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NRSG 206: OB > [Exam 2] Chapter 16 – Nursing Management During the Postpartum Period > Flashcards

[Exam 2] Chapter 16 – Nursing Management During the Postpartum Period Flashcards

1
Q

Nursing Assessment Postpartum Period: VS how often during first hour?

A

Every 15 mins

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2
Q

Nursing Assessment Postpartum Period: VS how often during second hour?

A

Every 30 mins

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3
Q

Nursing Assessment Postpartum Period: VS how often during first 24 hours?

A

Every 4 hours

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4
Q

Nursing Assessment Postpartum Period: VS how often after 24 hours?

A

Every 8 hours

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5
Q

Nursing Assessment Postpartum Period: Assessments typically include what?

A

VS, Pain Level, Epidural Site, Inspection for Infection, And systematic head-to-toe review

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6
Q

Nursing Assessment Postpartum Period: What acronym is used to guide head-to-toe review?

A

BUBBLE-EE

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7
Q

Nursing Assessment Postpartum Period: What does BUBBLE-EE stand for?

A 
Breast
Uterus
Bladder
Bowels
Lochia
Episiotomy/Perineum/Epidural Site
Extremities
Emotional Status
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8
Q

Nursing Assessment Postpartum Period - VS and Temp: Mothers temp during first 24 hours postpartum?

A

Within the normal range or a low-grade elevation

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9
Q

Nursing Assessment Postpartum Period - VS and Temp: Why might temperature be elevated?

A

Because of dehydration due to fluid loss during labor. Should be normal within 24 hours.

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10
Q

Nursing Assessment Postpartum Period - VS and Temp: Temp above 100 at any time after first 24 hours indicates

A

infection. Warrants continued monitoring until infection ruled out. May identify maternal sepsis

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11
Q

Nursing Assessment Postpartum Period - VS and Pulse: Normal rate one week after birth?

A

60-80 bpm, called puerperal bradycardia . This is due to the increased CO due to increase IV volume.

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12
Q

Nursing Assessment Postpartum Period - VS and Pulse: Tachycardia postpartum suggests what?

A

Anxiety, excitement, fatigue, pain, excessive blood/delayed hemorrhage, infection, or underlying cardiac problems.

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13
Q

Nursing Assessment Postpartum Period - VS and Resp.: What range should this be in?

A

12-20.

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14
Q

Nursing Assessment Postpartum Period - VS and Resp.: When does this return to normal?

A

After childbirth when diaphragm descends and organs revert to normal positions

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15
Q

Nursing Assessment Postpartum Period - VS and Resp.: Abnormal respirations may indicate what?

A

pulmonary edema, atelectasis, or pulmonary embolism

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16
Q

Nursing Assessment Postpartum Period - VS and BP: How is it after childbirth?

A

Should remain the same as during labor.

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17
Q

Nursing Assessment Postpartum Period - VS and BP: What would an increase in BP indicate?

A

Gestational hypertension

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18
Q

Nursing Assessment Postpartum Period - VS and BP: What would an decrease of BP indicate?

A

Shock or orthostatic hypotension or dehydration.

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19
Q

Nursing Assessment Postpartum Period - VS and BP: What range should this stay in?

A

140/90 - 85/60

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20
Q

Nursing Assessment Postpartum Period - VS and Pain: Nursing care to focus on providing comfort measures should include what?

A

Perineal care, clean gown, mouth care, providing warm blankets, ensuring adequate fluid intake, and enecouraiging rest

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21
Q

Nursing Assessment Postpartum Period - VS and Pain: Goal for pain management and their pain scale?

A

Have it be maintained beween 0 to 2 at all times.

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22
Q

Nursing Assessment Postpartum Period - Physical Exam and Breasts: Inspect breasts for what?

A

Size, contour, asymmetry, engorgement or erythema

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23
Q

Nursing Assessment Postpartum Period - Physical Exam and Breasts: Check nipples for what

A

Cracks, redness, fissures, or bleeding and note whether they are errect, flat, or inverted

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24
Q

Nursing Assessment Postpartum Period - Physical Exam and Breasts: What do cracked, blistered, bruised nipples indicate?

A

That baby is positioned improperly

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25
Q

Nursing Assessment Postpartum Period - Physical Exam and Breasts: What to know for palpatation?

A

Palpate lightly to see if they are soft, filling, or engorged.

For those not breast feeding, use gentle touch to avoid breast stimulation

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26
Q

Nursing Assessment Postpartum Period - Physical Exam and Breasts: What is Lactogenesis (onset of milk secretion) triggered?

A

By delivery of placenta, which results in failing amount of estrogen and progesterone.

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27
Q

Nursing Assessment Postpartum Period - Physical Exam and Breasts: How do engorged breats feel?

A

Hard, tender, and taut

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28
Q

Nursing Assessment Postpartum Period - Physical Exam and Breasts: How will colostrum and foremilk be described?

A

Colostrum = creamy yellow

foremilk = bluish white

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29
Q

Nursing Assessment Postpartum Period - Physical Exam and Uterus: What should you feel for?

A

The top of the fundus. Have women empty bladder before assessing the fundus.

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30
Q

Nursing Assessment Postpartum Period - Physical Exam and Uterus: Where should the fundus be

A

Should be midline and should feel firm

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31
Q

Nursing Assessment Postpartum Period - Physical Exam and Uterus: What does a boggy/relaxed uterus show?

A

Uterine atony (loss of muscle tone in the uterus), which can result in bladder distention which displaces uterus upward and to the right

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32
Q

Nursing Assessment Postpartum Period - Physical Exam and Uterus: How to determine location of fundus location wise?

A

Count number of fingerbreadths between fundus and umbilicus.

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33
Q

Nursing Assessment Postpartum Period - Physical Exam and Uterus:When should this return to its normal height?

A

After 14 days

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34
Q

Nursing Assessment Postpartum Period - Physical Exam and Uterus: How do you record that the fundus is 1cm below the umbilicus?

A

Record it as u/1

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35
Q

Nursing Assessment Postpartum Period - Physical Exam and Bladder: When does diuresis usually end?

A

By day 21

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36
Q

Nursing Assessment Postpartum Period - Physical Exam and Bladder: Signs of UTI?

A

Fever, urinary frequency, difficult or painful urination, and tenderness

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37
Q

Nursing Assessment Postpartum Period - Physical Exam and Bladder: What Q’s should we ask to assess voiding problems?

A

Have you gone to the bathroom yet?

Any burning??

Difficulty passing urine?

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38
Q

Nursing Assessment Postpartum Period - Physical Exam and Bladder: What does bladder distention feel like?

A

Palpation of a rounded mass. Dull to percussion. Lochia drainage will be more than normal

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39
Q

Nursing Assessment Postpartum Period - Physical Exam and Bowels: Bowel movements may not occur for how many days

A

Not until 1-3 days in. Due to decrease in muscle tone in the intestines because of progesterone levels

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40
Q

Nursing Assessment Postpartum Period - Physical Exam and Bowels: How does abdomen usually feel?

A

Soft, nontender, and nondistended

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41
Q

Nursing Assessment Postpartum Period - Physical Exam and Bowels: What question should you ask women here?

A

If they’ve had a bowel movement or has passed gas since giving birth.

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42
Q

Nursing Assessment Postpartum Period - Physical Exam and Lochia: What should you assess about this?

A

Amount, color, and odor. Assess how much they are bleeding and how many perineal pads have been used in past 1-2 hours.

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43
Q

Nursing Assessment Postpartum Period - Physical Exam and Lochia: What do large clots suggest?

A

Poor uterine involution

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44
Q

Nursing Assessment Postpartum Period - Physical Exam and Lochia: Why does lochia increase while breastfeeding?

A

Because Oxytocin releases causes uterine contraction

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45
Q

Nursing Assessment Postpartum Period - Physical Exam and Lochia: What is Scant?

A

1-2 inch lochia stain , 10 mL loss

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46
Q

Nursing Assessment Postpartum Period - Physical Exam and Lochia: What is light or small?

A

4 inch stain, or 10-25 mL of loss

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47
Q

Nursing Assessment Postpartum Period - Physical Exam and Lochia: What is moderate?

A

4-6 inch stain, with estimated loss of 25-50 mL

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48
Q

Nursing Assessment Postpartum Period - Physical Exam and Lochia: What is large or heavy?

A

Pad saturated within 1 hour

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49
Q

Nursing Assessment Postpartum Period - Physical Exam and Lochia: What would be an abnormal finding?

A

Heavy, bright-red lochia with large tissue gragments or a foul odor.

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50
Q

Nursing Assessment Postpartum Period - Physical Exam and Lochia: What to do if excessive bleeding occurs?

A

Massage the boggy fundus until it is firm to reduce flow of blood

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51
Q

Nursing Assessment Postpartum Period - Physical Exam and Lochia: When should the woman contact the provider for an abnormal finding?

A

If lochia rubra returns after the serosa and alba transitions. May indicate subinvolution or that women is too active

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52
Q

Nursing Assessment Postpartum Period - Physical Exam and Episiotomy/Perineum and Epidural Site: What should be inspected at episiotomy?

A

For irritation, ecchymosis, tenderness, or hematomas

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53
Q

Nursing Assessment Postpartum Period - Physical Exam and Episiotomy/Perineum and Epidural Site: What is a first-degree laceration?

A

Involves only skin and superficial structures above muscle

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54
Q

Nursing Assessment Postpartum Period - Physical Exam and Episiotomy/Perineum and Epidural Site: What is a second-degree laceration?

A

Extends through perineal muscles

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55
Q

Nursing Assessment Postpartum Period - Physical Exam and Episiotomy/Perineum and Epidural Site: What is a third-degree laceration?

A

Extends through anal sphincter muscle

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56
Q

Nursing Assessment Postpartum Period - Physical Exam and Episiotomy/Perineum and Epidural Site: What is a fourth-degree laceration?

A

Continues through anterior rectal wall

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57
Q

Nursing Assessment Postpartum Period - Physical Exam and Episiotomy/Perineum and Epidural Site: How often should this be assessed?

A

Every 8 hours

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58
Q

Nursing Assessment Postpartum Period - Physical Exam and Episiotomy/Perineum and Epidural Site: Large areas of swollen, bluish skin with complaints of severe pain in perineal area indicate what?

A

Pelvic or vulvar hematomas

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59
Q

Nursing Assessment Postpartum Period - Physical Exam and Episiotomy/Perineum and Epidural Site: What does a white line running the length of episiotomy indicate?

A

An infection

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60
Q

Nursing Assessment Postpartum Period - Physical Exam and Episiotomy/Perineum and Epidural Site: How to relieve comfort here?

A

Ice, sitz baths

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61
Q

Nursing Assessment Postpartum Period - Physical Exam and Extremities: What is the most important thing to look out for here?

A

VTE, which includes pulmonary embolism and deep vein thrombosis.

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62
Q

Nursing Assessment Postpartum Period - Physical Exam and Extremities: What three factors predispose women to thromboembolic disorders?

A

Stasis (compression of large veins bc of gravis uterus)

Altered Coagulation (state of pregnancy)

Localized vascular damage (may occur during birthing process)

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63
Q

Nursing Assessment Postpartum Period - Physical Exam and Extremities: RF for deep vein thrombi?

A

Anemia, Diabetes, Obesity, Preeclampsia, Hypertension

Pregnancy, and Cesarean Birth

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64
Q

Nursing Assessment Postpartum Period - Psychosocial Assess and Emotional Status: How do you asssess this?

A

How they interect with family, level of indepence, energy levels, and eye contact with infant

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65
Q

Nursing Assessment Postpartum Period - Psychosocial Assess and Bonding and Attachment: What is bonding?

A

The close emotional attraction to a newborn by the parents that develops during the first 30-60 mins after birth.

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66
Q

Nursing Assessment Postpartum Period - Psychosocial Assess and Bonding and Attachment: What is attachment?

A

Development of strong affection between an infant and a significant other. Attachment is reciprocal.

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67
Q

Nursing Assessment Postpartum Period - Psychosocial Assess and Bonding and Attachment: What is the developmental task the infant works on?

A

Trust vs mistrust. If they learn that mother will always be there, they will learn to trust the person.

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68
Q

Nursing Assessment Postpartum Period - Psychosocial Assess and Bonding and Attachment: According to Mercer, what are the four steps of “becoming” a parent , which may take 4-6 months?

A

Commitment, attachment during pregnancy

Acquaintance and increasing attachment to infant

Moving toward new routing in first 4 months

Achievement of parenthood role

69
Q

Nursing Assessment Postpartum Period - Psychosocial Assess and Bonding and Attachment: What factors affect attachment?

A

Parents background (what care did they receive growing up)

Infant (infants temperament and health)

Care practices (the support staff)

70
Q

Nursing Assessment Postpartum Period - Psychosocial Assess and Bonding and Attachment: What factors are associated with the health care facility hinder attachment?

A

Separation of infant/parent immediately after birth

Policies that discourage exploring infant

Intensive care environment

71
Q

Nursing Assessment Postpartum Period - Psychosocial Assess and Bonding and Attachment: What stages does attachment include?

A

Proximity, Reciprocity, and commitment

72
Q

Nursing Assessment Postpartum Period - Psychosocial Assess and Bonding and Attachment: What does Proximity refer too?

A

Physical and psychological experience of parents beign close to their infant. Has three dimensions

73
Q

Nursing Assessment Postpartum Period - Psychosocial Assess and Bonding and Attachment: What are the three dimensions of proximity?

A

Contact

Emotional State

Individualization

74
Q

Nursing Assessment Postpartum Period - Psychosocial Assess and Attachment: What does contact refer to?

A

Sensory experiences of touching, holding, and gazing at infant

75
Q

Nursing Assessment Postpartum Period - Psychosocial Assess and Attachment: What does Emotional state refer to?

A

Emerges from affective experience of the new parents toward their infant and their parental role

76
Q

Nursing Assessment Postpartum Period - Psychosocial Assess and Attachment: what does individualization refer to?

A

Aware of need to differentiate needs of infant from themselves

77
Q

Nursing Assessment Postpartum Period - Psychosocial Assess and Attachment: What does reciprocity refer to?

A

Process by which infants abiliteis and behaviors elicit parental response.

78
Q

Nursing Assessment Postpartum Period - Psychosocial Assess and Attachment: What two dimensions are there in reciprocity?

A

Complementary behavior and sensitivity behavior

79
Q

Nursing Assessment Postpartum Period - Psychosocial Assess and Attachment: What is complementary behavior in reciprocity?

A

Invovles taking turns and stopping when the other is not interested or becomes tired. Those who are responsive to infants cues promote their growth

80
Q

Nursing Assessment Postpartum Period - Psychosocial Assess and Attachment: What does Commitment refer to?

A

Enduring nature of relationships. Contains centrality and parent role exploration

81
Q

Nursing Assessment Postpartum Period - Psychosocial Assess and Attachment: What happens in centrality in commitment?

A

Parents place the infant at the center of their lives. They acknowledge and accept their responsibility to promote infants safety and growth

82
Q

Nursing Assessment Postpartum Period - Psychosocial Assess and Attachment: What is parents role exploration in commitment?

A

Parents ability to find their own way and integrate the parental identity into themselves

83
Q

Nursing Interventions: Positive behaviors from infant?

A

Smile is alert, demonsstrates strong grasp, sucks well, feeds easily

84
Q

Nursing Interventions: Negative behaviors from infant?

A

Feeds pooorly, cries for long periods, show flat affect, rarely smiles even when prompted

85
Q

Nursing Interventions: Positive behaviors from parents?

A

Makes direct eye contact, assumes en face posiiton, claims infant as famil y members, expresses pride

86
Q

Nursing Interventions: Negative behaviors from parent?

A

Expresses disappointment

Fails to explore the infant

Avoids caring for the innfant

87
Q

Nursing Interventions - Providing Optimal Cultural Care: Cultural practices that nurses need to be aware of include what?

A

Dietary restrictions, certain clothes, taboos, activites fro maintaining mental health, and use of silence, prayer, or medication

88
Q

Nursing Interventions - Providing Comfort and Cold: What is used as a first measure after birth to relieve perineal comfort?

A

An ice pack. Minimizes edema, reduces inflammation, decreased capillary permeability and reduces nerve conduction to the site

89
Q

Nursing Interventions - Providing Comfort and Cold: How long is ice pack applied for?

A

Intermittently for 20 minutes and removed for 10 minutes.

90
Q

Nursing Interventions - Providing Comfort and Heat: What is a peribottle?

A

Plastic sqeeze bottle filled with warm tap water that is sprayed oveer the perineal area after each voiding and before applying new pad

91
Q

Nursing Interventions - Providing Comfort and Heat: What may be prescribed after 24 hours?

A

A sitz bath with room temperature water to reduce local swelling and promote comfort for an episiotomy, perineal trauma, or hemorrhoids

92
Q

Nursing Interventions - Providing Comfort and Heat: How do you avoid accidents when attempting to take a Sitz Bath?

A

Stay in womans room, ensure that emergency call light is readily available, and being available during early period to ensure safety

93
Q

Nursing Interventions - Topical Preparations: What does Benzocaine Topical do?

A

Numb the perineal area and are used after cleaning the area with water via the peribottle or sitz bath.

94
Q

Nursing Interventions - Topical Preparations: What can be used to reduce Hemorrhoids?

A

Ice packs, ice sitz baths, and application of cool witch hazel pads.

95
Q

Nursing Interventions - Topical Preparations: What do witch hazel pads do?

A

Cool the area , help relieve swelling, and minimize itching

96
Q

Nursing Interventions - Topical Preparations: Pharmacologic methods to reduce hemorrhoid pain?

A

Local anesthetics (dibucaine) or steroids (hydrocortisone acetate)

97
Q

Nursing Interventions - Topical Preparations: What can be used to treat nipple pain?

A

Beeswax, glycerin-based products, petrolatum, lanolin, and hydrogel products

98
Q

Nursing Interventions - Analgesics: What may be prescibed to treat pain?

A

Acetaminophen and NSAIDS like Ibuprofen

For mod-to-severe pain, codeine or oxycodone with aspirin may be prescribed.

99
Q

Nursing Interventions - Assisting with Elimination: How is the bladder in the period after labor?

A

Edematous, hypotonic, and congested. Bladder distention, incomplete emptying, and inability to void are common.

100
Q

Nursing Interventions - Assisting with Elimination: Why is a full bladder problematic?

A

Interferes with uterine contractions and may lead to hemorrhage because uterus displaced .

101
Q

Nursing Interventions - Assisting with Elimination: How to help woman if she cannot void?

A

Pour warm water over perineal area, hearing the sound of running water, blowing bubble through a straw, taking a warm shower, drinking fluids, and providing her with privacy.

102
Q

Nursing Interventions - Assisting with Elimination: When will catheterization be encouraged?

A

After voiding does not occur within 4-6 hours after givign birth.

103
Q

Nursing Interventions - Assisting with Elimination: What predisposes woman to constipation?

A

Decrease bowel motility, high iron content in prenatal viamins, postpartum fluid loss, and adverse efects of pain meds

104
Q

Nursing Interventions - Assisting with Elimination: What measures can be taken to assist with BM’s?

A

Ambulating, and increasing fluid/fiber intake. A stool softener may also be prescribed.

105
Q

Nursing Interventions - Assisting with Elimination: Nutritional instructions for BM?

A

Increasing fruits and vegetables, drinking plenty of fluids to keep stool soft, drinking small amount of prune juice, and eating high-fiber foods

106
Q

Nursing Interventions - Promoting Activity, Rest, and Exercise: What recommendations will you give to get rest?

A

Nap when infant sleeping.

Reduce participation in outside activites

Determines infant sleep-wake cycles

Ask other family members to provide infant care during the night periodically

107
Q

Nursing Interventions - Promoting Activity, Rest, and Exercise: Benefits of exerccising postpartum?

A

Lose pregnancy weight, reduce risk of obesity, increased energly level, speeds return to prepregnant size/shape

108
Q

Nursing Interventions - Promoting Activity, Rest, and Exercise: Women who are unable to return to healthy weight by 6 months postpartum are at a increased risk for

A

chronic diseases like metabolic syndrome, obesity, and cardiovascular disease

109
Q

Nursing Interventions - Promoting Activity, Rest, and Exercise: When can jogging stroller be used?

A

When infant is 6-12 months (can hold their head up)

110
Q

Nursing Interventions - Promoting Activity, Rest, and Exercise: Exercises should begin with which type?

A

Pelvic floor exercises on first postpartum day, and progressing to abdominal, buttock, and thigh-toning exercises.

111
Q

Nursing Interventions - Promoting Activity, Rest, and Exercise: Recommended exercises for first few weeks postpartum include?

A

Abdominal breathing, head lifts, modified sit-ups, and double knee roll

112
Q

Nursing Interventions - Preventing Stress Incontinence: How can this be prevented?

A

By offering pelvic floor muscle exercises, and prepares the woman for any activity that causes an increase in intra-abdominal pressure

113
Q

Nursing Interventions - Preventing Stress Incontinence: Suggestions to prevent this?

A

Pelvic floor muscle excersises

Lose weight if necessary

Avoid smoking

Adjust fluid intak e

114
Q

Nursing Interventions - Assisting with Self-Care Measures: What measures can be done for this?

A

Frequently change perineal pads

Avoid using tamps

Shower once or twice daily using mild soap

Use sitz bath after every BM

Use peribottle filled with warm water.

115
Q

Biggest safety concern postpartum?

A

Orthostatic Hypotension

116
Q

Nursing Interventions - Ensuring Safety: What safeguards can be made for orthostatic hypotension?

A

Check BP first before ambulating

Elevate HOB for few mins before ambulating

Have client sit on side of bed

Help client stand up.

ambulate alongside the client

117
Q

Nursing Interventions - Counseling about Sexuality and Contraception: What can sex resume?

A

Once bright-red bleeding has stopped and perineum is healed from an episiotomy (3-6 weeks after).

118
Q

Nursing Interventions - Counseling about Sexuality and Contraception: What to know about woman and combined hormonal contraceptives?

A

Don’t use during frst 21 days because of high risk for VTE.

During days 21-42, wirhout risk of VTE, can initiate estrogen-containing contraceptives

119
Q

Nursing Interventions - Counseling about Sexuality and Contraception: When can normal combined hormal contraceptives be used?

A

After 42 days

120
Q

Nursing Interventions - Promoting Maternal Nutrition: Nutrition recommendations include what?

A

Eat wide variety of foods high in nutrient density

Eat meals that require little or no prep

Avoid high-fat foods

Drink plenty of fludis daily

121
Q

Nursing Interventions - Nutrition for Breast-Feeding Mother: What nutrient should women include in their diet?

A

Foods that contain iodine. Necessary to produce thyroid hormone, which helps brain development

122
Q

Nursing Interventions - Nutrition for Breast-Feeding Mother: Calorie changes?

A

+500 calories for first and second 6 months of lactation

123
Q

Nursing Interventions - Nutrition for Breast-Feeding Mother: Protein changes?

A

+20 g/day, adding 2 cups of skim milk

124
Q

Nursing Interventions - Nutrition for Breast-Feeding Mother: Calcium changes?

A

+400 mg daily, consumption of four or more servings of milk

125
Q

Nursing Interventions - Nutrition for Breast-Feeding Mother: Iodine changes?

A

290 mcg daily, dairy products, seafood, iodized salt

126
Q

Nursing Interventions - Nutrition for Breast-Feeding Mother: Fluid changes?

A

+2 to 3 quarts of fluids daily (milk, juice water), no soda

127
Q

Nursing Interventions - Women Who Should Not Breast-Feed: What drugs would enter breast milk and harm infant?

A

Antithyroid drugs, antineoplastic drugs, alcohol, herpes infection on breasts or street drugs

128
Q

Nursing Interventions - Providing Assisting with Breast Feeding: What benefits have kangaroo care been reported?

A

Physiologic (thermoregulation, cardiorespiratory stability)

Behavioral (sleep, breast-feeding duration)

domains (effective way to relieve procedural pain)

129
Q

Nursing Interventions - Providing Assisting with Breast Feeding: What 10 steps should be taken to provide an optimal environment for the promotion, protection, and suport of breast feeding?

A

Have well written breast feeding policy

Educate all stuff on policy

Inform mom of benefits

Show how to feed

Give no food to newborns

Demonstate to mom how to feed

Breast feed on demand

Allow no pacificers to be given

Establish breast feeding support group

Practice rooming in 24 hours daily

130
Q

Nursing Interventions - Providing Assisting with Breast Feeding: What problem do women who are obese have with hormones?

A

Problem with prolactin response to sucking, resulting in decrease in milk production

131
Q

Nursing Interventions - Providing Assisting with Breast Feeding: What is the sandwich technique?

A

Mother is taught to grasp her breast by making a “C” with her thumb or index finger. Thumb stabilzies top of breast while remaining four fingers support breast from below

132
Q

Nursing Interventions - Providing Assisting with Bottle Feeding: What are commercial formulas classified as?

A

Cow milk-based, soy protein-based, or specialized or therapeutic formulas for those with protein allergies.

133
Q

Nursing Interventions - Providing Assisting with Bottle Feeding: What forms can commercial formulas be used?

A

Powdered, condensed liquid, ready to use, and prepackaged

134
Q

Nursing Interventions - Providing Assisting with Bottle Feeding: How many calories needed per day?

A

About 650 cal/day. Means 2-4 oz to feel satisfied at each feeding.

135
Q

Nursing Interventions - Providing Assisting with Bottle Feeding: How many feedings needed per day until age 4 months?

A

About six feedings per day

136
Q

Nursing Interventions - Providing Assisting with Bottle Feeding: Instructions to give mother about bottle feeding?

A

Wash hands with soap, and make feeding relaxing time

Powder formula best with room temp water

Do not microwave formula

Never prop the bottle against newborn

137
Q

Nursing Interventions - Txing About Breast Care: How long should woman wear bra for?

A

24 hours a day to support enlarged breasts

138
Q

Nursing Interventions - Assessing Breasts: Daily assessments include what?

A

The milk supply, condiitons of nipples, and success of breast feeding

139
Q

Nursing Interventions - Alleviating Breast Engorgement: When does this occur?

A

During first week postpartum.

140
Q

Nursing Interventions - Alleviating Breast Engorgement in Breast-Feeding Women: Encourage frequent feedings, how often?

A

At least every 2-3 hours. using manual expression just before feeding to soften the breast.

141
Q

Nursing Interventions - Alleviating Breast Engorgement And Suppressing Lactation in Bottle Fed: Tell women that engorgement will disappear as what happens?

A

As increasing estrogen levels suppress milk formation

142
Q

Nursing Interventions - Alleviating Breast Engorgement And Suppressing Lactation in Bottle Fed: What could be done to alleviate engorgement?

A

Ice packs, wear snug supporitive bra 24 hours a day, and take acetaminophen. Avoid stimulation to the brasts such as warm shorts or massages breass

143
Q

Nursing Interventions - Txing About Postpartum Blues: What may the woman report feelings of?

A

Emotional lability such as crying 1 minute and laughing the next

144
Q

Nursing Interventions - Txing About Postpartum Blues: What has this been defined as?

A

Brief, benign and without clinical significance but several studies have proposed a link between blues and subsequent depression in 6 months following birth

145
Q

Nursing Interventions - Txing About Postpartum Blues: Treatment?

A

Requires no formal treatment other than suport and reassurance because they do not interfere with womans ability to function

146
Q

Nursing Interventions - Preparing for Discharge: How long should they stay before dischagred?

A

At least 24 hours

147
Q

Nursing Interventions - Preparing for Discharge: Shortened hospital stay may be indicated if what criteria met?

A

Mother is afebrile and VS within normal range

Lochia is approiate amount

Hgb adn Hct within normal range.

Fundus firm

RhoGAM administerd if needs

Surgical wounds healing

148
Q

Nursing Interventions - Preparing for Discharge and Providing Immunization: What vaccine should you check for?

A

Rubella.

149
Q

Nursing Interventions - Preparing for Discharge and Providing Immunization: Who should Rubella not be given to?

A

Those who are immune compromised

150
Q

Nursing Interventions - Preparing for Discharge and Providing Immunization: What should mother avoid after receiving vaccine?

A

Pregnancy for at least 28 days as it increases risk of teratogenic effects

151
Q

Nursing Interventions - Preparing for Discharge and Providing Immunization: What to do if patient Rh-negative?

A

check Rh status of newborn. Verify that she has not been sensitized, indirect Coombs test (antibody screen) negative, adn that newborn is Rh positive

Recieve RhoGAm shot.

152
Q

Nursing Interventions - Preparing for Discharge and Providing Immunization: What does the RhoGam shot do?

A

Prevents initial isoimmunization in Rh negative mothers by destroying fetal erythrocytes in the maternal system before maternal antibodies can develop

153
Q

Nursing Interventions - Preparing for Discharge and Providing Immunization: When is Rho(D) immune globulin usuall fiven?

A

One at 28 weeks and another at 72 hours after childbirth

154
Q

Nursing Interventions - Ensuring Follow-Up Care: Women who are discharged too early run the risk of what problems?

A

Uterine subinvolution, discomfort at an episiotomy or cesarean site, infection, fatigue, and maladjustment to their new role.

155
Q

Nursing Interventions - Ensuring Follow-Up Care: When is office visit usually scheduled?

A

4-6 weeks after childbirth after vaginal birth.

2 Weeks for C-Section

156
Q

Nursing Interventions - Ensuring Follow-Up Care: When are home visits usually made?

A

About one week after discharge to assess the mother and newborn.

157
Q

Nursing Interventions - Ensuring Follow-Up Care: MAternal assessment during home visit includes what?

A

General well-being, VS, breast health and care, abdominal and musculoskeletal statuss, voiding status, fundus and lochia status.

158
Q

Nursing Interventions - Ensuring Follow-Up Care: Infant assessment during home visit includes what?

A

Physical exam, general appearance, VS, hoem safety check, and child development status

159
Q

When assessing a postpartum woman, which of the following would lead the nurse to suspect postpartum blues?

Panic attacks and suicidal thoughts
Anger toward self and infant
Periodic crying and insomnia
Obsessive thoughts and hallucinations
A

Periodic crying and insomnia

160
Q

Which of these activities would best help the postpartum nurse to provide culturally sensitive care for the childbearing family?

Taking a transcultural course
Caring for only families of his or her cultural origin
Teaching Western beliefs to culturally diverse families
Educating himself or herself about diverse cultural practice
A

Educating himself or herself about diverse cultural practice

161
Q

Which of the following suggestions would be most appropriate to include in the teaching plan for a postpartum woman who needs to lose weight?

Increase fluid intake and acid-producing foods in her diet.
Avoid empty-calorie foods, breast-feed, increase exercise.
Start a high-protein, low carbohydrate diet and restrict fluids.
Eat no snacks or carbohydrates after dinner.
A

Avoid empty-calorie foods, breast-feed, increase exercise.

162
Q

After teaching a group of breast-feeding women about nutritional needs, the nurse determines that the teaching was successful when the women state that they need to increase their intake of which nutrients?

Carbohydrates and fiber
Fats and vitamins
Calories and protein
Iron-rich foods and minerals
A

Calories and proteins

163
Q

Which of the following would lead the nurse to suspect that a postpartum woman was developing a complication?

Fatigue and irritability
Perineal discomfort and pink discharge
Pulse rate of 60 bpm
Swollen, tender, hot area on breast
A

Sweollen, tender, hot area on breast

164
Q

Which of the following would the nurse assess as indicating positive bonding between the parents and their newborn?

Holding the infant close to the body
Having visitors hold the infant
Buying expensive infant clothes
Requesting that the nurses care for the infant
A

Holding the infant close to the body

165
Q

Which activity would the nurse include in the teaching plan for parents with a newborn and an older child to reduce sibling rivalry when the newborn is brought home?

Punishing the older child for bedwetting behavior
Sending the sibling to the grandparents’ house
Planning a daily “special time” for the older sibling
Allowing the sibling to share a room with the infant
A

Planning a daily “special time” for the older sibling

166
Q

The major purpose of the first postpartum homecare visit is to:

Identify complications that require interventions
Obtain a blood specimen for PKU testing
Complete the official birth certificate
Support the new parents in their parenting roles
A

Identify complications that require interventions

167
Q

The nurse is instructing the postpartum client who plans to bottle-feed her newborn about measures to prevent breast engorgement when she is discharged. Which of the following measures should the nurse include in the teaching plan?

Decreasing her fluid intake for the first week at home
Wearing a tight-fitting supportive bra 24 hours daily
Take a diuretic to release the extra fluid in the breasts
Manually express the milk that is accumulating
A

Wearing a tight-fitting supportive bra 24 hours daily

168
Q

A new mother was brought to the postpartum unit who gave birth 12 hours ago. Because this is her first child, which of the following goals by the nurse is most appropriate?

Early discharge for the mother and newborn
Rapid transition into her role of being a parent/caretaker
Minimal need for expression of her feelings now
Effective education of both parents before discharge
A

Effective education of both parents before discharge

NRSG 206: OB (42 decks)

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