exam 2 Flashcards by olivia mcnamara

whos at risk for jaundice

Preterm, breastfed, cephal hematoma, RH incapability

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returning to pre-pregnant state

involution of uterus

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boggy uterus

hemorrhaging

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types of lochia

rubra- 1-3 days, dark red
Serosa: 3-10 days, pink/brown
Alba: 10 days-6 weeks, creamy/yellow

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H/A, blurred vision, photophobia, proteinuria, abdominal pain (liver), does not go away with delivery

preeclampsia

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Rooting, sucking on fingers, smacking noises, looking around

feeding cues

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late sign of hunger

crying

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women with engorged breast what do we want to tell them

continue breastfeding on that side,massage her breasts, warm heat on breasts helps

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recommended weight gain

25-35 lbs

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Breast milk composition

colostrum, transitional, mature milk

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breastfeeding contraindications

HIV positive
Active drug dependency
Some medications ( Ex: chemotherapy)

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Administer within 1 hour of birth; can be delayed.
Give intramuscularly.
One dose prevents bleeding problems.

vitamin K

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signs of respiratory distress

tachypnea, retractions, nasal flaring, cynaosis, grunting

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blood pooling in the skull

Cephalohematoma

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an edematous area on the head from pressure against the cervix. It may cross suture lines.

Caput succedaneum

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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

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hypoglycemia symptoms

Jittery, floppy, poor suck, respiratory difficulty, or low temp

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normal glucose

40-60 mg/dL the first day of life

50-90 mg/dL thereafter

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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

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tiny white bumps that appear across a baby’s nose, chin or cheeks

milia

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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

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characterized by blotchy red spots on the skin with overlying white or yellow papules or pustules.

Erythema toxicum.

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hair that covers the body of some newborns.

languo

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occurs when the baby’s skin looks blue or pale and blotchy

mottling

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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

65-95/30-60