CSL Day 3 - The Newborn & Postpartum Flashcards
1
Q
What does it mean to be baby friendly for hospital
A
no separation of mom and baby
2
Q
what is the range of a heart rate of a newborn
A
110-160bpm
3
Q
how long do you assess the apical rate
A
1 full minute
4
Q
how long do you assess respiratory rate
A
1 full minute
5
Q
what are signs of respiratory distress
A
nasal flaring, grunting, cyanosis, tachypnea, apnea and retraction of chest
6
Q
what is the normal temp range and where do you take it at
A
axillary. 97.7-99.5
7
Q
it’s important to assess the newborn based on their ___ __ rather than DOB
A
gestational age
8
Q
this is the period between conception and birth of a newborn
A
gestation
9
Q
newborn assessment focuses on what key points
A
- knowledge about normal physiological and behavioral characteristics and abnormal variations
- comprehensive head to toe assessment
- documentation of findings
- provision of safe, competent family centered care
- providing educational support and resources to families regarding newborn care
- integration of assessment findings on physiological and behavioral adaptations of newborn
10
Q
newborns have a continuous machine like murmur related to the closing of what
A
patent ductus arteriosus
11
Q
normal respiration rate of newborn
A
30-60 breaths/min
12
Q
any signs of physical distress or illness the nurse needs to what
A
call the pediatrician
13
Q
bluish tint to hands and feet is called
A
acrocyanosis
14
Q
what can appear on third day, is secondary to increased bilirubin.
A
jaundice
15
Q
when jaundice appears in the first 24 hours of life - this is called ____ and needs treatment. this is the bad kind
A
pathologic
16
Q
this indicates newborn is well hydrated. skin should spring back when pinched
A
skin turgor
17
Q
this is protective, thick, cheesy covering. present in creases and skin folds
A
vernix caseosa
18
Q
what does desquamation mean. this occurs a few days after birth
A
peeling of skin
19
Q
fine downy hair of newborn
A
lanugo
20
Q
small raised pearly or white spots on the nose, chin, forehead
A
milia
21
Q
sports of pigmentation that are blue, gray, brown, or black - noted usually on back and buttocks
A
mongolian spots
22
Q
this appears 24-48 hours after life. normal newborn rash
A
erythema toxicum
23
Q
flat pink or red marks that easily blanch and are found on back of neck, nose, upper eyelids and middle of forehead. also called stork bites
A
telangiectatic nevi
24
Q
two soft spots on newborn’s head. one of the front and one on the back. they are called, and which one is bigger
A
anterior fontanelle is the larger one
posterior fontanelle is smaller on back of head
25
temporary malformation of skull so it can fit through birth canal
molding
26
what is a cephalohematoma
a bruise that doesn't cross the suture line
27
what causes a cephalohematoma
bleeding below the periosteum
28
this is caused by the breakdown of RBC
jaundice
29
a fluid accumulation occurs above periosteum due to force of delivery or vacuum assisted birth
caput succedaneum
30
for the ears - you check ear placement by drawing an imaginary line from the newborn's ___ to the __ ___ of the ear
eye to the upper portion of the ear
31
this is the improper formation or narrowing of nasal airways and can lead to respiratory compromise
choanal atresia or choanal stenosis
32
what do you check when you put your finger in newborn's mouth?
suck reflex, feel for the hard palate, soft palate - feel for any divisions, clefts
33
another name for tongue tied
ankyloglossia
34
if newborn's sternum is concave it may indicate what
baby has CT disease or cardiac disorder
35
crackles and wheezing are manifestations of...
fluid or infection in lungs
36
how should a newborn lungs sound
clear
37
what does AVA in regards to a newborn's umbilical cord refer to
2 small arteries and 1 large vein
38
an outpouching of skin around the umbilicus can indicate what...
umbilical hernia
39
is it normal for some newborns to have small amount of vaginal discharge or bleeding after birth
yes
40
what is hypospadias
ventral displacement of urinary meatus
41
what is an epispadias
when the urinary meatus is located on the top side of the penis rather than the tip
42
if infant has a long horizontal crease in the palm of the hand is called
single transverse palmar crease. this can indicate downs syndrome
43
if you see an indentation in the sacral area of the spine, this could indicate
spina bifida occulta
44
if you find a conspicuous patch of hair on lower portion of back, this may indicate
spinal cord abnormality/ neural tube defect
45
this should be absent, flexed or hyperreflexia
tone
46
this can be assessed through observation
motor activity
47
when assessing these - they should be symmetrical. asymmetry may indicate a neurologic or orthopedic condition.
primitive reflexes
48
to test, pull infant's hands until head is a few cm above bassinet, drop the infants head gently into your other hand
moro reflex
49
this reflex is elicited by pushing your fingertip into newborn's palm, causing newborns fingers to wrap around yours
palmar grasp
50
this is evaluated by stroking newborn's cheek, leading infant to turn head in direction and tries to eat
rooting reflex
51
what is considered tachypnea for a newborn
RR >60 breaths per min
52
nursing interventions for respiratory distress of newborn
1. respiratory assessments should be done every 30 mins for the first two hours of life
2. RR should be counted for one full min
3. monitor pulse ox
4. clear airway with bulb syringe as needed - mouth, trachea, nose
5. complete vital signs including temp. low temp could mean respiratory distress
53
early feces passed by newborn soon after birth
meconium
54
broad category includes injuries involving the head of newborn
soft tissue injury
55
one of the most common injuries that a newborn may suffer, if forceps or vacuum is used
cephalhematoma
56
the most common newborn fracture is the
clavicle
57
risk factors that may cause birth trauma
1. prolonged or rapid labor
2. prima gravida
3. large gestational age
4. cesarean birth
5. congenital abnormalities
6. fetal macrosomia
7. precipitous labor
8. multifetal gestation
58
potential signs of birth trauma
1. soft tissue swelling of scalp
2. ecchymosis or hematoma
3. asymmetric motor response
4. irritability
5. feeding difficulties
59
nursing interventions for birth trauma
1. active mgmt and ongoing assessment of newborn
2. inspect and palpate head and neck for swelling, abrasions, or lacerations
3. assess for pain and irritability
4. inspect skin for ecchymosis or hematoma or swelling
5. inspect for asymmetries among extremity movement
6. maintain warm environment
7, educate and reassure parents
60
if baby gets APGAR score 7-10 means
baby is normal
61
if APGAR score is less than 7
nurse is doing some resuscitation. and keep doing it ever 5 mins until APGAR is at least 7
62
at what time frames after birth is nurse doing APGAR
1 minute and then 5 minutes
63
why is vitamin K given to babies
helps babies clot
64
where do babies get their IM injections
vastus lateralis
65
what is the new ballard score
telling of gestational age.
66
how much weight can baby lose before doctor gets concerned
7%
67
when does the postpartum period occur
its considered the fourth trimester; occurs after birth and lasts approx 6 weeks
68
what are the 4 Ts
tone, trauma, tissue, thrombin
69
what is deep vein thrombosis (DVT)
blot clot forms in a deep vein
70
treatment for DVT
elevate legs, thigh high antiembolism stockings, anticoagulants, analgesics
71
symptoms of DVT
increased pain for pt, redness, warmth, swelling
72
what is the biggest concern for pt during partpartum
hemorrhaging
73
if a pt loses more than 500mL of blood after vaginal delivery - is that a hemorrhage
yes
74
how many mL of blood does a pt need to lose for a csection to be considered a hemorrhage
1000mL
75
when the fundus has no tone - it's called
atonic fundus
76
what is nursing intervention for boggy fundus
massage fundus to help it contract, if it doesn't work give pt oxytocin
77
what are a few traumas that could occur to mom during delivery
lacerations in birth canal, bleeding, develop hematoma, uterus falls out, rupture of uterus, thrombin issues
78
when is mom at increased risk for infection PP
prolonged labor, long time since membranes ruptured, retained placental tissue, lacerations or surgical incisions
79
how do we educate pt on signs of infection
swelling, heat, redness, foul smelling discharge, tachycardia, flu like symptoms, fever, chills, pain, nausea
80
when do you notify physician regarding pt's clots
clots are as big as oranges or grapefruit within first 3 days or after
pt experiences mastitis
81
should the mother's bladder be full or empty when assessing fundus.
empty
82
after delivery what do we check on mom for the first 1-2 hours ; and how often
fundal assessment (tone, position, location), lochia, blood pressure, pulse, respiration every 15 mins
83
fundal height is always measured in relations to what
umbilicus
84
what are early warning signs client may be at risk for PP hemorrhage
1. excessive bleeding (saturate one pad in <15 mins)
2. boggy fundus
3. abnormally large clots (larger than quarter)
4. elevated fundus level
5. tachycardia
6. hypotension
7. oliguria
85
waht do you do for a boggy fundus
massage uterus until it firms up and lochia flow decreases
86
firm and contracted uterus prevents
excessive bleeding and hemorrhage
87
what can occur within the first 2 days of delivery due to fluid shifts
lower extremity edema
88
what does breastfeeding stimulate
release of endogenous oxytocin which causes stronger and uterine contractions and milk ejection
89
what does BUBBLE HE stand for
Breast
Uterus
Bowel & Gi function
Bladder function
Lochia
Episiotomy
Hemorrhoids
Emotions
90
what secretes through the breast when breastfeeding the first few days after delivery
colostrum
91
how long does it take for milk to come in
3-5 days
92
what is mastitis
infection of milk duct of breast with concurrent flu like symptoms
93
assessment of uterus PP
fundal height, uterine placement, consistency
94
how much does the fundal height change per day
it descends one-two cm/day
95
how does a nurse massage uterus PP
support base of uterus with one hand, and massage with the other -- this prevents uterine inversion
96
how often should new mom pee
every 2-3hrs
97
what does a nurse admin after placenta is delivered to promote uterine contractions and prevent hemorrhage
oxytocin via IM or IV
