Final Exam Blueprint Flashcards

Question

Signs and symptoms of Mastitis

Answer 1

➤ Sudden onset of influenza-like symptoms:- * Chills * Headaches * Malaise * Body aches * High fever * Nausea & Vomiting ➤ Localized breast pain & tenderness ➤ Hot & red area on the breast 🔸 Most common in the Upper Outer quadrant of the breast 🔸Pts will need antibiotics & NSAIDs

Answer 2

- Temp (98.6-100.0 (rectal)) - HR (120-160) - RR (30-60) - BP: systolic 60-80; diastolic 40-50

Answer 3

To prevention of Ophthalmia Neonatorum cause by Gonococcal or Chlamydia

Answer 4

➤ Its the Gold standard for infant nutrition ➤ Its easy to digest ➤ It meets the nutritional needs for growing infants ➤ It improves the infants response to infection ➤ Its important in the regulation of inflammatory responses ➤ It contains immunologically active components that provide some protection against :- * Broad spectrum bacteria * Viral & protozoal infections ➤ Its highly complex with:- * Ant-infective * Nutritional components combined with growth factors, enzymes that aid in digestion & absorption of nutrients * Fatty acids that promote brain growth & development

Answer 5

- It’s the only thing missing from human breast milk Vitamin D is essential for :- * Facilitating intestinal absorption of Calcium & Phosphorus * Bone mineralization * Calcium reabsorption from the bones

Answer 6

- Vitamin K is required for Blood coagulation - Newborns don't have the intestinal flora to produce Vitamin K - So Vitamin K injection is given to every newborn at birth to prevent hemorrhagic complications in newborns

Answer 7

➤ Eat dry, starchy foods like toast or crackers on awakening in the morning ➤ Avoid drinking too much fluids in the morning or when nauseated ➤ Eat small amounts frequently like every 2-3 hours ➤ Avoid skipping meals ➤ Get out of bed SLOWLY ➤ Decrease intake of fried foods & other fatty foods ➤ Avoid brushing teeth immediately after eating

Answer 8

- Its used to confirm the hip dysplasia/ dislocation. - Hip integrity is assessed by using Ortolani Maneuver; only doctors or NP’s can do this! 🔸 Flex the infant's hips & knees to 90 degrees & apply pressure over the leg & gently adduct the leg with your thumbs. If the hip was dislocated a clunk will be felt as the hip relocates. This would be considered a positive ortolani test.

Answer 9

* Sucking /mouthing motions * Hand-to-mouth/hand-to-hand movements * Rooting reflex (infant moves towards whatever touches the area around the mouth & attempts to suck

Answer 10

🔸 Cradle position - Most common position for infants who learned to latch 🔸 Cross-cradle/Modified cradle positions - Across the lap - Works for smaller babies 🔸 Football/ clutch hold - Under the arm 🔸 Side lying - Allows the mother to rest while breastfeeding 🔸 Laid back position

Answer 11

➤ Infants should be exclusively breastfed for 6 months ➤ Breastfeeding should continue for 1 year & thereafter as desired by mother and infant ➤ Receive safe & nutritionally adequate complementary foods beginning at 6 months

Answer 12

🔸 Vision - Pupils react to light & they have the blink reflex. - They can see objects as far as 2.5ft - Clear visual distance is 8 -12 inches; this is kind of the distance between mom’s & infant’s faces during breastfeeding. (they can have blurry vision until a foot away) - Newborn’s prefer their mom’s face 🔸 Hearing - Prefer hearing their mother’s voice & rhythmic sounds - They recognize sounds & attempt to locate a source. - They are used to hearing a regular rhythm of mom’s heartbeat so this sound is very soothing to them. - You can even place a regular heartbeat stimulator nearby to help a fussy baby 🔸 Smell - Highly developed sense of smell & can react to odors. - Can smell their own mom’s milk 🔸 Taste & touch - Prefer sweet stuff & they respond to touch - Early skin-to-skin contact promotes tactile interaction & stimulation.

Answer 13

🔸 Skin is very thin at birth 🔸 Desquamation - skin peeling at few days old; happens more w post-term babies 🔸 Vernix caseosa - Its the cheesy white substance covering the body - It serves as a protective covering. ➤ Removal of this is followed by desquamation 🔸 Milia - Tiny white bumps usually on nose & forehead; these are sweat glands. 🔸 Congenital dermal melanocytosis - Also know as Mongolian spots - Its the blue/black areas of hyperpigmentation 🔸 Nevi - Also known as Stork bites - Are very common pink areas & require no treatment. 🔸 Erythema toxicum - Also known as Newborn rash - It looks alarming but doesn’t require treatment. ➤ Signs at risk for integumentary probs:- * Jaundice * Pallor * Lesions * Petechiae

Answer 14

- When the umbilical cord exits the cervical or before/below the fetal presenting part

Answer 15

- Long cord (longer than 100 cm) - Malpresentation (breech) - Transverse lie - Unengaged presenting part

Answer 16

➤ Put sterile gloves on and insert two fingers into vagina into the cervix. Push head back to relieve pressure ➤ Do not remove or move your hand bcoz you need to relieve cord compression! Have someone else put a towel under the woman's hip. ➤ Place women to extreme modified sims position or knee position (looks like doggy style) ➤ If cord is protruding from vagina, wrap it loosely in a sterile towel with saline. ➤ Administer oxygen with non-rebreather mask at 10L ➤ Start IV fluids ➤ Monitor FHR

Answer 17

🔸 VEAL * Variable decelarations (Cord Compression) * Early decelarations (Head Compression) * Accelarations * Late decelarations (Placenta insufficiency) 🔸 CHOP * Cord compression * Head compression * Ok * Placenta insufficiency 🔸 MINE * Move the mother (Change the position) * Intervention is not necessary * No intervention needed * Evaluate for why - Stop Pitocin - Give O2 - Give fluids - Reposition mother - possible c-section if persists

Answer 18

G2, T0, P1,A0, L1

Answer 19

🔸 Variability - is the fluctuation in the baseline FHR. ➤ Absent - 0 bpm - Undetectable or abnormal - Fetal hypoxemia or metabolic acidosis ➤ Minimal - < 5 bpm ➤ Moderate - 6 to 25 bpm - Normal ➤ Marked - > 25 bpm - Unclear significance ➤ Sinusoidal Pattern - Wavy line - Its a fatal sign (NOT A GOOD SIGN)

Answer 20

➤ Cord care is done to prevent or decrease risk of hemorrhage or infection becoz the stump is at risk for bacterial growth. ➤ Clean cord with water (Don't use an antiseptic) ➤ The plastic cord clamp that was applied at birth is removed once the stump has dried typically in 24-48 hrs. - Stump should be assessed for edema, redness, & drainage. - Area should be kept clean, dry, open to air, & loosely covered

Answer 21

🔸 Venipuncture & urine specimen & Newborn screening:- ➤ Screening for Genetic, Endocrine & Metabolic disorders - Screening is important for early detection of genetic diseases that result in severe health problems. - Blood samples are used to screen for those disorders; capillary heelstick! ➤ Newborn hearing screening - Rubber earpiece is placed in babies ear & in a healthy ear you can hear an “echo” ➤ Screening for critical congenital heart disease - Pulse ox is used to detect hypoxemia; if its at 90% you need to assess the baby

Answer 22

➤ Circumcision is removal of the foreskin (prepuce) of the penis ➤ Baby can be fussy, have disturbed sleep-wake states & disorganized feeding behaviors after the procedure. ➤ If bleeding occurs on an incision site nurse should apply gentle pressure with a gauze pad. ➤ Infant should have a wet diaper 2-6x every 24 hrs ➤ Keep the area clean & cleanse penis w water only; DO NOT USE BABY WIPES ➤ Apply diaper loosely to prevent pressure ➤ The glans of penis is dark red after circumcision & then becomes covered in yellow exudate (this is normal, DO NOT remove the exudate becoz its granulation tissue) ➤ Redness, swelling, discharge & odor indicates infection ➤ Nurse provides education to parents; discomfort for the baby will subside

Answer 23

➤ Hyperbilirubinemia is associated with high levels of bilirubin ➤ Physiologic jaundice requires no treatment; its caused by high levels of unconjugated bilirubin; it appears after 24 hrs & resolves in 1-2 weeks. ➤ Pathologic jaundice requires phototherapy to help treat becoz these are even higher levels of unconjugated bilirubin ➤ Phototherapy converts bilirubin to a form that can be excreted via urine & poop. Baby should only wear diaper! ➤ Exchange transfusion: when phototherapy is not effective this may be needed. A portion of the infant’s blood is replaced with donor blood. 🔸 Screening process: - Measure total serum bilirubin by getting blood from babies heel (heel stick)

Answer 24

➤ Early & regular feedings can help prevent this. 🔸 Symptoms of Hypogycemia * Jittery * Apnea * Seizures * Lethargy * Poor feeding * Abnormal cry * Hypotonia * Hypothermia, * Respiratory distress

Answer 25

🔸 Pain can cause:- * ↑ HR * ↑ or ↓ BP * Rapid, shallow respirations * Baby has high pitched & shill cry 🔸 Facial expressions include:- * Grimacing * Eye squeeze * Open mouth * Quivering tongue

Answer 26

🔸 Non-Pharmacological Interventions - Swaddling - Breastfeeding - Skin-to-skin contact - Tucking - Pacifier use - Oral sucrose 🔸 Pharmacological interventions - Non-opioid analgesia eg. (tylenol can be used for mild to moderate pain)

Answer 27

Bacteria that synthesize vitamin K are not present in the newborn’s intestinal tract/ help with the clotting factors

Answer 28

- Most common endocrine disorder associated with pregnancy!!!!! * High risk * Key to an optimal outcome is strict maternal glucose control of HbA1c optimal between 5-6%

Answer 29

➤ If you had diabetes before getting pregnant, its not gestational! ➤ Any degree of glucose intolerance with onset or recognition during pregnancy ➤ Glycosylated hemoglobin A1c * 5-6% optimal level to avoid babies that are too large (macrosomia) ➤Screen at 24 to 28 weeks with glucola drink * If blood sugar is too high, you have to do a 3 hour test and get blood drawn once every hour 🔸 Antepartum care * Diet & exercise * Insulin therapy * Monitor blood glucose levels * Fetal surveillance! 🔸 Intrapartum * Avoid dextrose solutions * Monitor glucose hourly🔸🔸🔸 🔸 After birth care * Encourage breastfeeding to decrease risk of getting type 2 diabetes after GDM 🔸➤ After birth reassess at 6-12 weeks because gestational is supposed to go away!

Answer 30

➤ 6 - 6.5 A1c before pregnancy may be an indicator

Answer 31

➤ Its HTN in pregnancy ➤ Most common medical complication reported during pregnancy ➤ Pregnancy specific condition in which hypertension and proteinuria develop after 20 wks gestation in previously normotensive women:- * HTN & protein in urine * Reflexes increased (+3 or +4) * Seizures (eclampsia) ➤ Resolves after placenta is expelled (usually) 🔸 Care management of Preeclampsia * Magnesium sulfate (always have calcium carbonate at bedside)

Answer 32

➤ Its a lab diagnosis for preeclampsia that involves hepatic dysfunction ➤ Can develop in women who do not have HTN & proteinuria ➤ Most common in White women * Hemolysis, Elevated Liver enzymes, Low Platelets * Diagnosed by labs * Increased risk of maternal death * Super sick ➤ HELLP Syndrome can cause * Pulmonary Edema * Acute renal failure * Placental abruption * Liver hemorrhage/failure * Acute respiratory distress syndrome * Disseminated intravascular coagulation (DIC)

Answer 33

🔸 Keep the bulb syringe easily accessible and visible - Its used only when there is a concern that the airway is obstructed. - This suctioning can cause trauma to the nasal mucosa 🔸 Suction Mouth before the nose - This prevents the infant from inhaling the pharyngeal secretions by gasping as the nares as touched 🔸 Compress the bulb and insert the tip into one side of the mouth. - Avoid the center of the infant's mouth becoz the gag reflex can be stimulated 🔸 Gently suction one nasal passages at a time 🔸 Stop suctioning when the airway is no longer obstructed 🔸 Clean the bulb with warm soapy water & rinse thoroughly after each use

Answer 34

- Focuses on the non-separation of mothers & babies (rooming in) to reduce the need for a separate nursery

Answer 35

Circumcision

Answer 36

The first 24 hrs

Answer 37

* Cyanosis * Stridor * Gasping * Wheezing * Nasal flaring * RR < 30 or >60 bmp * Retraction btw the ribs

Answer 38

- Its the period btw Birth & day 28 of life - Major adaptations occur the First 6-8 hours

Answer 39

- It lasts for 30 mins - HR ↑ btw 160-180 bmp (1st 30 mins) - HR ↓ after 30 mins to baseline (120 -160 bmp) - Infant alert & has spontaneous startles, Crying & head movements

Answer 40

- Lasts from 60 - 100 mins (1-2 hrs) - Infant is pink - RR are rapid & shallow up to 60 bmp - Baby is asleep or contented (has a marked decrease in motor activity)

Answer 41

- Lasts from 10 min - several hrs - Infant is wide awake, alert - Occurs btw 2 - 8 hrs after birth - Tachycardia & tachypnea occurs intermittently - Meconium may be passed - Increased muscle tone, Change in skin color (skin pinks -up) & mucus production

Answer 42

The thin layer of SubQ fat provides poor insulation