Maternal Newborn Flashcards
Hyperemesis gravidarum (severe vomiting and nausea with preganancy)
Indication that one has it?
Ketonuria - which occurs due to breakdown of fat due to malnutrition or starvation
Tachycardia / dehydration
Tachypnea
Indication of preeclampsia
Proteinuria
Nausea and vomiting during pregnancy?
Avoid not eating because it increases nausea
EatSmall frequent meals throughout the day
Eat foods that are served cold or at room temperature
Drinking fluids with meals increases nausea-Alternate every 2 to 3 hours between food and fluids
Eat a snack High in carbohydrates such as crackers before getting out of bed in the morning to decrease nausea
Who can transport the newborn to a different room?
Only facility staff with appropriate identification badges that indicate the nurse works specifically in the maternal newborn unit can transport newborns
Also the newborn must be in a designated bassinet
Interventions to treat breast engorgement During breast-feeding
Breast-feed the newborn every two hours during engorgement. This will soft in the breast and decrease pain
Drink enough fluids to satisfy Thirst
Apply cold pack compressed to the breast after feeding to decrease discomfort
A warm shower immediately before breast-feeding will soften the breasts
Use a breast pump during engorgement too soft in the breasts prior to breast-feeding
Hypotonic uterus (weak contractions) with vagina bleeding priority action of the nurse
Patient is at risk for postpartum hemorrhage
The first action the nurse should take is provide fundal massage to increase uterine muscle tone and move blood clots from uterus Which will decrease bleeding
Then…
Urinary cathedar to eliminate Bladder distention
Methylergonvine IM to enhance uterine contractions
Administer oxygen by face mask to increase o2 in cells
Butorphanol teaching?
This medication is an opioid medication which can cause:
dizziness, sedation, hallucinations
respiratory depression
Duration of action is 3 to 4 hours
constipation, nausea, vomiting, confusion, seems
What to report in second trimester of pregnancy
Frequent uterine contractions (can cause cervix to open early and start preterm labor)
Expected findings in pregnancy
Leukorrhea?
Hyper-pigmentation of face ?
Varcriose veins ?
Tingling of fingers ?
Leg cramp?
Wbc count of 15k
Labia edema
Firm fundus at belly button 6 hrs after birth
This is the whiteish discharge due to the hormonal changes that occur during pregnancy
This is known as the mask of pregnancy due to hormonal changes
Hormonal influence on the smooth muscle walls of veins
Tingling of fingers is a common discomfort of pregnancy cause by traction on the brachial plexus and slumping of the shoulders
Leg cramps are common and caused by compression Of the nerves by the enlarged uterus
Apply ice pack for labia edema and pain
Normal heart beat of newborn
110-160
100-180? While crying
Calcium level normal nb range?
7.6-10.4
Normal glucose for newborn ?
30-60
Normal newborn temp
97.7-99.5
Potential complication of pregnancy ?
Epigastric pain
Sign of postpartum hemorrhage and should be reported to doctor ?
Soaking a pad in 15 minutes or less
Expected findings in new born
Vernix in the skin folds
Positive Moro reflex from birth to 8 weeks
Apneic episode of 20 seconds or less - shallow and irregular respiration’s
What medication is contra indicated with the use of Nifedipine?
Magnesium sulfate (treatment of hypertension or sezures In preeclampsia) can cause weakness or paralysis
This medication is a hormone, which is used to facilitate the induction of labor or to control postpartum bleeding after expulsion of the placenta
Oxytocin
This is an antiemedic
Use for the prevention of nausea and vomiting
Promethazine
A Nurse should administer terbutaline to a client who is experiencing preterm labor by which route?
Subcutaneous-
It relaxes the smooth muscles and uterine activity. It should be administered every four hours
Mastitis teaching?
Warm compress to affected breast
Antibiotic medication
No underwire bra
Continue breast feeding
Contraception methods ?
Only water soluble lubricants should be used with Male condoms
The diaphragm should be left in place for at least six hours after intercourse
The sponge should be left in place for at least six hours but less than 24 hours after intercourse due to risk of toxic shock syndrome
The patch is changed weekly for three weeks following by one week in which the client does not wear the patch
How to prevent infant abduction
Ask the nurse to take care of the baby in the nursery when mother needs a nap – Never leave infant alone
Always wheel infant in a bassinet when transported to another location
Staff should always wear identification
Always make sure the newborn security band is in place – if removed alarm will sound
When to report maternal bp ?
Fetal hr ?
Fundal height ?
Weight?
140/90 or higher
110-160 is normal
Fundal height is same number of weeks of gestation plus or minus 2cm
Gain about .9 lbs per week in mom
Why folic acid is important ?
Prevent birth defects
Prevent neural tube defects and storage of iron in fetus liver
Best source of folate ?
0.5 cup- Dried peas (green split peas)
Tonic neck reflex?
Crawling reflex?
Moro reflex ?
Magnet reflex ?
Neck turned to one side
Placed on abdomen
Fingers form C shape
Pressure against soles of feet
How to prevent engorgement during lactation
Apply cold cabbage leaves or ice pack to breasts
Take mild analgesics
Wear well fitted bra with no underwire
Do not use pump or massage breasts because it can increase milk production
Consistent headache at 37 weeks of gestation? What does it mean
This could mean pre-clampSia
What does numbness of fingers at 26 weeks mean ?
Brachial plexus traction syndrome
Drooping of the shoulders
What to do for hypovolemic shock ?
Out in side or elevate right hip
Elevate legs 30 degrees
Administer oxytocic medication to increase contraction
Give 10L oxygen to improve oxygen
Insert urinary cathedar to monitor output
What medication causes uterine relaxation
Terbutaline
Formula feeding on newborn
Will drink about 15-30mL per feeding
Feed for 20-30 min
Burp through out feeding
Ecchymosis/edema pain of 6 out of 10 and fundus of 2cm above belly botton - what isnoriority ?
Help client to toilet to empty bladder first …
Then breadfeeding , ice pack, pain meds
Infant car seat safety
Rear facing until 2 y old
Turn of airbag if no backseat
Place car seat at 45 degrees
Secure seat with cars seat belt
Normal findings during the postpartum. Within 24 hours of delivery?
Diuresis (increase urine)
Discharge of clear yellow fluid from the breasts which is called colostrum
Lower ab cramping due to the uterus decreasing in size
When does lochia serosa occur ? Pink or brown a vagina discharge
3 to 4 days after delivery
Hydrotherapy teaching?
You need to be active in labor before using it
Water temperature should be between 96.8 to 98.6
The client may retain in the tub for as long as they want as long as the fetal heart rate remains with an expected reference range with breaks after 30 to 60 minutes
The nurse will use a Doppler stethoscope to monitor the fetal heart rate
The mother is receiving magnesium sulfate and has preeclampsia. What to include in teaching?
Just your clients fluid intake to no more than 125 mL per hour to prevent fluid overload
Blood pressure should be taking every 15 to 30 minutes because hypotension is an adverse effect of the medication
The medication can cause respiratory depression and the nurse should monitor the clients respiratory status every 15 minutes
The fetal heart rate will be continually monitored while receiving this medication
Newborn normal labs ?
Hemoglobin?
Platelets ?
Glucose?
WBC?
14-24
150k-300k
30-60
9k-30k
What nifedipine does ?
Dexamethasone? (Glucocorticoid)
Glyburide?
Antiemetic/ metoclopramide?
Decrease uterine contractions
Acceleration of lung maturity
Control glucose
Decrease nausea
Indications of respiratory distress
Tachypnea – heart rate greater than 60 /minute
Nasal flaring
Retractions
Expiratory grunting
When to give phytonadione?
Needle?
Where?
Immediately after birth or after initial breast-feeding to prevent hemorrhagic disease
5/8- inch needs
Vastus lateralis
Single dose
Finding to report at 30 weeks ?
2+ urinary protein (preeclampsia)
Report to provider of 40 weeks active labor ?
Prolonged deceleration of FHR
Temp 100.4 or above
Normal contraction times in active labor
Q 3-5 min
What to do to promote comfort in client in active labor?
Breathing exercises
When to tell client to push?
10 cm in second stage
When should sedative be given in labor ?
No less than 12 hour prior to birth
When to give nerve block ? In labor
Second stage of labor 10-20 min before birth
Antidote for magnesium sulfate toxicity?
Calcium gluconate
Antidote for heparin toxicity
Protamine
Treatment of allergies And decreases the symptoms associated with histamines
Diphenhydramine
How to prevent supine hypotension at 16 weeks of gas station
Lay on left side with head elevated on a pillow
When apply stockings were vercose veins
Before getting out of bed
How much sodium to intake during pregnancy
1.5 to 2.3 g daily
Hep B instructions
Handwashing, and do not share razors or toothbrushes, use a condom, Do not share drinking glasses or silverware
Receive the hepatitis B immune Globin immediately
Begin receiving vaccine series within 14 days of last known exposure to the virus or following positive test result
It can be transmitted to the fetus but risk is reduced when infection occurs before the end of the third trimester
Normal labs ?
Bun ?
Hematocrit?
Creatine?
10-20mg
33 or higher
.5-1
Methylergonovine adverse effect
Herpertention
To report to the doctor at 36 weeks
Blurred vision because it is an indication of preeclampsia
The nurse should do what for the infant who is receiving phototherapy
Place mask over eyes
Position the infant every 2 to 3 hours during phototherapy
Is your infant is adequately hydrated
Circumcision plan of care teachings
Monitor the site for bleeding and apply gentle pressure with sterile guys at the site
Apply diaper loosely
Wash penis with plain warm water
Apply petroleum got to the penis for the first 24 hours after circumcision
How to bathe newborn?
Keep newborn wrap tomorrow washing her hair which will help prevent heat loss
Avoid checking power on to the newborn skin due to possible rest of inhalation
Hunted swabs can cause injury to the newborns ears. Use washcloth
Do not rent under running water due to possible temperature change
What do you teach a client who has a prescription for serious sulfate?
Increase fluid intake while taking this medication to at least 2 L of water per day to decrease constipation
Take on an empty stomach
Do not take with milk or tea
Vitamin C such as fruit increases absorption
Take a Mr. Smith and 13 hours at the scheduled time but do not double dose
