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Mother Baby > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

What are the 5 Ps of labor?

A

Passageway, Passenger, Powers, Position, Psychological Response

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2
Q

what is the most common and favorable pelvic type?

A

gynecoid

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3
Q

what is fetal attitude and what leopold maneuver confirms it?

A

relationship of fetal body parts to one another, determined by 4th maneuver

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4
Q

what fetal attitude presents with the smallest diameter?

A

flexed, suboccipitobregmatic

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5
Q

what is fetal lie and which leopolds confirms it?

A

relationship of maternal spine to fetal spine, confirmed with leopold’s 1-3

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6
Q

what are the 3 types of fetal lie?

A

longitudinal, transverse, oblique

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7
Q

what is fetal presentation?

A

body part of fetus entering the pelvis

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8
Q

what are the 3 types of fetal presentation?

A

breech, shoulder, cephalic

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9
Q

what is fetal position?

A

relationship of fetal presenting part to one of the four quadrants of the mother’s pelvis

  • right or left
  • occiput, sacrum, mentum or scapula
  • anterior, posterior or transverse
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10
Q

what are powers?

A

uterine contractions, intra-abdominal pressure

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11
Q

how do you measure frequency?

A

timed in minutes, beginning of one UC to the beginning of the next

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12
Q

how do you measure duration?

A

timed in seconds, beginning of UC to the end of the UC

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13
Q

why is it important for a mother to have frequent position changes?

A

increases comfort, relieves fatigue, promotes circulation, assists in fetal descent, duration of labor decreases, perineal outcomes improve, maternal satisfaction increases

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14
Q

what stages make up intrapartum?

A

3 phases of stage 1 & stage 2

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15
Q

normal frequency of contractions

A

5 or less contractions in 10 minutes, averaged over 30 minute period

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16
Q

abnormal frequency of contractions (tachysystole)

A

more than 5 contractions in 10 minutes, averaged over a 30 minute period

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17
Q

normal FHR

A

111-160

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18
Q

what is FHR baseline?

A 
average FHR during a 10 minute period
excludes periodic (associated with UC) and episodic changes
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19
Q

what is FHR tachycardia and what could it be signs of?

A

> 160 bpm for ten minutes

-early fetal hypoxia, maternal fever, betasympathomimetic drugs, maternal hyperthyroidism, fetal anemia dehydration

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20
Q

what is FHR bradycardia?

A

<110 bpm for 10 minutes

-profound asphyxia, maternal hypotension, prolonged umbilical cord compression, fetal arrhythmia

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21
Q

FHR variability: absent

A

undetected variability - flat line

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22
Q

FHR variability: minimal

A

0-5 bpm - don’t like to see

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23
Q

FHR variability: moderate

A

6-25 bpm

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24
Q

FHR variability: marked

A

> 25 bpm

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25
Q

what are accelerations?

A

increase in baseline FHR, associated with fetal movement and adequate oxygenation - indicates baby is healthy

  • over 32 weeks: 15 beats above baseline that last for at least 15 seconds
  • less than 32 weeks: 10 beats above baseline that lasts for 10 seconds
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26
Q

what are decelerations in FHR?

A

decrease in baseline FHR, can be periodic or episodic, recurrent or intermittent

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27
Q

what are early decels?

A

normal, d/t contraction
could be due to head compression during pushing
always periodic!

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28
Q

what are variable decels?

A

abnormal, abrupt, sign of cord compression

  • decrease in baseline 15 or more bpm and lasts for 15 or longer seconds
  • V or U shpaed
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29
Q

what are late decels?

A

abnormal, occurs after peak of UC, may be due to uteroplacental insufficiency (decrease in O2 to fetus)
always periodic

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30
Q

what are prolonged decels?

A

abnormal
decrease in FHR of at least 15 bpm lasting more than 2 minutes but less than 10
cause: sudden and profound change in fetal environment

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31
Q

what is reassuring FHR?

A

baseline = 110-160

  • moderate variability
  • periodic patterns consist of accels with fetal movement
  • early decels may be present
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32
Q

what is non-reassuring FHR?

A

severe bradycardia/tachycardia

  • severe variable decels
  • late decels or prolonged decls
  • absence of variabilty
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33
Q

VEAL CHOP

A

Variable –> cord Compression
Early –> head compression
Acceleration –> oxygenated
Late –> placental insufficiency

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34
Q

LOCK method

A

L - left lateral position - reposition first!
O - oxygen via face mask
C- correct contributing factors (IV fluid bolus, maternal position change, hypotension)
K - keep monitoring FHR and uterine activity

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35
Q

If variability is absent, how can you stimulate the baby?

A
  • scalp stimulation via vaginal exam or FSE

- vibroacoustic

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36
Q

what is the first stage of labor?

A 
three phases (latent, active, transition)
from 1cm-10 cm dilation
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37
Q

what is stage two of labor?

A

from 10cm until birth of baby

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38
Q

what is the 3rd stage of labor?

A

after birth of baby until delivery of placenta

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39
Q

what is the 4th stage of labor?

A

delivery of placenta until 4 hours after birth

*assess every 15 minutes for 1 hour, every 30 minutes for 1 hour, hourly for 2 hours

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40
Q

what are the seven cardinal movements?

A 
Engagement (station 0)
Descent
Flexion
Internal Rotation
Extension: crowning
External Rotation/Restitution
Expulsion
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41
Q

what are signs of placental separation?

A

lengthening of the umbilical cord
sudden gush of dark blood
uterine fundus rises up
change in shape of uterus

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42
Q

Shiny Schultze

A

placenta separates from inside to the other margins, limited bleeding

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43
Q

Dirty Duncan

A

separates from outer margins inward - more bleeding

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44
Q

what should a nurse do after delivery of placenta?

A
  • make sure all cotyledons are present
  • inspect for lacerations
  • promote baby friendly activities
  • fundal palpation –> should be firm
  • cleanse perineum
  • oxytocics
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45
Q

Oxytocics

A
  • Pitocin - 10-20 units IV, 10 units IM, never push
  • Methergine - .2mg IM
  • hemabate - 250 mcg/mL IM
  • cytotec - inserted into rectum
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46
Q

what cardiovascular changes happen during second stage of labor?

A

BP, pulse and CO increase
blood flow to uterine arteries becomes blocked with contractions
Valsalva maneuver
*want mom on their side

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47
Q

what cardiovascular changes happen during the third stage of labor?

A

CO peaks and then decreases

elevated output for 24 hours post birth

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48
Q

where does water loss come from?

A
  • diaphoresis
  • hyperventilation
  • increased body temp from muscular activity
  • increased RR, increased evaporative volume
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49
Q

what respiratory changes happen during birth?

A
  • increased demand for O2

- RR increases

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50
Q

what renal changes occur during birth?

A
  • increased GFR can lead to proteinuria
  • increase in maternal renin
  • increase in urinary output
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51
Q

what GI changes happen during birth?

A
  • gastric motility and absorption decrease
  • gastric emptying time increases
  • increased gastric acidity
  • glucose infusions –> can lead to fetal hyperglycemia and newborn hypoglycemia
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52
Q

what does the 4th stage of labor include?

A

after birth of placenta to 4 hours after birth

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53
Q

how often are mothers assessed during the 4th stage of labor?

A

every 15 minutes for 1 hour, every 30 minutes for 1 hour, hourly after 2 hourse

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54
Q

what is assessed during the nursing assessments in the 4th stage of labor?

A

vital signs, fundus, bladder blood flow

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55
Q

puerperium

A

period during which the body adjusts and returns to near pregnancy state
usually lasts 6 weeks

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56
Q

how long can it take deep vein diameters to return to normal?

A

6 weeks

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57
Q

how long does it take to return to prepregnancy CO?

A

3 months

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58
Q

what is the typical blood loss for a vaginal birth?

A

200-500 mL

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59
Q

why are postpartum women at risk for hypotension?

A
  • natural hypovolemic state

- risk for DVT with increase diameter of veins

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60
Q

what is the decrease in hematocrit that would require investigation?

A

10%

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61
Q

three common occurrences after birth

A

postpartum chills
afterpain
diaphoresis

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62
Q

if bladder is full, where will the uterus be displaced to?

A

the right side

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63
Q

when does normal bowel eliminiation return?

A

2-3 days

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64
Q

how long is the immune system response to infection delayed for?

A

2-3 months

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65
Q

WBC levels after birth

A

increased without presence of infection

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66
Q

BUBBLE-HE

A

breast, uterus, bladder, bowel, lochia, episiotomy, homan’s, emotional status

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67
Q

2 common abdominal impacts PP

A

diastasis recti abdominis

striae

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68
Q

what would a temp of over 100.4 after the first 24 hours indicate?

A

puerperal sepsis, UTI, endometritis

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69
Q

Reva Rubin’s stage 1: taking in

A

passive, wants to be taken care of

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70
Q

Reva rubin’s stage 2: taking hold

A

initiates action, more interest in caring for self and child

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71
Q

reva rubin’s stage 3: letting go

A

more settled

happens more at home

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72
Q

PP depression

A

occurs after 14 days, but doesn’t have to begin immediately (can be within 1st year of life)
psychological disorder

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73
Q

PP Blues

A

affects 50-80% of all PP women
usually peaks at 5th day and goes away
characterized by mood swings, weepiness and let down

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74
Q

what would floaters in peripheral vision indicate?

A

increased BP

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75
Q

how often should breasts be examined?

A

every 8 hours for nipple soreness, tenderness, colostrum, pain and plugged ducts, engorgement

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76
Q

when does the fundus move to the umbilicus line?

A

6-12 hours after birth

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77
Q

involution of umbilicus per day

A

1 fingerbreadth per day

occurs faster in breastfeeding mothers

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78
Q

rubra lochia

A

red; first 3 days

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79
Q

serosa lochia

A

pink; day 3-10

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80
Q

alba

A

white; day 11-14

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81
Q

how long should you rest the pelvis post partum?

A

6 weeks

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82
Q

when should menstruation appear if not breastfeeding?

A

within 6 - 8 weeks

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83
Q

lochia: scant amount

A

less than 1 inch stain on peri pad within 1 hour

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84
Q

lochia: light amount

A

less than 4 inch stain on peri pad within 1 hour

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85
Q

lochia: moderate amount

A

less than 6 inch stain on peri pad within 1 hour

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86
Q

lochia: heavy amount

A

saturated peri pad within 1 hour

*needs to be evaluated

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87
Q

REEDA: perineum check

A 
redness 
edema
ecchymosis
discharge from laceration or episiotomy
approximation
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88
Q

what does clonus indicate?

A

neurological sign of increased BP

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89
Q

complications: when to call 911

A

P: pain in the chest
O: obstructed breathing or SOB
S: seizures
T: thoughts of hurting yourself or baby

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90
Q

complications: when to call healthcare provider

A

B: bleeding, soaking through one pad/hour, blood clots bigger than the size of an egg
I: incision that is not healing
R: red or swollen leg, that is painful or warm to touch
T: temperature of 100.4 or greater
H: headache that does not get better, even after medicine or bad headache with vision changes

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91
Q

what can increased stress during labor lead to?

A

increased O2 consumption for mom –> decreases O2 consumption to fetus

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92
Q

psychoprophylactic techniques

A
  • relaxation techniques
  • massage/effleurage
  • therapeutic touch
  • position change
  • music
  • hypnobirthing - breathing techniques
  • acupressure, ice massage
  • breathing techniques
  • hydrotherapy
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93
Q

systemic analgesia

A

IV narcotics, affects mother systematically

94
Q

when is systemic analgesia preferred?

A

stage 1, phase 1

95
Q

why do babies need to be reactive?

A

need them active in birthing process, need them to realize if their O2 is cut off

96
Q

what does systemic analgesia do?

A

provides pain relief without numbing or LOC

97
Q

who cannot receive Nitrous Oxide?

A

B12 deficient patients

98
Q

how long does systemic analgesia last?

A

2-4 hours

99
Q

how to manage a wet tap (puncture of dura mater)?

A

hydrate
prepare client for headache
prepare for blood patch (several ccs of mother’s blood to alleviate headache)

100
Q

how to combine epidural/spinal?

A

advance in place epidural catheter into the subarachnoid space

101
Q

paracervical/pudendal analgesia

A

1% lidocaine used
placed in pudendal nerve through vaginal wall bilaterally
good relief for delivery and post delivery vaginal repairs

102
Q

paracervical block

A

inject near cervix

103
Q

pudendal block

A

inject in the outer inguinal area

104
Q

general anesthesia - uses and side effects

A

used in emergency situations or if regional anesthesia is contraindicated
side effects: fetal depression, complete uterine relaxation, stops GI tract

105
Q

nursing care during general anesthesia

A
  • antacids
  • NPO
  • position in left lateral tilt
  • patent IV
  • neonatal team
  • cricoid pressure
  • preoxygenate
106
Q

what is cricoid pressure?

A

pressure on cricoid cartilage so it is easer to intubate

107
Q

when is a fetus considered full term?

A

38 weeks gestation

108
Q

how does a nurse prepare the newborn room?

A
  • warmer and room temp
  • resuscitation equipment and team (correct mask size is imp, blood sugar test is diabetic, meconium, does mom have a fever?)
  • warm blankets for mom and baby
  • birth plan
109
Q

what is included in the birth plan?

A
  • skin to skin
  • baby cleaned first?
  • who is cutting cord?
  • who is announcing sex?
110
Q

When should the umbilical cord be clamped?

A

When it’s done pulsing, provides extra oxygenation to newborn

111
Q

Palmar grasp

A

When placing a finger or stroking the inside of the infant’s palm the hand will close around it
Disappears around 4-6 months

112
Q

Plantar grasp

A

When a finger is placed under the toes, toes will curl

Disappears 9 monhts - 1 year

113
Q

Moro reflex

A

Startle reflex
When infant hears a sudden lound noise or unexpected movement, infant will extend arms palm up and move the arms back
Disappears 6 mons

114
Q

Rooting reflex

A

Head will turn towards the side of the mouth you stroke

Disaappears around 4 months of age

115
Q

Sucking reflex

A

When something touches the top of the infants mouth the infant wil begin to suck
Disappears around 4 months

116
Q

Babinski reflex

A

When bottom of foot is stroke, heel upward, the big toe dorsiflexes and other toes fan out (opposite of correct adult response
Disappers around 1 year

117
Q

Step reflex

A

Whe holding the infant upright with legs and feet touching a surface, the infant will move the legs like taking steps or walking
Disappears around 3-4 months of age

118
Q

Tonic neck (fencing) reflex

A

When infants head is turned to a particular side, the leg and arm on that side will extend
Arm and leg on the opposite side will flex
Disappears around 4 months

119
Q

what is another name for false labor?

A

prodromal

120
Q

characteristics of false labor contractions

A

false and intermittent, no change in intensity, will lessen with activity, and be alleviated by comfort measures

121
Q

where will you feel contractions during false labor

A

abdomen
“feels like baby is balling up”
do not radiate!

122
Q

true or false labor: mucus plug

A

false labor

123
Q

true or false labor: cervix is titled posterior towards the spine

A

false labor

124
Q

contractions during true labor

A

regular intervals, become more frequent w/ time, varying intensity, worse with movement, and can’t be alleviated with distraction or comfort

125
Q

where do you feel contractions in true labor?

A

discomfort in uterus/cervix/lower back area

they radiate!

126
Q

true or false labor: bloody show

A

true labor

127
Q

true or false labor: cervix is tilted anteriorly

A

true labor

128
Q

what does 80/3/-3 mean?

A

80% effaced, 3cm dilated, -3 station

129
Q

what position should the mother be in for a vaginal exam?

A

soles of feet together and knees apart

130
Q

effacement

A

thinning and shortening of the cervix

0-100%

131
Q

dilation

A

how the cervix is opening

132
Q

what dilation does the woman have to reach to push?

A

10cm

133
Q

station

A

the relationship of the fetal presenting part to the mom’s ischial spine
-3cm to 3cm

134
Q

what does a + station indicate?

A

the more + the number, the closer to birth

135
Q

what does 0 station mean?

A

fetus is engaged and committed

136
Q

what does antepartum mean?

A

before birth

137
Q

what makes up an initial labor assessment?

A 
vaginal bleeding
leaking of fluid
fetal assessment
contractions
prenatal record
vaginal exam
vital signs
pain assessment
138
Q

after a water breaks, when should a mom go into labor?

A

within 24 hours

139
Q

TACO

A

time, amount, color, and odor

assessment of water breaking

140
Q

what color should the nitrazine paper turn if woman has broken her water?

A

green-blue because it is basic

*if pink- it is urine!

141
Q

fern test

A

swab of discharge –> put on slide –> amniotic fluid will make a fern pattern

142
Q

leopold’s maneuver: 1st maneuver

A

sides of palms at top of fundus
if it’s mushy - baby’s bottom
if firm and moving - baby’s head
If you don’t feel anything - baby is lying across

143
Q

leopold’s maneuver: 2nd maneuver

A

sides of hands, push on one side and then the other
smooth and rounded = back
bumps = arms and legs

144
Q

leopold’s maneuver: 3rd maneuver

A

Use one hand at bottom part, confirms the 1st maneuver

can determine if head is in cervix

145
Q

leopolds maneuver: 4

A

face mom’s legs and feel to see if the chin is tucked in, out or straight ahead
used to determine fetal attitude

146
Q

How do you evaluate intensity?

A

Palpate while she is having a UC or IUPC

147
Q

Group beta strep status

A

A lot of women have strep in vaginal canal, no s/s, but can be transferred to fetus
Test done at 36 weeks

148
Q

What makes up an initial labor assessment?

A 
Vaginal bleeding - observe
Leaking of luid
Fetal assessment 
Contractions
Prenatal record
Vaginal exam
Vital signs
Pain assessment
149
Q

Characteristics of latent phase

A

0-3cm dilated
5-9 hours
UCs every 15-30 minutes, for 15-30 seconds
UCs are typically irregular

150
Q

Characteristics of active phase

A

4-7cm dilated
2-5 hours in duration
UCs every 2-5 minutes for 40-60 minutes, UCs are regular

151
Q

Characterisitcs of transition phase

A

8-10cm dilated
UCs every 2-3 minutes, for 45-90 seconds, are regular
May have urge to bear down (feeling of a bowel mvmt), emesis, shaking legs, rectal pressure, bloody show

152
Q

What is included in intrapartum maternal assessment?

A
  • IPV assessment
  • pregnancy history
  • any high risk factors?
  • physical assessment
  • labor and fetal status (ongoing)
  • lab tests (Rh factor)
  • cultural and psychosocial assessments
153
Q

what are signs of respiratory distress?

A 
persistent cyanosis
grunting respirations
flaring nostrils
retractions
respiratory rate blow 30 or above 60
HR below 110 or above 160
154
Q

why use the APGAR scoring?

A

objective way to determine if baby transitioned appropriately after birth

155
Q

when do you do the APGAR scoring?

A

1 and 5 minutes

156
Q

APGAR acronym

A

appearance, pulse, grimace, activity, respirations

157
Q

what are the priorities in the first hour?

A 
CV and respiratory assessment
thermoregulation
assessment and support of blood glucose
weight and newborn meds
identification and security
observing urinary/meconium passage
observing for major anomalies
158
Q

Lechitin-spingomeylin ratio and when does it form?

A

has to deal with surfactant, should be 2:1 - indication baby is ready for outside world
38-42 weeks

159
Q

what is the transition period?

A

6 hours after birth

160
Q

what helps initiate breathing?

A

mechanical, chemical, thermal stimulation

161
Q

what is the role of surfactant?

A

prevents alveoli collapse

162
Q

acrocyanosis

A

blue-ish hands and feet

normal immediately after birth

163
Q

breathing characteristics of newborns

A

diaphragmatic, shallow and irregular
periodic/episodic breathing (cessations should not last more than 20 secs!)
nose breathers

164
Q

why does heat loss occur rapidly?

A

large skin surface area
little subq fat/thin skin
increased skin permeability to water

165
Q

neutral thermal environment

A

temp range in which heat production is at the min. Needed to maintain normal body temperature
Normal newborn requires higher environmental temps to maintain a neutral thermal environment

166
Q

normal newborn skin temp

A

36.5 - 37.2 (97.8-99)

167
Q

conduction

A

touching something - heat will move from baby to surface that is colder
important to place them on something warm (mom’s chest, warmer)

168
Q

convection

A

drafts - don’t have open windows, AC, doors

169
Q

evaporation

A

water vapor - dry babies with blankets and give them new dry blankets

170
Q

radiation

A

baby’s lose heat to cooler air

need to increase temperature in room, hats

171
Q

fontanelles

A

where suture lines meet

172
Q

placental previas

A

often end up in C-sections

complete or partial - placenta is blocking the cervix

173
Q

CV assessment of newborn

A

HR should be between 110 and 160 bpm
listen to apical pulses for 1 minute
brachial and femoral pulses
listen for murmurs

174
Q

caput succedaneum

A

swelling due to fluid accumulation
crosses suture lines b/w scalp and bone
not concerning unless it gets larger

175
Q

cephalohematoma

A

does not cross suture lines
blood accumulation
could increase risk for jaundice
not normal!

176
Q

if fontanelles are depressed, what does that indicate?

A

dehydration

177
Q

when does the anterior fontanelle close?

A

12-18 months

178
Q

when does the posterior fontanelle close?

A

by end of 2nd month

179
Q

musculoskeletal assessment of newborn

A
  • symmetry of eyes and ears
  • five fingers and five toes
  • clavicles
  • movement of arms
  • hips for hip dysplasia
  • lower legs/feet for club foot
  • check back for curvatures or dimples
180
Q

epstein’s pearls

A
  • small, white glistening specks (keratin)
  • feel hard to touch
  • usually disappear within a few weeks
181
Q

erythema toxicum

A
  • eruption of lesions in the area surrounding a hair follicle that are firm - 1-3mm
  • white or pale yellow papule or pustule with a erythematous base
  • aka newborn rash or flea bite dermatitis
  • no lesions on hands or soles of feet
  • rarely presents after 5 days
  • unknown cause, no treatment
182
Q

harlequin color

A

characterized by momentary red color changes of half the child, sharply demarcated at the body’s midline

183
Q

stork bites

A

pale pink or red spots are are found on eyelids, nose, lower occipital bone and nape of neck - usually fade by second birthday

184
Q

nevus vasulosis (strawberry mark)

A

capillary hemangioma - raised, clearly delineated, dark red rough surfaced, commonly found in head region, begin to grow during second or third week or life and may not reach full size until 6 months → then shrink and resolve spontaneously

185
Q

average weight of newborn

A

2500-4000 grams (5.8 lbs to 8.13 lbs)

186
Q

what’s the normal weight loss for a newborn in the first 3-4 days?

A

5-10%

187
Q

average length of newborn

A

48-52 cm long (18-22 in)

188
Q

average head circumference

A

32-37 cm (12.6-14.6 in)

2cm greater than chest circumference!

189
Q

what factors influence blood volume?

A

placental transfusion (delayed cord clamping)
gestational age
prenatal hemorrhage

190
Q

true or false: babies have an elevated RBC levels at birth

A

true

191
Q

first period of reactivity

A

30 minutes after birth, good time to initiate breastfeeding

rapid RR and HR

192
Q

sleep phase

A

few minutes to 4 hours

RR and HR stabilize

193
Q

second period of reactivity

A

4-6 hours
mucus production increases –> need to maintain clear airway!
gastric activity
awake and alert

194
Q

deep/quiet sleep

A

closed eyes, no movements, regular, even breathing, jerky motions or staples at regular intervals
100-120 bpm when startled

195
Q

active or light sleep

A

REM sleep
irregular respirations, eyes closed, irregular sucking motions, minimal activity, irregular but smooth movements of extremities

196
Q

alert states

A

drowsy or semi dozing
quiet alert
active alert
crying (hunger, pain, boredom, temperature)

197
Q

what can lead to jaundice?

A
  • immature liver might not be able to bind up bilirubin effectively
  • Yellowish coloration of the skin and sclera
198
Q

what % of fetal glucose levels are mother’s glucose levels?

A

80%

199
Q

signs and symptoms of newborn hypoglycemia

A

jittery, weak cry, feeding issues, diuresis, resp. issues, poor muscle tone

200
Q

what can newborns not digest?

A

complex starches

lacking pancreatic amylase

201
Q

what will breastfeed stool look like?

A

yellow, soft, sweet odor

202
Q

what will formula stool look like?

A

pale yellow, light brown, firm, ordorous

203
Q

when should newborns void by?

A

within 48 hours after birth

204
Q

when are newborns able to concentrate urine?

A

3 months

205
Q

what happens to the GFR within first two weeks of life?

A

it doubles

206
Q

how often should a newborn urinate?

A

2-6x day first 2 days and increase after that

207
Q

uric acid crystals

A

can appear red and is normal

*not the same as red discharge in females

208
Q

what antibodies do newborns receive from mother?

A

IgG - transfer across placenta

passive immunity!

209
Q

what antibodies do they receive via colostrum?

A

IgA

210
Q

medications for newborns

A

erythromycin eye ointment - prophylaxis for gonorrhea
aquamephyton (vit K)
first hep B vaccine
HBIG if mother is Hep B surface anitgen positive

211
Q

newborn care

A
  • keep warm, skin to skin
  • keep cord dry
  • gently wash eyes from inner to outer
  • do not retract foreskin
  • gently clean labia
  • gently clean scalp
212
Q

bathing baby steps

A

start with legs and trunk –> do head last!
mild soap
do not cut nails for 1st week
keep parts not actively bathing covered!

213
Q

when do you start tub baths?

A

once cord has fallen off - usually 2 weeks

214
Q

how to avoid SIDS

A
  • place baby on back when sleeping
  • firm sleep surface
  • do not use bumpers
  • do not share beds
  • avoid overheating
  • parents should avoid alcohol and drugs
215
Q

when to call healthcare provider for newborn?

A
  • temp above 38 (100.4 F)
  • more than 1 forceful vomit or frequent vomit
  • refusal to feed for 2 feedings
  • lethargy
  • cyanosis or jaundice
  • absence of breathing for more than 20 s
  • inconsolable
  • no wet diapers for 18-24 hours, fewer than 6-8 diapers per day
  • drainage from circumcision, cord or eyes
216
Q

what happens to CO after birth?

A

transient increase for 48 hours

217
Q

what happens to GI after birth?

A

mother is hungry b/c of energy expended after labor

218
Q

when does acid base levels return to pregnancy levels?

A

within 24 hours

219
Q

what oxytocic is contraindicated in asthmatics?

A

hemabate

220
Q

what oxytocic would you not give to preeclamptic or high BP

A

methergine

221
Q

when is brown fat developed

A

26 weeks

222
Q

systemic analgesics

A 
NO
morphine 
stadol
nubain
phenergen
benadryl
fentanyl
223
Q

what are stool softeners?

A

colace, simethicone

224
Q

when does normal bowel elim return?

A

2-3 days

225
Q

lidocaine

A

for repairs

injection or topical

226
Q

which pain relievers can you take PO?

A

acetaminophen and morphine

227
Q

sedatives

A

benadryl, stadol, fentanyl, dermerol, nubain, NO, phenergen

228
Q

reassuring (reactive) fetus

A

accels, moderate variability, early decels are okay, HR 110-160

229
Q

when does placenta exchange start

A

10 weeks

230
Q

when does brown fat develop

A

26-30 wks

231
Q

how much does CO increase in response to labor

A

30%

232
Q

average number of peri pads per day

A

6

Mother Baby (3 decks)

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