Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

WOMENS > EXAM 3 > Flashcards

EXAM 3 Flashcards

1
Q

A low birth weight is considered anything less than…

A

2500g OR 5lbs, 8oz

Very low birth weight (VLBW) infant—Infant whose birth weight is less than 1500 g (3 lbs 5 oz)

Extremely low birth weight (ELBW) infant—Infant whose birth weight is less than 1000 g (2 lb 3 oz)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What weight percentile is the Appropriate-for-gestational-age (AGA) infant?

A

weight falls between the 10th and 90th percentiles on intrauterine growth curves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What weight percentile is the Small-for-date (SFD) or small-for-gestational age (SGA)?

A

An infant whose rate of intrauterine growth was slowed and whose birth weight falls below the 10th percentile on intrauterine growth curves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the difference between symmetric and asymmetric IUGR

A

Symmetric vs asymmetric: babies will shunt nutrients to the brain & head to grow first, trunk next, limbs last-both in utero and after delivery

So if have a baby that is asymmetric in growth, then it is a nutrition thing
If they are small symmetrically, look for congenital viral infections or other reasons that are more than just nutrition in utero (both head and body are below the 5th

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What weight percentile is the Large-for-gestational-age (LGA) infant?

A

Infant whose birth weight falls above the 90th percentile on intrauterine growth charts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What weight and gestational age will get a baby automatic NICU admission for observation

A

34 wk < 1800 almost always

some < 36 wk, < 2000 gm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Preterm (premature) infant

A

—Infant born before 37 0/7 weeks of gestation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Late-preterm infant

A

—Infant born between 34 0/7 and 36 6/7 weeks of gestation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Early-term infant

A

—Infant born between 37 0/7 weeks and 38 6/7 weeks of gestation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Full-term infant

A

—Infant born between 39 0/7 weeks and 40 6/7 weeks of gestation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Late-term infant:

A

Infant born between 41 0/7 weeks and 41 6/7 weeks of gestation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Postterm (postmature) infant

A

—Infant born after 42 0/7 weeks of gestation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are CHARACTERISTICS OF POSTTERM INFANTS

A

Dry, loose, peeling skin
Overgrown nails
Large amount of hair on the head
Visible creases on palms and soles of feet
Small amount of fat on the body
Green, brown, or yellow coloring of skin from baby passing meconium before birth
More alert and “wide-eyed”
May be LGA or SGA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Why is asphyxia so common for post-term infants

A

Asphyxia-placenta doesn’t function as well post term-can’t handle stress of delivery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What steroid do you give to mom to mature a pre-term labor baby’s lungs?

A

Betamethasone

2 doses 24 hours apart and 24 hours before delivery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

At what gestation do fetuses make their own surfactant?

A

32-36 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

At what gestation do fetuses develop alveoli

A

23-24 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

describe apnea of prematurity

A

This is where they have an immature response to high levels of carbon dioxide and low levels of oxygen, resulting in apneic episodes

apnea episodes should not exceed 20 seconds or becomes an issue.

to fix: Tactile stimulation-holding, suction, along with O2 therapy and ppv
Cns stimulants: caffeine, theophylline and others

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the 3 things that must matured before discharge from the NICU

A

Renal and gut function, and the ability to eat by mouth

Kidney don’t reabsorb Na and bicarb as well, renal function immature. Early feeding is good as it promotes gut development-enteral feeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What pathogen causes the most common infection in neonates

A

group B strep

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How can you tell if a neonate is suffering from an infection

A

because immune system is underdeveloped, may not be normal response to infection.

Resp status is often an early indicator of problems.

May have a decreased temp instead of a fever as a response to infection

Could have tachy or bradycardia. So want to look for any out-of-range s/s

Use a blood culture to officially Dx

Quick to give prophylactic antibiotics. Ampicillin or gentamycin. Be wary that antibiotics can cause hearing and kidney toxicity.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Describe NECROTIZING ENTEROCOLITIS in a neonate

A

inflammatory disease of bowel unique to infants, most common in premature

risk factors include, decreased blood flow to gut, pathogenic bacteria, substrate when baby is hypoxic, blood is shunted to brain & other vital organs and can cause ischemia of intestines & damage to mucosal cells of intestine.

cells are more susceptible to anaerobic bacteria and this problem is usually only seen after feeding has begun

Subtle Sx, increased abd girth and poor feeding, decrease in bowel sounds, Hematachezia (bright red blood from anus)

Stop feeds to take away medium for bacterial growth-put on TPN and abx.

Sometimes surgery is needed and often have some of bowel removed-can be fatal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Why would a baby have a INTRAVENTRICULAR HEMORRAHGE

A

Less than 30 weeks gestation and in-utero vasculature isn’t ready to change for outside living.

Assess for:
Full fontanels
Anemia
Acidosis
Apnea
Hypotonia

Prevent by:
Neutral Head for 1st 72 hrs
Gentle Ventilation
Slow IV’s, maintain BP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Describe RETINOPATHY OF PREMATURITY

A

Maturity of eye vessels is not really complete until about 3 weeks after term, so preterm is even more compromised. These vessels are meant to develop in a low oxygen environment. Increased O2 environment causes vessels to overgrow and these vessels are heavy and put tension on the retina, this can damage the retina and even cause detachment

Prevention-maintain and monitor O2 and keep infant from big changes-swings between hyper and hypoxia helps prevent this so make sure O2 sats are accurate-may need to change frequently and make sure to prevent skin breakdown from probes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

How do you treat RETINOPATHY OF PREMATURITY

A

Avastin is a drug that is injected into the eye to help treat from eye diseases. The drug blocks the growth of abnormal blood vessels in the back of the eye.

Laser treatment of tortuous vessels
Laser reattachment of retina if gets that far

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What are the 4 criteria that must be met before discharge from NICU

A

Thermoregulation

Control of breathing

Respiratory stability

Feeding skills and weight gain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What are the 4 types of hyperbilirubemia

A

Physiologic: liver can’t keep up

Breastfeeding: those exclusively breastfeeding that are not getting enough volume-dehydration

Breast milk: -not sure of the cause-happens 10-15 days after birth-stopping breastfeeding for 24 hours and restarting usually solves the issue-etiology unknown

Hemolytic: ABO; rH blood incompatibilities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

How do you treat Rh incompatibility

A

Rogam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is the difference between ABO incompatibility and Rh incompatibility

A

ABO incompatibility disease affects newborns whose mothers are blood type O, and who have a baby with type A, B, or AB. Baby;s blood from placenta mixed with mom DURING GESTATION and mom forms MORE MILD ATTACK on fetus. Usually successfully treated with phototherapy and sometimes, IVIG, immunoglobulin. Very rarely do we need transfusions.

Rh incompatibility: blood mixes & mom develops antibodies if baby is Rh +
Then SUBSEQUENT PREGNANCIES, mom’s body will attack fetal RBC’s and cause hemolysis & miscarriage is common.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

T/F: Red meat can sensitize a O mom to AB blood, causing the mom to attack the AB fetus

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Explain how phototherapy works

A

Sends unconjugated bili out of the body and bypasses gut-sends bili directly from liver to kidneys for excretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What’s different about transfusing blood in a neonate than an adult (in a Rh incompatibility scenario)

A

You need to take out the volume of blood you’re going to put in if you’re replacing blood affected by Rh incompatibility.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What are the five most common pathogens that cross the placenta and infect fetuses

A

T–oxoplasmosis
O—Other (e.g., syphilis, HBV, parvovirus, HIV, West Nile virus, Zika virus)
R—Rubella
C—CMV infection
H—Herpes simplex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What maternal infection causes severe hemolysis in fetuses

A

parvovirus B19

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What do you do if you feel like a neonate isn’t acting “right”

A

sepsis workup

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What are early Sx of neonatal sepsis

A

Tired, difficulty breathing, high/low temps,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What are late Sx of neonatal sepsis

A

cyanosis, abdominal distention, seizures, hypotonia (very little tone)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What do you need to be worried about for Neonatal Opioids Withdrawal Syndrome (NOWS)

A

Watch for dehydration b/c don’t feed well & diarrhea.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

How do you treat NOWS

A

Start with non-pharm like limit stimulation, swaddle, etc

Morphine solution to start, then methadone but that is harder to wean off b/c longer half-life

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

How can you tell the difference between Caput & cephalon and subgalea

A

Caput & cephalon will stay put when palpated but subgalea

shifting of ear position, fluctuant scalp mass, irritability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Symptoms of EXTRACRANIAL BLEEDING

A

symptoms generally are neurological and occur shortly after birth (6-12 hours) apnea is often the first, also seizure activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

How does IPV impact the neonate

A

Low birth weight
Pre-term birth
Decreased blood flow to uterus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What are the three things a nurse considers when dealing with an IPV patient

A

COMPREHENSIVE ASSESSMENT: ASSESS ALL WOMEN FOR SIGNS OF VARIOUS PHASES OF POSTTRAUMATIC EXPERIENCES, AS IPV VICTIMS MAY PRESENT WITH ACUTE INJURIES, BUT OTHER PHASES OF TRAUMA CAN COEXIST.

EMERGENCY DEPARTMENT (ED) PROTOCOLS: IMPLEMENT ED PROTOCOLS SPECIFICALLY DESIGNED FOR VICTIMS OF PHYSICAL ASSAULT TO ENSURE APPROPRIATE MEDICAL CARE AND EVIDENCE COLLECTION.

CRITICAL INITIAL RESPONSE: RECOGNIZE THAT THE INITIAL RESPONSE FROM HEALTHCARE SETTINGS AND OTHER PROFESSIONALS IS CRUCIAL TO THE HEALING PROCESS AND THE VICTIM’S OVERALL WELL-BEING.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

At what age do women need to start getting annual mammograms

A

45 to 54

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Most common benign breast change

A

Fibrocystic changes: More common in 20-30’s
Most significant contributing factor: Normal hormonal variation during monthly cycle
Estrogen/progesterone cause cells to proliferate
Clinical manifestations
Breast lumpiness, with or without tenderness
Symptoms usually develop week before menstruation begins and subside about week after
Treatment
Diet, vit E & B6 supplements, NSAIDS, reduce smoking & alcohol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Name of a common benign solid mass of the breast in younger women

A

Fibroadenoma

Exact cause is unknown
Influenced by estrogen
Clinical Manifestation
Discrete , solitary lumps <3 cm in diameter, firm, round, smooth
Woman may experience tenderness during menstrual cycle
Treatment
Cryoablation
Surgical excision

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

How do you officially label someone “menopausal”

A

Complete cessation of menses for one year
Average age 51.5 (45-55)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What are the clinical manifestations of estrogen deficiency

A

Dyspareunia
Increased vaginal ph
Urinary frequency
Increase in LDL cholesterol
Increase CVD risk
Osteoporosis
Redistribution of fat
Insomnia-common in menopause
Fatigue
Depression, anxiety, emotional labile, nervous
Difficulty concentrating
Hot flashes
Night sweats

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

How do you treat estrogen deficiency

A

Low dose vaginal estrogen
Antidepressants - primary pharmacologic treatment for menopause-associated depression
Other drugs for vasomotor symptoms
Clonidine (Catapres) – antihypertensive drug
Gabapentin (Neurontin) – an antiseizure drug

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

What does taking estrogen do to a woman’s body

A

Restores bacterial flora and pH
Improves thickness and elasticity of tissue

Risks and Side effects
Increased risk for breast and endometrial cancer, blood clots
Associated with estrogen use: Headaches, nausea, vomiting, bloating
Treatment guidelines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What is the most effective Non-Pharmacologic method of managing adequate estrogen levels

A

Exercise and healthy eating
(Adequate intake of calcium and vitamin D)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

When do women reach peak bone mass

A

25-50 years old

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

What drugs can women take to improve osteoporosis

A

Calcium supplements

Bisphosphonates
Inhibits resorption of bone

Estrogen-receptor modulators
Binds with estrogen receptors, producing estrogen-like effects on bone, and reduces resorption of bone

Denosumab (Prolia, Xgeva)
Targeted treatment Human monoclonal antibody
Works by preventing the development of osteoclasts which are cells that break down bone (bone reabsorption)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Name the 3 major BACTERIAL STIs

A

Chlamydia
Gonorrhea
Syphilis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

How do you treat chlamydia

A

Doxycycline 100 mg po twice daily for 7 days

DOXYCYCLINE IS CONTRAINDICATED IN PREGNANCY. TREATMENT DURING PREGNANCY IS AZITHROMYCIN 1 G PO IN A SINGLE DOSE

54
Q

What is the difference in Sx between chlamydia/gonorrhea

A

Gonorrhea: cervix with Copious amount of discharge

Chlamydia: bleeding between periods

55
Q

T/F: Prior infection of chlamydia/gonorrhea provides immunity from future infections

A

FALSE

56
Q

How do you treat Gonorrhea

A

Ceftriaxone 500 mg im in a single dose

57
Q

Difference in Sx between SYPHILIS and HSV

A

Ulcer can look like HSV but is painless where HSV lesions are painful

58
Q

Can SYPHILIS infect your baby if pregnant? If so, how?

A

Yes, can become infected through the placenta and cause SKIN RASHES, BONE DAMAGE, SEVERE ANEMIA, ENLARGED LIVER AND SPLEEN, JAUNDICE, NEURO ISSUES: BLINDNESS, DEAFNESS, MENINGITIS

59
Q

Hoe do you treat SYPHILIS

A

BENZATHINE PENICILLIN G (2.4 MILLION UNITS ADMINISTERED INTRAMUSCULARLY) WILL CURE A PERSON WHO HAS PRIMARY, SECONDARY OR EARLY LATENT SYPHILIS.

PENICILLIN G IS THE ONLY KNOWN EFFECTIVE ANTIMICROBIAL FOR PREVENTING MATERNAL TRANSMISSION TO THE FETUS AND TREATING FETAL INFECTION

60
Q

T/F: you can cure HERPES SIMPLEX VIRUS (HSV)

A

False: Life-long, incurable infection

61
Q

What STI causes liver issues in neonates

A

Hep B

62
Q

How do you treat a mom with HIV

A

Zidovudine (ZVD) is the most common medication used to reduce viral load

HAART does not show any negative effects on pregnancy and must be started as soon as possible to reduce the risk of transmission to less than 2%

63
Q

What are the TORCH infections

A

Toxoplasma Gondi
Other agents
Rubella
Cytomegalovirus
Herpes simplex

64
Q

How does a mom get Toxoplasmosis

A

From raw or undercooked meat, or through exposure to cat feces

Body aches, headache, fatigue, sore throat

Infants may develop chorioretinitis, the inflammation of the choroid and retina of the eye that can lead to blindness; obstructive hydrocephalus; mental retardation; seizures, motor delays; developmental delays

65
Q

What is bacterial vaginosis

A

Not an STI: condition where normal vaginal flora are replaced by high concentrations of anerobic bacteria

S/S: thin white/gray vaginal discharge with a “fishy” odor, pruritis (itching)

Treatment
Metronidazole (pills or vaginal gel)
If need flagyl, wait till 2nd trimester to give that

66
Q

What is Salpingitis:

A

inflammation of the fallopian tubes

67
Q

What is Oophritis:

A

inflammation of ovaries

68
Q

What is Parametritis:

A

Inflammation of the parametrium, the connective tissue of the pelvic floor, extending from the subserous coat of the uterus laterally between the layers of the broad ligament

69
Q

What is Peritonitis:

A

inflammation of the lining of the abdome

70
Q

What is involution

A

The return of the uterus to a nonpregnant state after birth is called involution. This process begins immediately after expulsion of the placenta with contraction of the uterine smooth muscle.

71
Q

Describe the timeline for the fundus returning to it’s normal size postpartum

A

The fundus descends 1 to 2 cm every 24 hours. The uterus should not be palpable abdominally after 2 weeks and should have returned to its nonpregnant location by 6 weeks after birth

72
Q

What is Subinvolution

A

the failure of the uterus to return to a nonpregnant state due to ineffective uterine contractions. The most common causes of subinvolution are retained placental fragments and infection

73
Q

When do you give pitocin postpartum

A

Because it is vital that the uterus remain firm and well contracted, exogenous oxytocin (Pitocin) is usually administered intravenously or intramuscularly immediately after expulsion of the placenta

74
Q

When do women resume ovulating after having a baby

A

About 70% of nonlactating women resume menstruating by 12 weeks after birth. The mean time to ovulation in women who breastfeed is about 6 months (Isley, 2021).

The persistence of elevated serum prolactin levels in lactating women appears to be responsible for suppressing ovulation

75
Q

How do you reverse the diabetogenic effects of pregnancy

A

Natural decreases in human placental lactogen, estrogens, cortisol, and the placental enzyme insulinase reverse the diabetogenic effects of pregnancy, resulting in significantly lower blood glucose levels in the immediate postpartum period.

Mothers with diabetes will likely require much less insulin for several days after birth, especially if they are breastfeeding.

76
Q

What is dyspareunia

A

Localized dryness and coital discomfort (dyspareunia) can persist until ovarian function returns and menstruation resumes.

77
Q

Describe the nursing interventions for postpartum hemorrhage

A

massage of the uterine fundus. Express any clots in the uterus.

elimination of bladder distention

continuous IV infusion of 10 to 40 units of oxytocin added to 1000 mL of lactated Ringers or normal saline solution also are primary interventions.

78
Q

T/F: Blood pressure is the best indication of hypovolemic shock

A

False: Respirations, pulse, skin condition, urinary output, and level of consciousness are more sensitive indicators of hypovolemic shock

79
Q

When would you suspect sepsis related to labor in a postpartum woman

A

A diagnosis of puerperal sepsis is suggested if an increase in maternal temperature to 38 ° C (100.4 ° F) or higher is noted after the first 24 h after birth and recurs or persists for 2 days.

80
Q

What is the most accurate way to objectively determine blood loss.

A

weighing clots and items saturated with blood (1 mL equals 1 g)

The nurse always checks for blood under the mother’s buttocks, as well as on the perineal pad

81
Q

What is the normal respirations range for a postpartum woman

A

Lower than 16 breath per minute, higher than 20 breaths per minute

82
Q

Describe the correlation of breast changes and the establishment of milk postpartum

A

Should be soft for the first two days PP.

2-3 days = filling with milk

day 3-5 = hard breasts when full, will soften with feeding. R/o engorgement (firmness, heat, and pain)

83
Q

Where should you feel the fundus immediately postpartum

A

SHOULD BE FIRM/MIDLINE AT UMBILICUS 1ST 24HRS AND DECREASE BY 1 FINGER WIDTH A DAY

If the uterus is soft “boggy”, higher than expected = uterine atony (muscles too weak to clamp down on uterus), lateral deviation of uterus (uterus felt on either side of pt d/t full bladder)

84
Q

Describe the normal progression of lochia changes postpartum

A

Days 1– 3: rubra (dark red)

Days 4– 10: serosa (brownish-red or pink)

After 10 days: alba (yellowish white)

Amount overall: scant to moderate Few clots Fleshy odor

ABNORMAL: Large amount of lochia, large clots: uterine atony, vaginal or cervical laceration Foul odor: infection

85
Q

How much output of fluid is expected the first 24hours postpartum

A

Diuresis (peeing out excess fluid of pregnancy) starts 12hrs after birth (can void 3k ml of fluid/day)

86
Q

A new mom hasn’t pooped since before her labor. It’s been two days. What do you say to her?

A

Bowel movements usually don’t come until 2-3 days after birth. ABNORMAL if BM doesn’t come after 3 days OR is constipated/loose stool

Also: educate the woman about measures to prevent constipation, such as ambulation and increasing the intake of fluids and fiber. Alert the woman to the side effects of medications. Encourage her to implement measures to reduce the risk for constipation. Stool softeners or laxatives may be necessary during the early postpartum period.
The mother can avoid foods (e.g., legumes, beans, broccoli) that tend to produce gas.

87
Q

When can new moms start having sex again

A

Unless your health care provider indicates otherwise, you can safely resume sexual activity (intercourse) by the second to fourth week after birth, when bleeding has stopped.

F/U w/ maternal doc w/ in 2 weeks of discharge

88
Q

T/F: Acrocyanosis, the bluish discoloration of hands and feet, is a normal finding in the first 24 hours after birth.

A

True: Its central cyanosis that is abnormal and signifies hypoxemia.

89
Q

What are 6 things that need to happen in order for a baby to take it’s first breath

A

Decreased levels of oxygen and increased levels of carbon dioxide as a result of contractions during labor seem to have a cumulative effect that is involved in initiating neonatal breathing by stimulating the respiratory center in the medulla.

As a result of clamping the cord, there is a drop in levels of a prostaglandin that can inhibit respirations.

As the infant passes through the birth canal, the chest is compressed. With birth this pressure on the chest is released, and the negative intrathoracic pressure helps to draw air into the lungs

Crying increases the distribution of air in the lungs and promotes expansion of the alveoli. The positive pressure created by crying helps to keep the alveoli open.

The profound change in environmental temperature stimulates receptors in the skin, resulting in stimulation of the respiratory center in the medulla.

Shortly before the onset of labor, there is a catecholamine surge that seems to promote fluid clearance from the lungs, which continues during labor. The movement of lung fluid from the air spaces occurs through active transport into the interstitium, with drainage occurring through the pulmonary circulation and lymphatic system.

90
Q

What is a normal heart rate range for a newborn

A

The heart rate for a term newborn ranges from 120 to 160 beats/ min, with brief fluctuations greater and less than these values usually noted during sleeping and waking states.

Irregular heart rate or sinus dysrhythmia is common in the first few hours of life but thereafter may need to be evaluated.

91
Q

Describe the changes in “normal” blood pressure in a neonate after birth

A

At birth: 75– 95/ 37– 55 mm Hg

At 12 hours: 50– 70/ 25– 45 mm Hg

At 96 hours: 60– 90/ 20– 60 mm Hg

92
Q

What causes the functional closure of the foramen ovale

A

The infant’s first breaths, combined with increased alveolar capillary distention, inflate the lungs and reduce pulmonary vascular resistance to pulmonary blood flow from the pulmonary arteries. Pulmonary artery pressure drops, and pressure in the right atrium declines. Increased pulmonary blood flow from the left side of the heart increases pressure in the left atrium, which causes a functional closure of the foramen ovale

93
Q

Why does a neonate have excess RBCs at birth

A

Because fetal circulation is less efficient at oxygen exchange than the lungs, the fetus needs additional RBCs for transport of oxygen in utero.

94
Q

How do protect a neonate from convection Convection

A

Convection is the flow of heat from the body surface to cooler ambient air.

Newborns in open bassinets are wrapped to protect them from the cold. A cap may be worn to decrease heat loss from the infant’s head.

95
Q

How do protect a neonate from Radiation

A

Radiation is the loss of heat from the body surface to a cooler solid surface not in direct contact but in relative proximity.

Baby is placed away from outside windows, and care is taken to avoid direct air drafts.

96
Q

How do protect a neonate from Evaporation

A

Evaporation is the loss of heat that occurs when a liquid is converted to a vapor.

This heat loss is intensified by failing to completely dry the newborn after birth or with bathing.

97
Q

How do protect a neonate from Conduction

A

Conduction is the loss of heat from the body surface to cooler surfaces in direct contact.

During the initial assessment, the newborn is placed on a prewarmed bed under a radiant warmer to minimize heat loss. The scales used for weighing the newborn should have a protective cover to minimize conductive heat loss.

98
Q

If babies can’t shiver, how do they stay warm?

A

BABIES USE NONSHIVERING THERMOGENESIS BY USING BROWN FAT TO PRODUCE HEAT, THEY ENTER POSITION OF FLEXION, AND MAY CRY/BE RESTLESS

99
Q

How much should a neonate urinate

A

During the first few days, term infants generally excrete 15 to 60 mL/ kg/ day of urine; The frequency of voiding varies from 2 to 6 times per day

output gradually increases over the first month

An infant who has not voided by 24 hours should be assessed for adequacy of fluid intake, bladder distention, restlessness, and signs of discomfort.

100
Q

What is one of the only enzymes not present in a neonate that is present in colustrum

A

pancreatic amylase

101
Q

when is the mucosal barrier in the intestines fully mature

A

4 to 6 months

102
Q

what synthesizea vitamin K, folate, and biotin

A

Intestinal flora, or gut microbiota, are established within the first week after birth

103
Q

Describe the capacity of the newborn stomach

A

less than 10 mL on day 1
30 mL on day 3
60 mL on day 7

104
Q

What is REEDA

A

redness (erythema), edema, ecchymosis (bruising), drainage, and approximation

105
Q

Adjustment phase Taking in:

A

First 24 hours focus on self care and Basic needs

106
Q

Adjustment phase Taking hold:

A

2nd to 3rd day, focus on care of the baby

107
Q

Adjustment phase Letting go:

A

several weeks after birth, moving forward as a family

108
Q

Difference between early and late PPH

A

Early: less than 24 hours after birth
Late: more than 24 hours/less than 6 weeks

109
Q

4 T’s of pph

A

tone. trauma, tissue, thrombin

110
Q

Leading cause of PPH

A

Uterine atony

111
Q

what is Puerperal sepsis:

A

any infection within 42 days after abortion or birth

Most common-numerous streptococcal and anaerobic organisms
Predisposing factors: prolonged rupture, C/S, invasive interventions, retained placenta, pre-existing infection
Assessment findings: temp, abnormal lochia, poor involution, tachy, pain
Labs: WBC increase greater than 30% in 6 hours indicates pathology (increased neutrophils & immature bands)

112
Q

When do you use Cystocele and rectocele

A

Uterine displacement and prolapse

113
Q

What is N-PASS

A

N-PASS: Neonatal Pain, Agitation and Sedation Scale

114
Q

What is a Ballard score

A

It assesses six external physical and six neuromuscular signs. Each sign has a numeric score, and the cumulative score correlates with a maturity rating (gestational age).

115
Q

Postpartum Depression with psychotic features

A

syndrome characterized by depression, delusions, and thoughts of harming either the infant or herself

Psychiatric emergency; may require hospitalization

115
Q

Describe the brachial plexus injury during birth

A

head is pulled too hard while shoulder is stuck and C8-T1 in spine and shoulder is dislocated

115
Q

What is the difference between cephalohematoma and caput succedaneum?

A

Cephalohematoma is a buildup of blood (hemorrhage) underneath a newborn’s scalp. It appears soon after birth. The bulge is discrete, does not cross the suture lines of the bones on their head, and is located at the back of the head. It may take months to go away.

Caput succedaneum causes swelling (edema) on the top of the scalp that is usually noticeable at birth. This swelling causes the scalp to feel spongy, does cross suture lines, and starts to go down soon after birth.

116
Q

How does a newborn get RDs (respiratory distress syndrome)

A

diabetes slows lung maturity b/c surfactant production is delayed, 4-6 times more likely to develop RDS. Increased glucose also interferes with surfactant production

117
Q

How do you test a newborn for hip dysplasia

A

a positive Ortolani test, and a positive Barlow test.

118
Q

how are the 6 sleep/wake states divided

A

2 sleep states, 4 awake states

119
Q

What are warning signs that a newborn is in respiratory distress?

A

RR of < 30 or > 60 breaths per minute. Tachypnea can be first sign of distress

120
Q

What are the three shunts that close in the intrapartum/postpartum period?

A

Foramen ovale
Ductus arteriosus
Ductus venosus

120
Q

First period of reactivity: up to 30 minutes after birth

A

HR increases to 160-180 bpm, gradually falls to 100-120 bpm after 30 min
Irregular respirations; 60-80 breaths per minute
Fine crackles on auscultation
Audible grunting, nasal flaring, and retractions of the chest (cease w/in first hour of birth)
Alert; spontaneous startles, tremors, crying, and head movement side to side
Bowel sounds audible; meconium may be passed

120
Q

Period of decreased responsiveness: 60-100 minutes

A

Infant is pink
Rapid respirations; up to 60 breaths per minute, shallow but unlabored
Bowel sounds audible, peristaltic waves noted over rounded abdomen

121
Q

Second period of reactivity: 2-8 hrs after birth and lasts 10 mins to several hours

A

Brief periods of tachycardia and tachypnea
Ass. w/ increased muscle tone, change in skin color, and mucus production
Meconium commonly passed

122
Q

Describe the anatomy of the umbilical cord

A

contains two arteries (the umbilical arteries) and one vein (the umbilical vein ), buried within Wharton’s jelly.

123
Q

when do you asses Apgar

A

1 and 5 minutes after birth. 1 minute tells you how newborn tolerated birth, 5 min tells you how newborn is tolerated being outside the womb

124
Q

what are the 2 results possible from Congenital heart disease screening

A

Pre-ductal – Part of the aorta proximal to the aortic opening of the ductus arteriosus. Right Hand (RH)

Post-Ductal – Part of the aorta distal to the aortic opening of the ductus arteriosus. Left/right foot (FT)

125
Q

When would you do car seat testing for a neonate

A

less than 37 weeks gestation, at risk for airway issues with positioning, or weigh less than 2500 grams at birth. The infant is placed in the seat for 90-120 minutes or however far away they live on cardiac and pulse Ox monitor

126
Q

How do you fail the car seat test

A

Apnea that lasts 20 seconds or more
Heart rate of < 80 beats/minute for > 10 seconds
Oxygen saturation level of < 90% for > 10 seconds

127
Q

What is kernicterus

A

Aka bilirubin encephalopathy: bilirubin-induced neurological damage

128
Q

How often should a baby eat?

A

15-30 ml q feed max
Need 6-8 feeds in 24 hours for newborn

129
Q

What are general breastmilk storage guidelines?

A

Fresh donor: room temperature 2hrs, fridge 24hrs, freezer 6mo
Fresh from mom: room temperature 4hrs, fridge 96hrs, freezer 6mo

130
Q

What are pessaries used for?

A

A pessary is a prosthetic device inserted into the vagina to support its internal structure. It’s often used in cases of urinary incontinence or vaginal prolapse.

WOMENS (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions