Brainscape's Knowledge GenomeTM

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


See full index

Maternal Health > EXAM #4 > Flashcards

EXAM #4 Flashcards

1
Q

What four factors influence the initiation of the first breath?

A

-Chemical
-Sensory
-Thermal
-Mechanical

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

What chemical factors help with the first breath?

A

-Hypercarbia (too much CO2 in the blood)
-Acidosis (O2 is low)
-Hypoxia (baby has to be when born)
-Increased CO2 prompts medulla to initate breathing

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

What can prolonged asphyxia cause in newborn?

A

CNS mediated respiratory depression

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

How do healthcare workers know what the pH of the newborn’s blood?

A

ABG drawn from the umbilical cord immediately after birth

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

What are signs of respiratory disress in a newborn?

A

-Grunting
-Nasal flaring
-Sternal retractions

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

Normal newborns will have periods of apnea lasting…

A

10 to 20 seconds

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

What sensory factors help with the first breath?

A

-Visual and auditory stimulation also help initiate cry
-Increased stimulation of the neonate during the birthing and drying process helps to initate a cry

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

What Thermal factors help with the first breath?

A

-Drastic change in temperature from 98 to 70-75 degrees prompts the newborn to cry
-Sensors in the skin respond to the drastic temp change, sending signals to the brain to initate respirations

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

How can cold stress be prevented?

A

Dry newborn and place baby in a radiant warmer or skin-to-skin

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

What Mechanical factors help with the first breath?

A

-Removing fluid from the lungs and replacing it with air on the first breath
-Fetal chest compression/ thoracic squeeze from the vaginal birth increased intrathoracic pressure helps push fluids out of the lungs
-Recoil of the chest wall after delivery of the trunk creates negative intrathoracic pressure

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

What 5 changes occur to the cardiovascular system after placental expulsion?

A

-Increased aortic pressure & decreased venous pressure
-Increased systemtic pressure and decreased pulmonary pressure
-Closure of the foramn ovale, ductus arteriosus, and venosus

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

What is the neutral thermal environment?

A

The range of temperature in which the newborn’s body temp can be maintained with minimal metabolic demands and oxygen consumption

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

What happens to the newborn when they experience cold stress?

A

Anerobic glycolysis
-Transforms glucose to lactate
-Will turn to lactic acid leading to a state of metabolic acidosis
-Only effective for 10 seconds to 2 min
-Breaksdown brown fat

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

Evaporation heat loss: Def & intervention

A

-Loss of heat when fluids cover the body are air-dried and converted into vapor
-Dry baby & keep them warm and covered

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

Conduction heat loss: Def & interventions

A

-Loss of heat to a cooler surface via direct skin contact
-Minimize, radiant warmer, blankets, covering scales, skin-to skin

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

Convection heat loss: Def & interventions

A

-Loss of heat from the warm body surface to the cooler air currants
-Avoid fans and drafts

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

Radiation heat loss: def & interventions

A

-Heat loss occurs when there is a transfer of heat between objects that are not in direct contact with each other.
-Prewarmed radiant warmer, avoid placement of cribs near walls or cold windows

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

What hematopoietic adaptations occur?

A

-Volume is determined by the timing of the cord clamping
-Helps enhance pulmonary perfusion
-Extra blood Increases risk for jaundice due to breakdown of the RBC leads to increase in bilirubin. Babies cannot easiy rid of bili quickly

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

What hepatic adaptations occur?

A

-Liver stores glucose for the use after birth
-Glucose provides ready energy source for brain and other vital organs
-1st 3 hours
-Can be depleated after a stressful event

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

What is acrocyanosis?

A

An expected finding at birth that shows oxygenated blood is shunted to the central area of the body and vital organs
-Only extremities are blue/purple or pale which is not true cyanosis

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

What are factors that affect the blood glucose of a newborn?

A

-Small or large for gestational age
-Mothers with DM
-Post-term or intra uterine growth restricted (insufficient placental nourishment

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

What are signs of hypoglycemia in a newborn?

A

-Irrtability/fussy
-Jittteriness/tremors
-Lethargy
-Cold

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

When is the best time to feed and bond with an infant during the behavioral states?

A

Quiet alert

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

What are GI/GU adaptations for a newborn?

A

-Size of neonate’s
stomach
* 6 ml at birth to 90 ml by end
of first week
* First meconium stool within 8-24 hours after birth
* Can pass 1-10 meconium stools within 24 hours
* No stool within first 72 hours may indicate bowel obstruction
* Initial bladder capacity
between 6ml-44ml
* Normally void between 2 and 6 times in a 24-hour period
* May pass glucose and protein in urine as kidneys learn to
concentrate urine
* Urate crystals (pink or red in color) may pass in urine causing urine to look pink (ends after 24 hours)

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

Where is passive immunity acquired?

A

From mother to baby through IgG from placenta
IgA from milk

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

What does apgar stand for?

A

Appearance, Pulse, Grimace, activity, respiration

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

What is a normal apgar score?

A

> or equal to 7

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

When is apgar conducted?

A

1 min & 5 min

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

What medications are given at birth?

A

-Eye prophylaxis: Erththromycin ointment for STIs
-Vitamin K: IM Vastus lateralis. 1 dose for clotting
-Hep B vaccine: IM Vastus lateralis in 3 doses. 1st one 1 hour after delivery. Signed consent needed if refused

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

Ballard scoring

A

Used to determine gestational age

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

Dubowitz exam

A

he method used at our institution to determine the baby’s gestational age. This examination evaluates both physical characteristics and neurological characteristic

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

How is weight recorded?

A

On a warm scale and in grams

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

How is length measured?

A

-In cm
-Crown to heal is the recumbent length

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

How is head circumference measured?

A

-Place tape measure
immediately above
eyebrows and pinna of
the ear and wrap around
the occipital prominence
at the back of the head
-Measure three times and
record the largest finding

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

How is chest circumference measured?

A

-Place measurement tape on
nipple line and wrap around
entire thoracic area
-Head and chest may be
equal during first few days of
life

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

How is abdominal circumference measured?

A

-Place tape above umbilicus and circle infants’ body
-Abdomen should be
same size as chest

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

What is included in the integumentary system for a newborn?

A

*Assess skin color visually first
*Always wear gloves during skin assessment to protect yourself from any infection processes
*Assess for any lesions, bruising or rashes
* Nevi
* Port Wine Spots
* Mongolian Spots
* Vernix
* Erythema toxicum
* Milia
* lanugo

*Sclera and conjunctiva
*Eye/Ear alignment
*Check head for size and shape of fontanels
*Check head for caput, molding, cephalohematoma
*Epstein pearls/natal teeth
*Cleft lip and palate

38
Q

What is a nevi (stork bite) & when will it go away?

A
  • Birth Mark
  • On back of neck or forehead
  • Usually disappears by 2 years old
  • Gets more red when baby cries
39
Q

Does a port wine stain (nevus flammeus) blanch or disappear?

A

No

40
Q

What is a mongolian spot and when will it go away?

A
  • Appear gray, dark blue,
    or purple
  • Back & buttocks,
    shoulders, wrists,
    forearms, ankles
  • Usually disappear by 2
    yrs old
  • More often seen in
    infants whose ethnic
    background include
    African American,
    Mediterranean, Latin
    American, Asian, or
    African
41
Q

Why do babies have vernix caseosa?

A

To protect their skin

42
Q

What is erythema toxicum?
-How long will it last and what is the tx?

A
  • Normal newborn rash
  • Transient rash
  • May start on face and
    spread to rest of body
  • Persists up to one month
  • No treatment needed
43
Q

What is milia?

A
  • Small white papule or
    sebaceous cysts
  • Disappear spontaneously
44
Q

What is lanugo?

A

Fine, downy hair on back, shoulders, head
* Preterm -more lanugo present
* Post term -skin is tough, leathery, cracked, peeling skin

45
Q

What is a normal ear/eye alignment supposed to look like?

A
  • Look for symmetry, noting
    placement of the eyes, nose, lips, mouth & ears
    A. Normal ear
    B. Low set ear
    C. Slanted low-set ear
    (chromosomal abnormalities)
46
Q

What should the fontanels not look like and will require emergency intervention?

A

-Bulging fontanelle in absence of crying can indicate increased intracranial pressure

47
Q

What is caput succedaneum?

A
  • Generalized tissue swelling
    that will go away
  • Edema that crosses suture
    lines
48
Q

What is a cephalohematoma?

A
  • Does not cross the suture line
  • Can predispose newborn to jaundice
49
Q

What shape is the anterior and posterior fontanelles?

A

A-diamond
P-Triangle

50
Q

What are natal teeth?

A

Natal teeth are usually loose and will need to be pulled to eliminate choking hazard

51
Q

What are epstein pearls?

A

-Will disappear within a few weeks (normal finding)
* Whitish hardened nodules on the gums or roof of the mouth

52
Q

What interventions are used to treat club feet?

A
  • Stretching
  • Casting
  • Surgery
53
Q

What is hypospadias & the tx?

A
  • Urethra on ventral side of penis
  • DO NOT CIRCUMCISE
  • Surgery to repair
54
Q

What are the type of circumcisions?

A
  • Yellen/Gomco -protects head of penis
  • Mogan -credit card
  • Plastibell -plastic ring & string lef
55
Q

What is needed in preparation of a circumcision?

A

Sterile, lidocaine, oral sucrose,
consent needed, radiant warmer

56
Q

Care for circumcision:

A

Q30min x 2hrs, check for
bleeding/infection, petroleum
ointment (NOT for plastibell), UOP by 8 hrs

57
Q

What are some risks for an uncircumcised penis?

A

UTI, cancer, STIs

58
Q

What should be included in the discharge teaching for a newborn?

A

▪Discharge Tests: Blood Pressure, PKU, O2 Sats
▪Bathing
▪Feeding: Breast & Bottle Feeding
▪Safety
▪Child Care
▪Follow-up Care

59
Q

What complications can happen a newborn that is small for gestational age?

A

-Cold stress
-Pain
-Hypoglycemia
-Polycythemia

60
Q

What complications can happen a newborn that is large for gestational age?

A

-Transient
Tachypnea of the
Newborn
-Hypoglycemia
-Hypocalcemia
-Hypomagnesemia
-Birth Injuries

61
Q

What are signs and symptoms of cold stress?

A
  • Lethargy
  • Bradycardia
  • Respiratory distress
  • Poor feeding
  • Cold pale or bluish skin
62
Q

What are s/s of pain in a newborn?

A
  • Tachycardia
  • Increased blood pressure
  • Shallow respirations
  • Pallor
  • Flushing
  • Diaphoresis
63
Q

What are complications of pre-mature newborns?

A

RDS, Apnea, Bronchopulmonary Dysplasia, Jaundice, Anemia, NEC, GERD, Retinopathy (from hyper oxygenation), Intraventricular Hemorrhage

64
Q

Necrotizing enterocolitis: Def and interventions

A

-Immature gut
-Do not give formula
-If suspected, stop feedings and report to PCP
-Antibiotics and complete rest

65
Q

What are complications for a post-term newborn?

A

Persistent Pulmonary Hypertension, Meconium Aspiration Syndrome

66
Q

What is physiological jaundice? Solution?

A

Appears after 24 hours
-Total bili rises by less than 5mg per day, gradual
-Bili is not extreted in the stool
-Serum stays at 15mg or lower
-Feed the baby so they poop

67
Q

What is pathological jaundice? Solution?

A

Appears within first 24 hours of age
-Increased of >5mg per day
-Serum is > 15mg
-Is persistent, 14+ days
-Stool is clay/white colored and urine will stain clothes
-TX: light therapy and feeding

68
Q

What can a serum bilirubin of over 15mg cause (in pathological jaundice) ?

A

Toxicity
-Kernicterus: Increase in bili circulating in the body and goes to the brain leading to neurological/ development disorders/issues

69
Q

What are s/s of Jaundice?

A

 Slight yellowish tint on the skin
 Yellow stains on the whites of the eye
 Yellow discoloration becomes more pronounced when you press on the
skin
 Aversion to feeding or unusually low appetite
 Increased drowsiness
 Restlessness
 More irritable than usual
 Dark, yellow urine
 Light-colored or pale stools
 Arching of the back
 A high-pitched cry

70
Q

What should be monitored when the baby is undergoing bilirubin light therapy (phototherapy)?

A

-Adequacy of hydration (urine
output) and nutrition (weight
gain). Assess diapers (count and COACH), cap refill, s/s of dehydration)
-Temperature continuous. Not on chest or areas of discoloration bc yellowing starts at the head and works its way down
-Clinical improvement in jaundice
-TSB or SBR levels (total serum
bilirubin or serum bilirubin)
-Potential signs of bilirubin
encephalopathy
-Cover eyes at all times and keep a diaper on
-Keep all other skin exposed for proper tx

71
Q

What should Phenylketonuria PKU avoid?

A

Phenylalanine Free Diet for
Life

72
Q

What should galactosemia avoid?

A

Galactose-Free Diet for Life

73
Q

What should a patient with Maple Syrup Urine Disease
(Branched-Chain Ketoaciduria) have in their diet?

A

Low Protein Diet and Thiamine Supplements for life

74
Q

What are s/s of congenital hypothyroidism?

A

Lethargy, Poor Feeding,
Constipation, Prolonged
Jaundice, Hoarse Cry,
Hypotonia, Slow Reflexes,
Delayed Growth and
Neurodevelopment

75
Q

How is congenital hypothyroidism dx?

A

Newborn Screening, Elevated TSH, Low T3/T4

76
Q

What medication is given for congenital hypothyroidism?

A

Levothyroxine

77
Q

What is anencephaly? How can it be prevented?

A

-Lack of skull & brain tissue formation
-Pre-pregnancy folic acid intake of 400mcg/day

78
Q

What is an encephalocele? Nursing care?

A

-Area where the skull did not fully form and there is blood tissue and fluids in a sack.
-Cover defect with warm sterile gauze to prevent infection until surgical intervention

79
Q

What is microcephaly?
Nursing care?

A

-Small skull and brain growth is stunned due to lack of space
- No treatment; supportive on-going care

80
Q

What is congenital diaphragmatic hernia (CDH)?

A

Hernia of the diaphragm that normally seperates the lungs from the bowels
-Bowels are in/near the lungs & can hear bowel sounds in the chest

81
Q

What are the nursing interventions in priority order for congenital diaphragmatic hernia?

A

-Protect airway
-NG tube insertion for decompression
-Surgical repair

82
Q

What is gastroschisis?

A

Bowels are exposed

83
Q

Nursing interventions for gastroschisis:

A

▪Sterile moist gauze and wrap in plastic
▪Fluid replacement at 1.5 times the normal
▪TPN, NO ORAL feedings
▪Prevention of infection (priority)
▪Pain management

84
Q

What is the prevention & tx plan for herpes simplex?

A

▪Prevention: No vaginal
delivery with active lesions
▪Treatment: Acyclovir

85
Q

What are the s/s of neonatal sepsis?

A

Subtle signs, behavioral
changes, hypothermia, lethargy, hypoglycemia, poor feeding, apnea, bradycardia

86
Q

What are the s/s of neonatal abstinenence syndrome?

A

Irritability, tremors,
wakefulness, uncoordinated feeding patterns, loose stools,
yawning, hiccups, poor weight gain, hypertonia, seizures, exaggerated rooting reflex, vomiting, tachypnea, apnea,
sneezing, stuffy nose, profuse sweating
Essentially withdrawal

87
Q

TPN benefits

A

Promotes positive nitrogen
balance, energy, and infant growth

88
Q

When can babt start breast/bottle feedings?

A

Begins at 32 weeks… if baby
stable
High calorie formula (preterm
formula

89
Q

When should surfactant therapy be done?

A

-1st 2-6 hours of life in baby more than 1000g
-Continued
mechanical ventilation after
administration helps the
medication to be spread
throughout the lung tissue.
- DO NOT SUCTION NEWBORN AFTER SURFACTANT IS PLACED
IN TUBE

90
Q

What is the criteria for the baby to be discharged?

A

Eating/tolerating full feedings
Maintaining own temperature
Consistently gaining weight
No apnea, bradycardia or
desaturation events for 5 to 7
days

91
Q

What should be included in discharge planning?

A

-Nutrition
-Condition Based
-Follow-up Care
-Safety
-CPR

Maternal Health (4 decks)

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