Maternal Newborn 2 Flashcards
Crib slats should be no more than how far apart to prevent entrapment/fractures/suffocation?
2.25 inches
Space between mattress and the sides of the crib?
Less than two finger widths (.8 inches)
How often to check smoke detectors to ensure proper functioning?
How often to replace batteries?
Once a month
Twice per year
Set water heater to what degree?
Set bath water to?
120.2 F or less
100 F
16 weeks pregnant with diabetes and BMI of 31 (overweight) what to include in teaching about diet ??
If BMI greater than 30- limit total caloric intake to 25 kcal/day or less
Do not skip a meal (eat on a schedule) to prevent hypoglycemia and ketoacidosis
Carbs 55% , Protein 20%, Fat 25%
Eat large bedtime snack with at least 25g of complex carbs
How often one should formula feed newborn?
3-4 hours
How much will new born drink of formula during first 24-48 hrs?
15-30mL
Why not to feed newborn water between feedings
Formula Contains enough water to meet newborns fluid needs
Feeding water between feedings can lead to improper calorie intake
How often to burp newborn during feeding ?
A few times during the feeding
to reduce spitting up after feeding
How to listen to fetal heart tones at 12 weeks (3 months)
Ultrasound stethoscope
When should the nurse obtain a blood sample for the MSAFP (maternal serum alpha - fetoprotein) screen?
Between 15 and 20 weeks of gestation
The AFP blood test determines how much AFP is in the mother’s blood.
High levels of AFP may suggest the developing baby has a neural tube defect such as spina bifida or anencephaly
When should the nurse collect a vaginal and anal specimen for GBS? Guillain-Barré syndrome (Streptococcus group B) (rare disorder in which a person’s own immune system damages their nerve cells, causing muscle weakness and sometimes paralysis)
35 -37 weeks
When to measure Fundal height for gestational age?
Between 18 and 30 weeks
What actions should the nurse take for a client who is 18 hours postpartum and his 4th° perineal laceration? Client says the pain is a 4
Witch hazel pads
(cleanse and condition your skin gently and thoroughly. helps tighten pores and tone skin without drying, leaving skin feeling clean, soft and refreshed)
Give ice packs
Cool water sitz bath
Practice relaxation techniques
Client teaching before taking medroxyprogesterone acetate injection for contraception ?
Client may gain weight on this med
Client may also have decrease in bone density (take calcium supplement)
This medication is safe with lactation, however client should wait six weeks after delivery to start medication if breast-feeding
Client will receive injection every 11 to 13 weeks (3 months) as a form of contraception
What finding to report to dr at 38 weeks ?
Glycosuria - (excess sugar in urine - complication of gestational diabetes)
Expected finding of pregnancy?
Leg cramps- poor circulation
Insomnia- physical discomforts
Leukorrhea - Due to an increased amount of cervical mucus from hormonal changes
Best source of folate ? How much a day?
1 cup cooked spinach
600 mcg
What to do for a client receiving betamethasone for preterm labor)
Inject IM in vastus lateralis
Side effect of terbutaline? (treatment of asthma)
Dizziness
Which electrolyte level to monitor for when giving magnesium sulfate?
Magnesium
What is a contraindication (when not to use) for the use of oral contraceptives?
Frequent headaches with visual changes
(It can indicate a cardiovascular conditions such as hypertension) It can lead to increase risk of stroke, heart attack, thromboembolism
Some Antibiotics and antiviral meds (for oral contraceptives- reduce effectiveness)
Serious disorders such as gallbladder disease and liver cirrhosis
UTI prevention teaching for 25 week gestation ?
Empty bladder before going to bed at night
(a full bladder Provides environment that can grow bacteria)
Wipe from front to back
Where all cotton undergarments to avoid trapping heat and moisture
Education about prevention of newborn abduction?
An alarm will sound of someone removes the newborn safety device
The client should only transport newborn between the nursery and room in a bassinet
Never leave a newborn unattended even while showering
Only facility personnel with badges indicating that the individual work specifically in the maternal newborn unit should transport newborns
What is a non-stress test?
Used to determine FHR, baby’s movement, contractions (changes of heart rhythm when moving and contractions )
Client teaching about non-stress test at 33 weeks?
Press the button when you feel the baby move
Eat and drink as usual prior to the test
The stress monitors for accelerations in the fetal heart rate with fetal movement
contraction stress test teaching?
measure the baby’s heart rate during uterine contractions During contractions, the flow of blood and oxygen to the placenta temporarily slows down.
measure the baby’s heart rate during uterine contractions
Might require a IV infusion for the administration of Oxytocin
Might require the client to perform nipple stimulation to initiate contractions
Postpartum discharge teaching instructions
Do not use powder on newborn due to aspiration
Use a firm mattress in the newborns crib to reduce SIDs
Do not put pillows or comforters in crib
Place in Supine position
Car seat safety with a newborn
Place in car seat rear facing in the middle of the backseat until two years old or until weight and height restrictions are ok
Position the retainer clip at the level of the babies armpits
Play shoulder harness straps in the slats at or below the level of the newborn shoulders
The guardian should position the newborn in the car seat at 45° angle to prevent the newborns head from falling forward which can lead to airway obstruction
What to do for constipation and pregnancy?
Drink 2L water/ day
Do not take mineral oil - depletes vit A,D, E, K
Avoid enemas because it can trigger labor or cause injury to client or fetus
Do not take docusate sodium because it can cause dependence and electrolyte imbalance
What to report with a pt taking oxytocin
Stimulates uterine contractions
If urine output is less than 120 mL q 4 hours -
can indicate urine retention which can lead to hyponatremia and water intoxication
Nausea, vomiting, headache, hypotension
More than five contractions in 10 minutes or single contractions lasting longer than two minutes