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CSL Maternity > CSL Day 3 - The Newborn & Postpartum > Flashcards

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

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2
Q

what is the range of a heart rate of a newborn

A

110-160bpm

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3
Q

how long do you assess the apical rate

A

1 full minute

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4
Q

how long do you assess respiratory rate

A

1 full minute

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5
Q

what are signs of respiratory distress

A

nasal flaring, grunting, cyanosis, tachypnea, apnea and retraction of chest

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6
Q

what is the normal temp range and where do you take it at

A

axillary. 97.7-99.5

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7
Q

it’s important to assess the newborn based on their ___ __ rather than DOB

A

gestational age

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8
Q

this is the period between conception and birth of a newborn

A

gestation

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9
Q

newborn assessment focuses on what key points

A
  1. knowledge about normal physiological and behavioral characteristics and abnormal variations
  2. comprehensive head to toe assessment
  3. documentation of findings
  4. provision of safe, competent family centered care
  5. providing educational support and resources to families regarding newborn care
  6. integration of assessment findings on physiological and behavioral adaptations of newborn
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10
Q

newborns have a continuous machine like murmur related to the closing of what

A

patent ductus arteriosus

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11
Q

normal respiration rate of newborn

A

30-60 breaths/min

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12
Q

any signs of physical distress or illness the nurse needs to what

A

call the pediatrician

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13
Q

bluish tint to hands and feet is called

A

acrocyanosis

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14
Q

what can appear on third day, is secondary to increased bilirubin.

A

jaundice

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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

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16
Q

this indicates newborn is well hydrated. skin should spring back when pinched

A

skin turgor

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17
Q

this is protective, thick, cheesy covering. present in creases and skin folds

A

vernix caseosa

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18
Q

what does desquamation mean. this occurs a few days after birth

A

peeling of skin

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19
Q

fine downy hair of newborn

A

lanugo

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20
Q

small raised pearly or white spots on the nose, chin, forehead

A

milia

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21
Q

sports of pigmentation that are blue, gray, brown, or black - noted usually on back and buttocks

A

mongolian spots

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22
Q

this appears 24-48 hours after life. normal newborn rash

A

erythema toxicum

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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

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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

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25
Q

temporary malformation of skull so it can fit through birth canal

A

molding

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26
Q

what is a cephalohematoma

A

a bruise that doesn’t cross the suture line

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27
Q

what causes a cephalohematoma

A

bleeding below the periosteum

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28
Q

this is caused by the breakdown of RBC

A

jaundice

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29
Q

a fluid accumulation occurs above periosteum due to force of delivery or vacuum assisted birth

A

caput succedaneum

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30
Q

for the ears - you check ear placement by drawing an imaginary line from the newborn’s ___ to the __ ___ of the ear

A

eye to the upper portion of the ear

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31
Q

this is the improper formation or narrowing of nasal airways and can lead to respiratory compromise

A

choanal atresia or choanal stenosis

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32
Q

what do you check when you put your finger in newborn’s mouth?

A

suck reflex, feel for the hard palate, soft palate - feel for any divisions, clefts

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33
Q

another name for tongue tied

A

ankyloglossia

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34
Q

if newborn’s sternum is concave it may indicate what

A

baby has CT disease or cardiac disorder

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35
Q

crackles and wheezing are manifestations of…

A

fluid or infection in lungs

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36
Q

how should a newborn lungs sound

A

clear

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37
Q

what does AVA in regards to a newborn’s umbilical cord refer to

A

2 small arteries and 1 large vein

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38
Q

an outpouching of skin around the umbilicus can indicate what…

A

umbilical hernia

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39
Q

is it normal for some newborns to have small amount of vaginal discharge or bleeding after birth

A

yes

40
Q

what is hypospadias

A

ventral displacement of urinary meatus

41
Q

what is an epispadias

A

when the urinary meatus is located on the top side of the penis rather than the tip

42
Q

if infant has a long horizontal crease in the palm of the hand is called

A

single transverse palmar crease. this can indicate downs syndrome

43
Q

if you see an indentation in the sacral area of the spine, this could indicate

A

spina bifida occulta

44
Q

if you find a conspicuous patch of hair on lower portion of back, this may indicate

A

spinal cord abnormality/ neural tube defect

45
Q

this should be absent, flexed or hyperreflexia

A

tone

46
Q

this can be assessed through observation

A

motor activity

47
Q

when assessing these - they should be symmetrical. asymmetry may indicate a neurologic or orthopedic condition.

A

primitive reflexes

48
Q

to test, pull infant’s hands until head is a few cm above bassinet, drop the infants head gently into your other hand

A

moro reflex

49
Q

this reflex is elicited by pushing your fingertip into newborn’s palm, causing newborns fingers to wrap around yours

A

palmar grasp

50
Q

this is evaluated by stroking newborn’s cheek, leading infant to turn head in direction and tries to eat

A

rooting reflex

51
Q

what is considered tachypnea for a newborn

A

RR >60 breaths per min

52
Q

nursing interventions for respiratory distress of newborn

A
  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
Q

early feces passed by newborn soon after birth

A

meconium

54
Q

broad category includes injuries involving the head of newborn

A

soft tissue injury

55
Q

one of the most common injuries that a newborn may suffer, if forceps or vacuum is used

A

cephalhematoma

56
Q

the most common newborn fracture is the

A

clavicle

57
Q

risk factors that may cause birth trauma

A
  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
Q

potential signs of birth trauma

A
  1. soft tissue swelling of scalp
  2. ecchymosis or hematoma
  3. asymmetric motor response
  4. irritability
  5. feeding difficulties
59
Q

nursing interventions for birth trauma

A
  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
Q

if baby gets APGAR score 7-10 means

A

baby is normal

61
Q

if APGAR score is less than 7

A

nurse is doing some resuscitation. and keep doing it ever 5 mins until APGAR is at least 7

62
Q

at what time frames after birth is nurse doing APGAR

A

1 minute and then 5 minutes

63
Q

why is vitamin K given to babies

A

helps babies clot

64
Q

where do babies get their IM injections

A

vastus lateralis

65
Q

what is the new ballard score

A

telling of gestational age.

66
Q

how much weight can baby lose before doctor gets concerned

A

7%

67
Q

when does the postpartum period occur

A

its considered the fourth trimester; occurs after birth and lasts approx 6 weeks

68
Q

what are the 4 Ts

A

tone, trauma, tissue, thrombin

69
Q

what is deep vein thrombosis (DVT)

A

blot clot forms in a deep vein

70
Q

treatment for DVT

A

elevate legs, thigh high antiembolism stockings, anticoagulants, analgesics

71
Q

symptoms of DVT

A

increased pain for pt, redness, warmth, swelling

72
Q

what is the biggest concern for pt during partpartum

A

hemorrhaging

73
Q

if a pt loses more than 500mL of blood after vaginal delivery - is that a hemorrhage

A

yes

74
Q

how many mL of blood does a pt need to lose for a csection to be considered a hemorrhage

A

1000mL

75
Q

when the fundus has no tone - it’s called

A

atonic fundus

76
Q

what is nursing intervention for boggy fundus

A

massage fundus to help it contract, if it doesn’t work give pt oxytocin

77
Q

what are a few traumas that could occur to mom during delivery

A

lacerations in birth canal, bleeding, develop hematoma, uterus falls out, rupture of uterus, thrombin issues

78
Q

when is mom at increased risk for infection PP

A

prolonged labor, long time since membranes ruptured, retained placental tissue, lacerations or surgical incisions

79
Q

how do we educate pt on signs of infection

A

swelling, heat, redness, foul smelling discharge, tachycardia, flu like symptoms, fever, chills, pain, nausea

80
Q

when do you notify physician regarding pt’s clots

A

clots are as big as oranges or grapefruit within first 3 days or after
pt experiences mastitis

81
Q

should the mother’s bladder be full or empty when assessing fundus.

A

empty

82
Q

after delivery what do we check on mom for the first 1-2 hours ; and how often

A

fundal assessment (tone, position, location), lochia, blood pressure, pulse, respiration every 15 mins

83
Q

fundal height is always measured in relations to what

A

umbilicus

84
Q

what are early warning signs client may be at risk for PP hemorrhage

A
  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
Q

waht do you do for a boggy fundus

A

massage uterus until it firms up and lochia flow decreases

86
Q

firm and contracted uterus prevents

A

excessive bleeding and hemorrhage

87
Q

what can occur within the first 2 days of delivery due to fluid shifts

A

lower extremity edema

88
Q

what does breastfeeding stimulate

A

release of endogenous oxytocin which causes stronger and uterine contractions and milk ejection

89
Q

what does BUBBLE HE stand for

A

Breast
Uterus
Bowel & Gi function
Bladder function
Lochia
Episiotomy
Hemorrhoids
Emotions

90
Q

what secretes through the breast when breastfeeding the first few days after delivery

A

colostrum

91
Q

how long does it take for milk to come in

A

3-5 days

92
Q

what is mastitis

A

infection of milk duct of breast with concurrent flu like symptoms

93
Q

assessment of uterus PP

A

fundal height, uterine placement, consistency

94
Q

how much does the fundal height change per day

A

it descends one-two cm/day

95
Q

how does a nurse massage uterus PP

A

support base of uterus with one hand, and massage with the other – this prevents uterine inversion

96
Q

how often should new mom pee

A

every 2-3hrs

97
Q

what does a nurse admin after placenta is delivered to promote uterine contractions and prevent hemorrhage

A

oxytocin via IM or IV

CSL Maternity (14 decks)

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