic disease of the newborn | erythroblastosis fetalis, infants RBCs are broken down and destroyed producing severe anemia and hyperbilirubineenemia. Severe: heart failure, brain damage, death.
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| 45 What is postpoartum depression | nonpsychotic depressive disorder, appears 6 mo postpartum or symptoms may develop during pregnancy but persist after birth. Strong feelings of sadness, irritability, and anxiety.
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| postpartum continued | Lack of interest in surroundings, tearful, motivation to do normal activities, disinterest in others and lack of enjoying life. feelings of inadequacy, inability to cope, ambivalence, guilt and unworthiness, problems sleeping. loss of libido.
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| 46 What is respiratory distress syndrome | hyaline membrane disease occurs because immature lungs that lack sufficient surfactant to decrease the surface tension of the alveoli.
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| 49 Why are infants placed in incubator | To avoid the development of RDS in the newborn at risk. Newbrons with RDS usually receive additional oxygen through continuous positive airway pressure, using intubation or a plastic hood.
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| 50 What is respiratory distress syndrome> | Hyaline membrane disease that occurs in premature newborns because their lungs are too immature and lack sufficient surfactenet to decrease the surface tension of the alveoli.
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| 51 What is the proper teaching during a gavage feeding? | Check preferred gastric residuals (aspiration of gastric contents before a feeding). If stomache is not empty by the next feeding, allow more time between feeding or give smaller feedings. Newborns tolerance level dictates the quantity.
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| 52 What is the proper urine output range? | 1 ml/kg/hr.
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| 53 What are the physical characterisitics of a preterm infant? |
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| 40 What is necrotizing enterocolitis | acute inflammatory diserase of the intestine
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| 41 what is down's symdrome | most common chromosomal abnormality a result in chromosomal nondisjunction with an extra chromosome on chromose 21. trisomy 21.
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| 43 What is a hemolytic disease of the newborn | erythroblastosis fetalis, infants RBCs are broken down and destroyed producing severe anemia and hyperbilirubineenemia. Severe: heart failure, brain damage, death.
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| 45 What is postpoartum depression | nonpsychotic depressive disorder, appears 6 mo postpartum or symptoms may develop during pregnancy but persist after birth. Strong feelings of sadness, irritability, and anxiety.
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| postpartum continued | Lack of interest in surroundings, tearful, motivation to do normal activities, disinterest in others and lack of enjoying life. feelings of inadequacy, inability to cope, ambivalence, guilt and unworthiness, problems sleeping. loss of libido.
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| 46 What is respiratory distress syndrome | hyaline membrane disease occurs because immature lungs that lack sufficient surfactant to decrease the surface tension of the alveoli.
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| 49 Why are infants placed in incubator | To avoid the development of RDS in the newborn at risk. Newbrons with RDS usually receive additional oxygen through continuous positive airway pressure, using intubation or a plastic hood.
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| 50 What is respiratory distress syndrome> | Hyaline membrane disease that occurs in premature newborns because their lungs are too immature and lack sufficient surfactenet to decrease the surface tension of the alveoli.
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| 51 What is the proper teaching during a gavage feeding? | Check preferred gastric residuals (aspiration of gastric contents before a feeding). If stomache is not empty by the next feeding, allow more time between feeding or give smaller feedings. Newborns tolerance level dictates the quantity.
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| 52 What is the proper urine output range? | 1 ml/kg/hr.
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| 53 What are the physical characterisitics of a preterm infant? | Tiny, scrawny, red thin head and abdomen are disproportionately laree testes are undsecended, weak or absent
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| what are the physical characteristics of post term infant | little languo or vernix, scal hair is abundant, fingernails are long, little subq fat, appears long and thin.
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| 36 Complications of a diabetic mother? | Macrosomia. Disproportionate fat buildup on the shoulders and upper body Risk for should dystocia. Hypoglycemia during first hours. Delayed fetal lung maturity. Hypocalcemia, hypomagnesemia, polycythemia, hyperbilirubinism, increased risk for diabetes.
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