FINAL blue print Flashcards by Yuko Porter

Respiratory distress
What we do?

Oxygen therapy!!
Prevention of cold stress and infection

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Respiratory distress
why?
causes?

a lack of surfactant in the lungs
-premature infant
-C-section delivery
-a mother that has diabetes
-infection(lungs inflamed)
-cold stress

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Respiratory distress
s/s

Apnea/ Longer than 15 sec
Cyanosis
Grunting, nasal flaring
Poor feeding
Tachypnea (more than 60)
TTN

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Meconium aspiration
What to do?

Life-threatening!!
Oxygen therapy!!

suctioning at birth harm vocal cords NOT even effect meconium decrease

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Meconium aspiration
why?
s/s

postpartum fetal d/t poor perfusion
Respiratory distress

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Fetal infection
s/s

Any signs of respiratory distress
Temperature instability
Lethargy 無気力
Irritability 過敏
Pallor
Cyanosis
poor feeding
Vomiting

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Fetal infection
treatment?

antibiotic
collect the culture before it starts!!

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hypoglycemia
risk factors?

Glucose <45 mg/dL with 24hr
LGA, SGA
Maternal diabetes
macrosomia infant (>90th percentile)

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hypoglycemia
what to do?

Early breastfeeding!!!
Skin-to-skin with the mother

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Neonatal Abstinence Syndrome (NAS)
Recognize behavior

High-pitched cry
Tremors, muscle stiff
tachypnea
Fussy with frequent sneezing and jittery movements
poor feeding/no sleeping

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Neonatal Abstinence Syndrome (NAS)
intervention

hold them a lot, skin-to-skin
offer a pacifier
frequent small feeding
position on the right side or semi-Fowler

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Jaundice
a) Physiological
b) Pathologic

a)on days 2 to 4
immature liver function
b) within the first 24 hours!!!
d/t ABO incompatibility

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Jaundice
intervention

Phototherapy
increased frequency of breastfeeding

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Prematurity
#1 problem is?

RDS!
immature lungs
Place in a side-lying or prone position to improve oxygenation

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Prematurity
#2 problem is?

Aspiration!
DO NOT bottle feed a baby in respiratory distress!

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Prematurity
Heat loss
intervention

Keep them warm!
they don’t have enough fat to maintain temp!

Prematurity
Weight loss
intervention

d/t weak suck and poor absorption
Semi-elevated, side-lying position
Tube feedings
IV fluids
Consultation with a speech therapist

Babies in NICU
parents support

Kangaroo care
-encourage a mom to hold a baby
-encourage them to visit their baby often
Includes parents as part of the care team

Perineal hematoma
how do we know?

The uterus is firm, but the mom is still bleeding
Mom stated a strong pain

Perineal hematoma
causes?

Forceps deliver (tool)
Precipitous birth (within 3 hr)
3rd or 4th degree
Large baby
First-time mom

Perineal hematoma
intervention

Call the provider immediately
need to suture

PPH
how do we know?
what to do?

Pad saturated <15 mins
Uterus massage till it gets firm

Risk Factors for PHH
#1 cause?

Uterine atony
-a full bladder
-big baby
-prolong labor
-administered Mg

Risk Factors for PHH
Other than uterine atony

Infection
Lacerations
Placenta fragment

baby blue?

on 2nd day and lasts 1-2 weeks normal finding, rapid hormonal change resolves without intervention

Postpartum depression (PPD)?

within 1 year of delivery sadness persists beyond 2 weeks intense mood swing rejection of infant flat affect

Postpartum psychosis?

within 2 weeks hallucinations, destinations history of bipolar The biggest concern is harming their baby and harming themselves!!!!

Postpartum　Mood disorders Interventions

Encourage bounding Encourage them to share their feelings Ensure the baby’s safety

Mastitis s/s

in the first 2-8 weeks warmth, redness, and swelling of one breast ful-like symptoms

Mastitis interventions

Completely empty out!! Cracked nipple( nipple to air dry) educate proper infant positioning Education about hygiene Encourage good fluid intake Ice pack may apply

Endometriosis S/S Intervention

Pelvic pain Fever, chills, flu-like symptoms Collect virginal and blood culture Administer antibiotics

UTI S/S Intervention

Urinary frequency Pain while urinating Cloudy urine Obtain urine samples administer antibiotics

Surgical Site infection S/S Interventions

Redness Warmth Edema Purulent discharge Increased pain Fever greater than 100.4 C-section is at risk!!

Thromboembolism how to prevent?

Ambulation ASAP!!! If a mom cannot get out the bed yet, then SCDs Elastic hose socks ROM in the bed

Thromboembolism how to care?

Bed rest is important -prevent clots travel to the lungs or brain -elevate the affected leg -monitor for bleeding while receiving anticoagulant medication DO NOT massage

Methylergonovine Maleate (Methergine) Used? ADRs ?

Controlled PPH Assess uterine tone and virginal bleeding Headache N/V Contraindication Hypertension!!

Carboprost (Hemabate) Used? ADRs ?

Controlled PPH Fever, chills Headache N/V Major GI issue!! Uncorralled diarrhea and vomiting=hypovolemia