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OB FINAL MOD 5-7 > Ch 21-24 objectives > Flashcards

Ch 21-24 objectives Flashcards

1
Q

Vitamin K administration

A

Admin within 1 hour of birth

.5-1mg IM 25g needle
90 degrees vastus lateralis

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2
Q

Eye treatment post birth

A

Prophylaxis for opthalmia neonatorum

Erythromycin ointment or tetracycline topical

Remove drainage w/ sterile saline and cotton

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3
Q

Baby temp checks

A

Shortly after birth

Q30min til stable, more freq. if abnormal

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4
Q

When should Hep B globulin be given

A

Within 12 hours birth

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5
Q

Congenital heart screening

A

Pulse ox should be 95%+

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6
Q

Newborn and calories

A

Need more cals from formula than breastmilk

May lose up to 10% birth weight- should be evaluated after 7%

Regain weight after two weeks

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7
Q

Breast milk pros

A

Infection preventing, stimulates leukocytes, immunoglobulins

Lowers risks of

  • SIDS
  • Asthma
  • Diabetes

Improve cog development

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8
Q

Breastfeeding hormones

A

Suckling causes prolactin and oxytocin release

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9
Q

Breastfeeding positions

A

Across chest

Football

Laying next to mom

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10
Q

Breast engorgement interventions

A

Proper fitting bra

Massage breasts

Cold between feedings
Heat just before feedings

Try to release milk frequently

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11
Q

Preterm gestational age

A

before 37 weeks

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12
Q

Late preterm gestational age

A

34-36 weeks

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13
Q

Term gestational age

A

38-41 weeks

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14
Q

Post term gestational age

A

Over 42 weeks

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15
Q

Preterm concerns

A 
Resp
Fluids
Skin
Infection
Pain
Nutrition
Temp
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16
Q

Preterm respiratory

A

Low surfactant until 34 weeks
Poor cough reflex

Apneic spells, periodic breathing

Side lying or prone position helpful (while being watched)

need suction

17
Q

Preterm thermoregulation

A

rapid heat loss

Immature temp regulation in brain

Maintain neutral thermal environment

18
Q

Preterm skin

A

Very fragile skin, prone to infection (NO IgG!!)

Watch for diaper rash

avoid iodine, alcohol wipes

19
Q

Avoiding overstimulation in pre term infants

A

Cluster care: multiple tasks performed at once

Rest periods for baby

Reduce stimuli: Noise, lights

20
Q

Motor development pre term baby

A

Reposition every 2-3hr gently and slowly. Hands midline

21
Q

Acrocynosis

A

Blue lips, fingers, feet

NORMAL

22
Q

Periodic breathing vs apneic spells

A

Periodic breathing: cessation for 5-10sec w/o other changes–followed by 10-15sec rapid respirations. NORMAL

Apneic spells: Cessation for over 20 seconds or less but w/bradycarida, cyanosis, pallor.

23
Q

Signs of overstimulation in pre term

A

BP, HR, RR instability

Cyanosis, pallor

Flaring nares, low O2 sats, apnea
Coughing

Stiff extended arms and legs
Arching
Worried look
Turning away from eye contact
Regurgitation, hiccuping
Fatigued
24
Q

signs of maternal drug exposure

A 
Irritable, jittery, restless
seizures
Rigid muscles
Excess suckling
Diarrhea/weight loss/Vomiting

Tachypnea
Retractions, apnea

HTN, Diaphoresis

25
Q

Risks for post term infants

A

Decreased placental functioning

Meconium aspiration (from amniotic fluid)

Low amniotic fluid

Labor intolerance

Decreased oxygen
Hypoxia, malnourishment

26
Q

Intraventricular hemorrhage

A

Bleeding into/around ventricles of brain

Rupture of blood vessels, can cause IICP

S&S: Determined by severity

  • Low muscle tone/lethargy
  • Bradycardia
  • Poor respiratory status
  • Hct drop
  • Tense fontanelle
  • Seizures

Interventions:

  • Ultrasound at 7 days old
  • Maintain respiratory function
  • Watch for hydrocephele
  • May need shunt to drain fluid
27
Q

Retinopathy of Prematurity

A

Blood vessel injury in eye

Visual impairment

LASER SURGERY

28
Q

Broncho-pulmonary dysplasia

A

Damage to lungs, need to be on vent for long time

S&S:

  • inability for vent weaning
  • Tachycardia/pnea
  • Retractions, wheezing, crackles
  • Resp acidosis, cyanosis

Interventions;
-Maternal steroids to reduce prematurity

Supportive antibiotics, bronchodilators, diuretics (pulmonary edema)
HIGH cals

29
Q

Necrotizing enterocolitis

A

Intestinal inflammation

S&S:

  • Inc abd girth/tenderness
  • Low to no bowel sounds
  • Loops of bowel seen through abd wall
  • Vomiting, vomiting bile
  • Occult blood

AIR IN INTESTINAL WALL

Management (preventative)

  • Probiotics, preventing NEC
  • Breastfeeding

Management (treatment)

  • Antibiotics
  • NPO
  • Gastric suction
  • surgery maybe

Ostomy may be indicated, can lead to SBS

30
Q

Short Bowel Syndrome

A

S&S:

  • Malabsorption
  • Diarrhea
  • Failure to thrive

Interventions:

31
Q

Short Bowel Syndrome

A

S&S:

  • Malabsorption
  • Diarrhea
  • Failure to thrive

Interventions:

  • Surgery
  • TPN primary source
  • Restore fluids/electrolytes post surgery

Begin enteral nutrition asap

32
Q

Transient tachypnea of Newborn

A

Resolves in 24-48hr

Inadequate absorption of lung fluid

33
Q

Normal bilirubin range

A

Under 5 first 24 hrs.

34
Q

Early onset sepsis

A

Acquired during birth

Prolonged rupture of membranes/prolonged labor

Chorioamnionitis

Symptomatic within 72hr

RAPID PROGRESSION

35
Q

Late onset sepsis

A

During or after birth, before or after discharge

Sx 8-90days after birth

36
Q

Newborn signs of sepsis

A

Temp instability

Resp problems

Odd feeding habits

OB FINAL MOD 5-7 (2 decks)

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