exam 3 Flashcards
Newborn respirations
30-60
Shots given at birth
Hep B
2 month shots
(BDRHIP)
B-hep B
D- tDap
R- Rv
H- HIB
I- IPV
P- Penumococcal
4 months
(DRHIP)
D- tDap
R- Rv
H- HIB
I- IPV (Polio)
P- Pnemunococcal
6 month shots
(BDRHIP)
B-hep B
D- tDap
R- Rv
H- HIB
I- IPV
P- Penumococcal
Interventions for Conjunctivitis
Appy woarm soaks
Use good hand hygiene
Apply cool compress to edematous eye
Family education for conjuctivitis
Good hand hygiene before and after touching eye
Do not share personal items such as pillows or wash clothes
Carefully dispose of tissues or whipes
DIspose of contact lese or eye make up and use new one once infection is gone
school attendence can resume after 24 hours of treatment and after discomfort and drainage subsides
Nursing interventions for otitis media
o Administer pain medication: acetaminophen or ibuprofen
o Antibiotics recommended for children over 6 months of age.
o Course of ttmt is 10-14 days.
o Ceftraixone IM once- FOR RESISTANT organisms. Or inability to take oral meds
o Administer topical anesthetics : benzocaine or lidocaine to relieve pain
o TEACH FAMILY to complete course of medication.
Treatment for engorged breast
o Empty breast at each feeding, allowing infant to nurse q2-3 hrs= 8-12 times. 24 hr massaging during feeding
o Feeding the infant until breast are soft
o Alternate breast with each feeding
o Analgesics or anti-inflammatory medications can be taken for pain or discomfort .
Should women with HIV breastfeed
NO
Education for lactation supression
o Wear well fitting bra for first 72 hrs
o Avoid breast stimulation and running warm water over breast for Lon periods of time
o Fresh cold cabbage leaves
o Apply ice compression on day 3-5 day for 15 mins on and 45 mins off.
o Mild analgesics or anti-inflammatory medication can be taken for pain and discomfort.
Lochia Stages
Lochia Rubra
Lochia Serosa
Lochia Alba
Lochia rubra
Stage 1
Lasts 1-3 days after delivery; color is bright red, bloody consistency, fleshy odor, can contain small clots. Increased during breastfeeding and upon rising
Lochia Serosa
Stage 2
Lasts 4-10 days after delivery, pinkish brown color, and sersangineous consistency
Lochia Alba
Stage 3
Last day 11-48 weeks post partum. COnsist of yellow white creamy color
If a patient advances to serosa and regresses to rubra what should you do?
Call HCP
How would Lochia is less than 2.5 cm be classified?
Scant lochia
How would lochia 2.5-10 cm be classsified
Light
How would lochia saturating one pad within 2 hours be classified
Moderate
How would lochia saturating one pad in 15 mins or less or pooling of blood under buttocks be classified
Exessive blood loss
How does walking and massaging the uterus cause?
A gush of clots and dark blood but it will go back to a trickle
Excessive spurting of bright red blood from vagina could indicate what?
possible vaginal tear
Numerous large clots and excessive blood loss (one pad in 15 mins)
possible hemorrhage
Persistent lochia rubra beyond day 3 could mean what?
possible retained placenta fragments
Continued flow of lochia serosa or alba beyond normal length can indicate what?
Endometriosis, especially if fever, pain or abnormal tenderness present
Post partum chills are a normal occurance unless accompanied byt what?
elevated temp
How to treat postpartum chills
Provide warm blanket, fluids, and provide assurance it is a common occurance that only lasts a short while
What should you teach parents to help prevent SIDS
‘Back to sleep’
Avoid exposure to tobbaco smoke
Prevent overheating
encourage breast feeding
avoid co-sleeping
reomove pillows, quilts, and stuffed animals from crib during sleep
In instances where mom and baby have to be separate what should you make sure to always do?
keep family informed
If a premature infant requires oxygen therapy what needs to be scheduled before discharge?
eye exam
This occurs as a result of surfactant deficiency in the lungs, characterized by poor gas exchange
REspiratory distress syndrome
Respiratory distress, tremors, seizures, fever, excessive sweating, poor feeding, vomiting, high pitched cry, hyperactivity, excessive constant sucking, unconsolable
these symptoms can indicate what in a newborn?
Neonatal abstinence syndrome
Nursing care for an infant with neonatal abstinence syndrome
Decrease environmental stimuli
swaddle newborn
administer small frequent feedings
give a pacifier
try various nupples to compensate for poor suck reflex
monitor for respiratory distress
Monitor cardiac status
Initiate seizure precations
Ensure hydration
A stresful fetal event
respiratory distress
Crackles
rhonchi
cyanosis
Baby is stained in brown, yellow or green
this can all indicate what in a newborn?
Meconium aspiration syndrome
What is a good APGAR score?
10
An APGAR score less than 8 can be associated with what?
Poor outcomes
When to take APGAR scores
1 and 5 mins 10 if abnomal
Medication that can cause rapid uterine titanic contractions, may trap placenta, can cause HTN
Methgergine
Methergine cannot be given to what kinds of patients
patients with HTN or pre-eclampsia
When do you give rhogam?
Negative moms with positive babies, during any kind of testing, after any kind of trauma, after birth, and at 28 weeks
Posterior fontanel closes by _____ and is _______ shape
8 weeks
small triangle shape
Anterrior fontanel closes by ______ and is ______ shaped
18 months
diamond
When a newborn is quiet the fontanel is _____ and _______
flat and soft
When newborns cry, cough, or vomit the fontanel can what?
bulge
A bluging fontanel can indicate what?
Intracranial pressure, infection, or hemorrhage
A depressed fontanel can indicate what?
Dehydration
Collection of blood between peristeuom and the skill bone that it covers.
DOes not cross the suture line
resolves in 2-3 weeks
increased risk of hyperbilirubin
Cephalonematoma
Swelling of soft tissue on the scalp caused by pressure during birth
Can cross suture line
resolves 3-4 days
Caput succedaneum
