exam 2 Flashcards
whos at risk for jaundice
Preterm, breastfed, cephal hematoma, RH incapability
returning to pre-pregnant state
involution of uterus
boggy uterus
hemorrhaging
types of lochia
rubra- 1-3 days, dark red
Serosa: 3-10 days, pink/brown
Alba: 10 days-6 weeks, creamy/yellow
H/A, blurred vision, photophobia, proteinuria, abdominal pain (liver), does not go away with delivery
preeclampsia
Rooting, sucking on fingers, smacking noises, looking around
feeding cues
late sign of hunger
crying
women with engorged breast what do we want to tell them
continue breastfeding on that side,massage her breasts, warm heat on breasts helps
recommended weight gain
25-35 lbs
Breast milk composition
colostrum, transitional, mature milk
breastfeeding contraindications
HIV positive
Active drug dependency
Some medications ( Ex: chemotherapy)
Administer within 1 hour of birth; can be delayed.
Give intramuscularly.
One dose prevents bleeding problems.
vitamin K
signs of respiratory distress
tachypnea, retractions, nasal flaring, cynaosis, grunting
blood pooling in the skull
Cephalohematoma
an edematous area on the head from pressure against the cervix. It may cross suture lines.
Caput succedaneum
it occurs when the infants head and trunk are allowed to drop back 30 degrees when the infant is in a slightly raised position
moro reflex
hypoglycemia symptoms
Jittery, floppy, poor suck, respiratory difficulty, or low temp
normal glucose
40-60 mg/dL the first day of life
50-90 mg/dL thereafter
waxy or cheese-like white substance found coating the skin of newborn human babies. It is produced by dedicated cells and is thought to have some protective roles during fetal development and for a few hours after birth.
vernix
tiny white bumps that appear across a baby’s nose, chin or cheeks
milia
color change is a cutaneous condition seen in newborn babies characterized by momentary red color changes of half the child, sharply demarcated at the body’s midline.
Harlequin
characterized by blotchy red spots on the skin with overlying white or yellow papules or pustules.
Erythema toxicum.
hair that covers the body of some newborns.
languo
occurs when the baby’s skin looks blue or pale and blotchy
mottling
discoloration of the human skin caused by a vascular anomaly (a capillary malformation in the skin).
Port-Wine Stain (Nevus Flammeus)
lesions are flat and can occur on any part of the body, but are most commonly seen on the head and neck
nevus simplex
what does ballard score measure
gestational age; used for physical characteristics and neuromuscular
posture in term and preterm baby
The healthy full-term infant remains in a strongly flexed position.B, The preterm infant’s extremities are extended.
produced as lungs mature
surfactant
can occur during birth or bathing from moisture on skin, as a result of wet linens or clothes, and from insensible water loss
evaporation
when the infant comes into contact with cold objects or surfaces such as a scale, circumcisin restraint board, cold hands, or a stethoscope
conduction
occurs when drafts come from open doors, air conditioning, or even air currents created by people moving about
convection
heat loss occurs when an infant is near cold surfaces. heat is loss from the infants body to the sides of the crib or incubator and to the outside walls and windows
radiation
hemoglobin
48-69%
leukocytes
9-30
platlets
84-478
first stool excreted
meconium ; black and tarry stool
second type of stool
transitional ; yellowish green
Stools are seedy and mustard colored.
breastfed
stools are more frequent
breastfed
Stools are firmer in consistency.
formula
Stools have a sweet-sour smell.
breastfed
Stools are pale yellow to light brown.
formula
Stools have the characteristic odor of stools.
formula
Unconjugated bilirubin causes
jaundice and kernicterus.
physiologic Jaundice is visible when bilirubin level
greater than 5
what is considered hypoglycemia
below 40-45
who/what gets after pains
multipara
distension of the bladder
breastfeeding
what can a nurse do for after pains
medicate immediately before breastfeeding; analgesics
Less than a 2.5-cm (1-inch) stain on the peripad
scant
Saturated peripad in 15 minutes
excessive
Less than 15-cm (6-inch) stain
moderate
Saturated peripad in 1 hour
heavy
what influences lochia
activity, breastfeeding, and time of day
fully saturating pad in 15 minutes
excessive
what is the permanent change in the cervix
slit os
unrelieved by meds and is super painful; heaviness or pressure pain in vaginal or rectal area
hematomas
risk for bleeding by inhibiting PLT function for the half-life of the drug
NSAIDS
poisons the PLT for the rest of the PLT life
aspirin
separation of rectus muscles of the abdomen
diastasis recti
headaches unrelieved by analgesics think
preeclampsia
H/A, blurred vision, photophobia, proteinuria, abdominal pain (liver), does not go away with delivery
preeclampsia
what to know about moms pulse
could be bradycardia first 6-10 days but if shes tachycardia think hemorrhage / infection
assessment of the perineum
REEDA
sharp dorsiflexion
positive for DVT; this is the homans sign
kegel exercises
help with muscle tone and the release of urine
nothing in the vagina
for 6 weeks
what to know about the rubella vaccine
it is a live virus and is given before discharge
do not get pregnant for at least 28 days after vaccine
who needs rhogam
if mom is rh - and baby is rh +
given within 72 hours to prevent antibodies
it is also given to rh - moms at 28 weeks
Warning Signs to Report
- Bright red bleeding, passing large clots
- Odor to lochia
- Temperature above 100.4
- Excessive pain
- Reddened or warm areas of breast
- Inability to urinate
- Calf pain, redness
wbc elevation
as high as 30,000 immediately post partum but usually 14-16,000
Puerperal Phases
taking in phase- focused on own need for fluid, food, sleep
taking hold phase- mother becomes more independent
letting go phase- couple relinquishes role as a childless couple
Gives up idealized expectations of birth experience
Accepts real infant
Allow to verbalize feelings of grief
letting go phase
Assumes responsibility for own self-care
Begins to shift attention to infant
Welcomes information about newborn behavior
May verbalize anxiety about her competence as a mother
Ideal time to provide instructions and demonstrations
taking hold phase
Allows others to make decisions
Mother is integrating her birth experience into reality
taking in phase
stages of transition in mom role
o Anticipatory: during pregnancy
o Formal: birth of the infant to 4-6 weeks
o Informal: parents learn to respond to the infant’s cues
o Personal: parent feels comfortable in parental role
whats given for post partum depression
Psychotherapy, medication (SSRIs), TCA’s
blood pressure for baby
65-95/30-60
temp in c
36.5-37.5 C
weight
5 lb. 8 oz. to 8 lb. 13 oz.)
length
19-21 in
head
13-15 in
chest
2-3 cm smaller than head
can cause respiratory depression
ssri
knowing maternal history for respiratory
GBS, narcotic use, ssri
crackles are normal for baby when
for the first 2 hours
signs of ttn
retractions, flaring, wheezing, cyanosis, grunting, asymmetry
blocked nasal passage
Choanal atresia
reddish/ruddy skin tone
Plethora
what is Plethora indicative of
polycythemia which increases risk for jaundice
sign of insufficient oxygen
flaring of nares
Murmur is common until WHAT is functionally closed
ductus arteriosus
how is cap refill checked
pressing on chest, abdomen, or extremity
Bluish hands and feet after birth is normal
Acrocyanosis
how to differentiate bruising from central cyanosis
assessing the pulse ox
shape of anterior fontanel
diamond
shape of posterior fontanel
triangle
sunken fontanels
dehydration
bulging fontanels
increased cranial pressure
edema over all of head from pressure in vaginal birth of use of vacuum
- Caput Succedaneum:
bleeding between periosteum and skull, increased risk for jaundice
cephal hematoma
webbing on the neck means
Trisomy 21 or Turner’s Syndrome
what is the umbilical cord made up of
1 vein 2 arteries and whartons jelly
webbing between digits
- Syndactyly
extra digits
polydactyly
Simian crease
down syndrome
sign of low glucose or low calcium
jittery
when is blood glucose necessary
if mom has gestational diabetes or if baby is large for gestational age
hypoglycemia signs
o Jittery o Floppy o Poor suck o Respiratory difficulty o Low temp
what treats thrush
nystatin
when does baby have first stool
12-48 hours
soft, yellow, seedy stools
breastfed stool
tan pasty stools
bottle fed stool
when do babies usually void
within first 24-48 hours
- Brick dust staining of diaper is normal
caused by uric acid crystals
meatus on underside of penis
Hypospadias
meatus on top of penis
epispadias
strawberry hemangioma
o Nevus vasculosus
harmless permanent light brown areas
o Café au lait spots
neuromuscular ballard scale
look up
physical characteristics on ballard scale
look up
APGAR Scoring
- Activity (muscle tone)
- Pulse
- Grimace
- Appearance (skin color)
- Respirations
See-saw respirations, nasal flaring, expiratory grunting or sighing, intercostal or xiphoid retractions, central cyanosis, increased RR with hyperthermia, circum-oral cyanosis
respiratory depression
periods of no breathing
5-15 seconds is normal
over 20 seconds - apnea NOT GOOD
TTN: transient tachypnea of the newborn
60-70 rr
first feeding is important becaus
it helps to stabilize infants blood sugar and temp
Rich in immunoglobulins and IgA
colostrum
decrease of 2 pts hgb is equal to
500 cc of blood loss
bp
65-95/30-60
