Maternal Test - Feb 2016 Flashcards
What is the most important vital organ that needs to be adequately functional in the neonate?
Lungs!
Pulse decreases to ___ for the first ___ days
50-70, 6-10 days
Pulse remains decreased for ___, when it returns to normal
8-10 weeks
Pulse >100 indicates what?
Hypovolemia and/or infection
Respiration decrease to within normal prebirth by ___
6-8 weeks
There should be a small transient rise of blood pressure within the ____?
Last 4 days of postpartum (watch for orthostatic hypotension first. 48 hours as a result of abdominal engorgement also could be late sign of pp hemorrhage)
Temperature: In 24 hours, temp may increase to ___ as a result of ___
38 degrees, dehydration
After ___, mother should be afebrile?
After 24 hours
Blood pressure decreases within ____ and returns to non-pregnant values by ___
1st 2 weeks; 6 months
What is total weight loss expected for mom?
19-25 lbs
Weight loss for perspiration and diuresis in 1st week pp (affected by amount of edema in mom)
5-8lbs
Weight loss from uterine involution/lochia over 6 weeks?
2-4 lbs
Weight loss from fetus, placenta, amniotic fluid, and blood loss at delivery?
12-13 lbs
If you see a chart and it says u/2, what does that mean?
Fundus is 2 fingerbreadth below the umbilicus
If you see a chart and it says 1/u, what does that mean?
Fundus is 1 figerbreadth ABOVE the umbilicus
When does Rubra occur?
2-3 days post delivery
When does Serosa occur? How long does it last?
3-4 days postpartum, lasts 10 days
How long does Alba last?
Last 2-6 weeks after birth
What amount of fluid is considered “light?”
Less than 10 cm
What amount of fluid is considered “scant?”
Less than 2.5 cm
What amount of fluid is considered “moderate?”
More than 10 cm
What amount of fluid is considered “heavy?”
1 pad an hour
H & H increases by ___?
7th day pp
Expected blood loss for vaginal delivery?
250-500 cc (700-1000cc for c-section)
When does onset of first menses occur?
7-12 weeks in nonlactating mothers
When does menstratiojn begin for bottlefeeding moms (only if exclusively breastfeeding)?
6-10 weeks, 90% resumed by 12 weeks
If you breast feed for longer than a month, how long will menstration be delayed?
MEnstration delayed 3 months?
AWHONN’s role in establishing standards of care by..
providing support and critical information to deliver the highest quality care for maternity and gynecological nursing
When caring for a muslim mother, do not feed them..
pork, caffeine or alcohol
When caring for an asian mother, they may refuse
iron and eggs
neonatal mortality rate
death of infants in less than 28 days of age. number of deaths of infants within 1,000 live births
risks for neonatal mortality rate
low birth weight, preterm birth, developmental disabilities
goals of healthy people 2020
increase the percentage of women who receive early prenatal care, increase the proportion of mothers who breastfeed, decrease the number of low birth rate babies, decrease preterm births, increase percentage of babies put on their backs, and increase in abstinence from substance abuse
ballard scale
assesses neuromuscular and physical maturity. Totals are added to give maturity rating. 35 points means 38 weeks gestation
gestational assessment is performed at…
2-12 hours after birth
low birth weight
2500g or less
a baby is considered preterm if it is how many weeks?
37 weeks or less
vital sign sequence for assessing a newborn
respiration, heart rate, BP then temp
BP range should be..
Systolic- 60-80
Diastolic- 40-50
KNOW 78-42
Temp for a newborn should be..
- 5-37.2 C
97. 7- 98.9
Jaundice may appear on what day after the newborn is born?
third day
Lanugo is typically found where..
forehead, shoulders, pinnas, back
greatest at 28-30 weeks
head circumference of a baby
33-35cm or 13-14in
chest circumference of a baby
30-33cm or 12-13 in
anterior fontanels should be what shape
diamond
posterior fontanels should be what shape
triangular
caput succedaneum
DOES cross the suture lines, localized swelling of soft tissues caused by pressure on the head during labor
Cephalohematoma
DOESNT cross suture lines, it occurs when there is a collection of blood between the periosteum and skull bones which results form pressure or trauma during birth such as pressure against maternal pelvis.
Hgb lab values for infant
14-24 g/dl
Hct lab values for infant
44%-64%
Bilirubin levels for infant..
0-6 mg/dl—1 day
8mg/dl or less–2 day
12mg/dl or less–3 day
glucose level for an infant
40-60 mg/dl
if infant has a temp of less than 36.5 or 97.7 they may be
hypothermic
Hct levels for an adult
40-50 for adult
35-45 for women
conduction
heat loss involved when there is direct skin contact with a cooler object
convection
heat loss involved when there is cool air (air conditioning)
Vitamin K administered. How much and why?.
0.5-1mg IM in vastus lateralis within 1 hour after birth
Babies do not produce vitamin K in the gut until about day 8. this helps any hemorrhaging that may occur
Hep B shots
if born to a health mother, should be administered at birth, 1 month then 6 months. Should not be given in the same thigh as the vitamin k shot
newborns should be warmed slowly within a
2 to 4 hour period
Barlow maneuver
rules our possibility of developmental dysplastic hip. Examiner will adduct the infants thigh and apply gentle pressure downward
brazelton neonatal behavioral assessment scale
assessment tool that identifies newborns behavioral responses to environment and documents neurologic capabilities.
mottling
lace like pattern of discoloration of the skin
Rubella vaccine should be administered prior to
discharge. They are instructed to avoid pregnancy for 3 months due to live immunity
Maternal pulse postpartum
decreases to 50-70 bpm for the first 6-10 days but returns back to normal within 8-10 weeks
Respirations postpartum
decrease to within normal limits by 6-8 weeks
Blood pressure postpartum
small transient rise withing the first 4 days. watch for orthostatis hypotension for the first 48 hours
H& H increases by
7th day postpartum
WBC in postpartum mother
25000=35000 but if there is a 30% rise within 6 hours there may be pathological infection
after two weeks postpartum the uterus should be located in the..
pelvis
anesthesia prolongs involution– true or false
true
What drug remains the first line drug for excessive bleeding related to uterine atrophy
pitocin
Record the first two voids after post partum true or false
true
if patient has not voided 6-8 hours after delivery then ..
use straight cath
profuse diaeresis of post partum mother occurs..
at night within the first 2 to 3 days post partum
Postpartum chill
this occurs when the mother has excess adrenaline, decrease in pressure on the pelvic nerve or response to fetal mother transfusion or reaction to epidural. This is not significant unless there is a fever.
Assess the mother how often post partum
every 15 minutes for the first hour then every 30 minutes for the second hour then every 4 hours for 24 hours
Rhogam
after mom has first Rh postitive baby they give Rhogam which prevents the mother from building the antibodies . Inhibits memory cell formation and prevents development of sensitization. Give within 72 hours of first delivery and deep repeating after every pregnancy. given at 26-28 week gestation also. Can be given IM average dose 300 micrograms
Lab test indicated for hemolytic diesease
Direct Coombs- test the baby
Indirect Coombs- mother test
Hydrops
most severe case of erythroblastosis. Causes severe hypoxia and cardiac failure occurs.
erythroblastosis
occurs if Rh sensitization occurs and causes anemia, enlargement of spleen, generalized edema, jaundice. Rh incompatibility or ABO.
Diabetic mothers L/S ratio should be
2.5-1
after 35 weeks L/S ratio
2-1
foramen ovale closes
1-2 hours after birth
ductus arteriosus
closes within 18 hours after birth
ductus venosus
closes within 2 months
mumurs disappear by
6 months of age
fetal hemoglobin has a decreased or increaed O2 affinity
INCREASED
0.5mg
prolonged exposure to the cold can result in
depleted glycogen stores and acidosis
Burp the baby every…
0.5 to 1 ounce
Green stools may be due to
excreted bilirubin
babies temp should stabilize within
8 to 12 hours
bowel sounds of a baby should be heard
within 1 hour
nevus pilosus
hair tuft associated with spina bifida
O2 monitor on which hand
Right hand
Assess newborn vitals
every 6 to 8 hours
when bottle feeding
babys head should be above their hips. DO NOT PROP BOTTLE
