C&C test 3 A Flashcards
Uterine discharge that lasts ___-____ days and is blood and debris
Rubra “Lochia” 3-4 days
old pinkish brown blood/debri ___-___ days Lochia
Serosa 4-10 days
Serum debris and bacteria (yellow white) ___-__ lochia
Alba 10 days to 6 weeks
A PP woman is having bleeding that is reoccurring 10 days after birth what does this suggest.
In-completed placental sight healing
Snow and Charming just had Emma although now in story brook Snow has continued to bleed for 3-4 weeks what two factors might be occurring?
Infection or subinvolution - wk bleed maybe endometriosis with fever pain or tnderness.
Peristant lochai rubra in early PP (more than 3 days) suggest what? (acutally during first 24 hrs is considered early hemorrage after 24 hrs it is late.
Retained fragment of the placenta or membranes
Belle and Rumple have just welcomed their first child. PP Belle begins to present with pelvic pain and heaviness, backache, fatigue and a persistent Malaise. Her uterus is prgoon!esenting larger and softer than normal for 2 days postpartum. She may have persistent red lochia even after a few days. Rumple demands you help her or he will turn you into a goon!
Belle has sub-involution of the uterus can be caused by hemorrhage, retained placental fragments, pelvic infection(don’t allow uturesu to clamp).
Vaginal Hemorrahage is considered
> 500mL Vaginal
C-section hemorrahge is considered
> 1000mL C section
A woman presents with pernial a stain of 6 inches
Moderate: 6 inch stain (25-50mL)
A woman presents with a perineal pad stain greater than 6 inches what are the mL ofr this large lochia guidelien
Large: 50-80ML
Meri has a 10 mL stain on her Peri pad what is this in inches relatied to teh lochai guideline
could be 2 inch scant(10mL)
or could me 4 inches small (10-25 ML)
What are the four guidlines for lochia
Scant
Small
Moderate
Large
Emma is post partum from giving birth to 10 lb baby Henry .Her inmate status meant that she was induced(oxytocin). The doctor ordered 10-40 untis in 1000ML. her nurse is doing postpartum assessments but can’t find Emma’s uterus. She is having excessive lochia. When it is finally found it is at a higher level thatn expected what is the initial action (me thinks).
1st line is Massage because of the uterine atony
What is it called when the uterus remains inadequately contracted and what does it caues__
Uterine atony -boggy doesn’t clamp can cause early postpartum hemorrahge.
Retained placental fragments can be the cause of what two things that may lead to pp hemmorage
Subinvolution of the uterus:
or Urine atonly related to Early postpartum hemoorage
This is the 2nd most common cause of early PP hemorrahge WHAT IS THE FIRST
Trauma to the birth cannal
UTERINE ATONY is first
A PP patient is presenting with a firm uterus and frank bright red blood her she had a quick delivery with a large baby what is likely the caue of the blood
A laceration on teh cervix
A PP patient is presenting with a firm uterus but is starting to complain of increasing pressure not relieved by pain pills. in her vulva or retropernial area what is the cause and what will be done
Likely Hemotoma with occult bleeding needs ultrasound
COmpression of the intramyotreal vessels casues
Afterpains/contractions
Blanca is PP and just had twins vaginally. She is breastfeeding and this is her 3rd pregnancy. One of her infants weighted 9lbs and the other 5lbs. She is receiving some pitocin because of early PP. Which of these factors puts her at risk for AFTER PAINS that should rapidly decrease within 48hours.
All Multifetal Breast feeding –stimulate uterinen contractions Not first pregnancy Large inflant (9lbs) Pitocin –stimulate uterine contractions
Having a larger bay can cause these four things
- Urine Atony which may lead to early PPP hemorrahge
- After pains
- Trauma which also may lead to early PP hemorrahge
- Diastasis recti abdominis
Multifetal pregency can cause
diastasis recti abdominis
afterpains
Match the breast milk descriptions with their title.
A. Thick ,sticky yellow contains immunoglubluins
B. Creamy thicker milk bluish color, high fat cotnent
C. thin blushish white sweet tasting, less fat content
A. Colostrum
B. HInd (milk comes into sip about 10-20min)
C. early mature milk
Cora is breastfeeding her newborn infant Regina. Her magical skills are quite up to par yet and she is experiencing, swelling,enlarged nipple sensation, redness, fever, discharge, itching ,pain tenderness and a lump on her left breast what is likely going on
Mastitis or abscess from
milk duct not being emptied
Which of the following immunizations are given PP? A. TB B. Rubella C. Hepatitis C D.T dap
B. Rubella
D.T dap
Temp over ______is bad
100.4 so give rubella when leaving
Iron supplement, coninuance on prenatal viamins and diet changes with retest in 6 weeks should all be done for a low
Hgb and HCt
Name three meds decribed for pp depression that can be taken while breast feeding
Paxil
Zoloft
Pamamil
Name when each might occur
A.Baby Blues
B. Postpartum depression
C. psychosisPostpartum
A. occurs in the first 1-2 weeks(transiet& mild)
B. Occurs at about 3 months but can be up to a year aftewards
C. 1 1/2-3 yrs
which is not a risk factor for PP depresson A. Age 20 D. Alchol/drug un/bipolar G. Family hx H. Multifetal gestation I. Stressful evse E. Crappy nurse or doctor F. Hx depressioent/personal injury J. Single /bad relationship status K. Emergent delivery L. Infant health issues
C. it is age lower than 20
E. it is what it is
H. just not it
The rest are all risk factors
Baby emma is lethargic, weak, jittery and hypoglycemic. Pinochio doesn’t know what to do what is likey going on
Cold stressed temp 97.6 or below
what is the ideal first line defense for baby Emma to warm up at a temp of 97.6. What about second line?
Skin to skin with snow-20 min
but second line b/c she’s snow (ha) and she’s in story brooke with no memory: baby under warmer. if lower may have been there before
what is the most common way that a baby looses heat?
Evaporation
Match with the ways Emma lost heat
a. Emma is laying on the cold surface inside the magical tree
b. Emma didn’t get dried properly and is sweating
C. Emma in the cool night air in the other realm
D. Emma is laying in nice cushined crib but next to the winter’s window
A. Conduction
B. Evaporation
C. Convection
D. Radiation
what is normal HR for neonate
120-160 100 if sleeping
What is normal respiration for neonate
30-60
What is normal temo
97.7-99.5
Didi has just delivered baby dill. You are doing an assessment on the neonate when you notice that his lungs are inflating during inspiration and balloning out during expiration. In additoin his respiration are at 65 (tachypnea greater than 60). He is cyanoic, hypotonia, with nasal flaring. . What does he have and what could have put him at risk for this?
RDS:
repiratory distress sydrome
premature babies 10% of all these babies are premature
clamping of the cord leads to ____pressure in the ____________ and _____side leading to first breath
Increaesd, Aorta, Left
This is the opening between two atria and it is where pressure in L side> right side
Foramen ovulaue
How long is Forman ovulaue open
open after birth but closes in a minute. Permanently closed after 6 months.
This is the opening between the pulmonary artery and the _______.
Ductus arteriousous , aorta
When does ductus arteriousus close
Closes within 96 hrs after birth functional
and structural within 4 months so4hrs, 4months.
Opening between the umbilical vein and_________ the _____umbiliCloses when cord is clamped.cal arteries/vein r/t _____ flow.
ductus venous, inferior ca venava decreased flow
What is newborn BP
72/47
What is Preterm BP
64/39
What is regular neonate glucose?
What is 1 day glucose
What is 3 days glucose
regular 40-97
1 day 40-60
3 days 60-70
Although the liver is immature in the neonate it can metabolie capbs and coagulate blood but what 3 factors might cause hypoglycemia
Is it hypo or hyper?
- high enregy need
- incresed RBC
- increased brain size
- decreased glucose
Normal biloirubin
0.2-1mL
You can’t see Jaundice until it’s ______ and you don’t treat until it’s higher than ____but depnedent on normograhph (their age and amount of jaudice present)
4-6mg/dL approx. treat if higher than 9
What are the causes of Physiologic Jaundice? What is the treatment? wHAT IS The LEVEL
-destruction of RBC
-impaired conjugation (so yellow lipid soluable not turning to good water souluable)
-increased bilirubin reabsorption from the intestinal tract.
NO treatement it’s in 50% newborns & 80% PREMIES
level:4-6mg/DL
If jaundice it is _______and occurs before day ___, or if bilirubin rises above __-___mg/dL, there could be another cause ie:_______
Pathological day 1
18-20mg/dl
another cause : ABO or RH incompatibility.
This type of Jaundice occure in 1-5% levals can reach 20-25 causing hyperbilurubin? How can it be treated
Bre cues. ast milk Jundice caused by decresased caloric intake. Need to feed 10-12 tims a day no supplenent recognie
Mouth and tongue movements, rooting, hand to mouth are all cues baby is hungry feeding ____-____times day can prevent starvation Jaundice
10-12 x’s day
In utero the fetus practices these two things
Swallowing & Breathing
Passage of meconium is followed by transitional stools compare breastmilk transition stools to formula
overall they are
Breastmilk: loose greenish yellow
Formula: formed and pale yellow
overall: greenish brown and looser than meconium
How long is fecal matter passed after transitional stools
1-2 days.
About how often to breast fed babies pass stool
q 5-7 days breasters others anytime 1 q 2-3 days or 10 daily
The fetus receives Ig_ passive immunity when the immunoglublin crosses teh placenta in ______trimester. Immunity lasts
IgG, 3rd trimester
it lasts 4-6 weeks to 4-6 months
what are six things that are in passive immunity
Please don’t stand there making moves
poliomyelitis diphtheria Smallpox teatnus mumps measles
Review last four on the other page
gottacha
IN shock r.t to a hemotoma describe what’s going on
BP HR
fundus lochia
BP down
HR up
fundus: firm
lochia: normal
