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1210 > MIH exam 3 > Flashcards

MIH exam 3 Flashcards

1
Q

How long does the postpartum phase last?

A

6 weeks

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2
Q

What is involution?

A

Shrinking of the uterus

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3
Q

What is pitocin?

A

Synthetic form of oxytocin, will cause the uterus to contract

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4
Q

What happens if a client has a negative titer for rubella?

A

They should receive the vaccine subut postpartum because it’s a live vaccine and a teratogen (can cross the placenta), counseled to use birth control and avoid pregnancy 1-4 months after immunization. Not transferred through breast milk. Inquire about sensitivity to eggs

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5
Q

What vaccines can be given during pregnancy?

A

Hep B, Tdap

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6
Q

What is the average expected weight gain during pregnancy?

A

25 to 35 lbs (11 to 16 kg) for women with a normal prepregnancy weight

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7
Q

How many calories should intake increase by?

A

300 calories/day

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8
Q

When are caloric needs greater?

A

Last 2 trimesters

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9
Q

Why is folic acid important for pregnant women/all women of childbearing age?

A

Prevents neural tube defects and orofacial clefts in fetus

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10
Q

How many glasses a day should a pregnant woman drink?

A

8 to 10 8oz glasses per day

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11
Q

What is eating ice an indicator of?

A

Anemia

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12
Q

What is an episiotomy?

A

an incision made into the perineum to enlarge the vaginal outlet and facilitate birth

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13
Q
  • Check the episiotomy/laceration site
  • Institute measures to relieve pain
  • Educate on the use of an ice pack for the first 24 hours, then sitz bath thereafter
  • Analgesic spray or ointment as prescribed (dermoplast, benzocaine)
  • clean technique peri care
  • Wipe perineal area front to back, blot don’t wipe (warm water bottle to cleanse the area)
  • witch hazel pads (tucks pads) placed on peri pads
  • stool softener
  • monitor for s/sx of infection
  • report any bleeding or discharge from the site to PHCP
A

What are nursing interventions for an episiotomy/perineal laceration?

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14
Q
  • Labor is not progressing
  • Fetal wellbeing
  • Breach baby (footling breach, breach babies have a higher risk for complications during delivery)
  • History of spinal cord injury
  • Certain STDs
  • If mother has a history of c section
  • If the baby is big
A

What are reasons someone might get a C section?

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15
Q

How much does fundal height decrease?

A

1 to 2 centimeters below the umbilicus per day

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16
Q

When can the uterus not be palpated abdominally?

A

By week 2

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17
Q

Discharge from the uterus that consists of blood from the vessels of the placental site and debris from the decidua, result of involution and the regeneration of the endometrium

lochia rubra: red, present for first 3 to 4 days
lochia serosa: pinkish brown, can last up to 4 weeks postpartum
lochia alba: whitish color, noted up to 6 weeks postpartum

should smell like normal menstrual flow, may increase with ambulation, decreases daily in amount

during fundal rub nurses should assess lochia (huge part of postpartum assessment): check the peri pad prior to rubbing, what is coming out? what color is it? how much? what does it smell like?

A

What is lochia?

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18
Q

What does a boggy fundus indicate?

A

Uterine atony - inability of uterus to stay contracted. leads to postpartum hemorrhage

Interventions: massage fundus until firm

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19
Q

inability of uterus to return to non pregnant state.

Contributing factors: full bladder, mother should void before fundal rub. Tender fundus indicates infection, may be a sign of sub involution.

Long labor (18+ hours), anesthesia (epidural), multiparity (previous labors can slow involution, with each labor the chances of sub involution will be increased)

A

What is sub involution?

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20
Q

as early as 27 days

1 to 2 months in non breastfeeding mothers

3 to 6 months in breastfeeding mothers

Breast-feeding mothers may experience amenorrhea during the entire period of lactation so long as they are exclusively breastfeeding

first 3 to 4 menstrual cycles will be heavier

A

When does menstrual flow resume postpartum?

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21
Q
  • A decrease in estrogen and progesterone levels after birth from pregnant to nonpregnant state stimulates increased prolactin levels, which promote breast milk production
  • Breasts continue to secrete colostrum for the first 48 to 72 hours after birth (colostrum is rich in antibodies, high in protein, low in fat)
  • milk will be readily available to nurse the newborn within 72 to 96 hours
  • Immunoglobulins are passed through breastmilk
  • The more the nipples are stimulated the more milk production occurs
A

What happens to the breasts postpartum?

22
Q

What do breastfed babies need?

A

Supplemental vitamin D, given in the form of oral drops

23
Q
  • Nipple stimulation will release oxytocin which is responsible for the milk ejection reflex (oxytocin aids in uterine contraction)
  • Decreases risk of SIDS, respiratory infections, GI infections/complications, in mother breast or ovarian cancer
A

What are the benefits of breastfeeding?

24
Q
  • HIV is passed through breastmilk
  • Active TB is passed
  • Galactosemia: baby is unable to metabolize milk protein and cannot have milk protein at all
A

What are the contraindications for breastfeeding?

25
Q

How often do newborns drink formula?

A

15 to 30 ml q 3 to 4 hours

26
Q

What do you do if baby is spitting up formula?

A

Decrease the amount taken in at one time

Take a break, burp them (v important)

27
Q

What position should baby be in when bottle fed?

A

Semi fowler’s

28
Q

When do you introduce pureed food?

A

6 months, introduce 1 thing at a time, wait 3 to 5 days before beginning a new food, get used to taste and check for allergies

29
Q

How much blood should the mother lose at the time of delivery?

A

<500ml for vaginal, <1000ml for C section

30
Q

When does BP go back to normal?

A

2 to 6 weeks postpartum

31
Q

What happens to the blood during pregnancy?

A

Enters a hyper coagulable state as a protective mechanism against postpartum hemorrhage. Mother is at risk for blood clot formation, look for s/sx of blood clot/dvt: leg pain, unilateral changes

32
Q

Why does urinary retention happen postpartum?

A

Prolonged labor
Anesthesia
Foley catheter
Increased risk of UTI due to urinary retention

33
Q

Does intestinal motility increase or decrease postpartum?

A

Decrease

34
Q

How do you tell if a headache is due to a leak of cerebrospinal fluid?

A

If it goes away when the mom lies down

35
Q

What is the neonatal HR 30 mins after birth

A

160 to 180 bpm

36
Q

When does the meconium get passed?

A

within 24h of birth

37
Q

Why is there passive immunity present?

A

Placental transfer from mother of immunoglobulin G

38
Q

When should the baby void?

A

within first 24h of life

39
Q

Is brick dust urine a normal finding?

A

Yes

40
Q

How long is the neonatal period?

A

Birth to 28 days of life

41
Q
  • Females can have discharge, bloody spotting, external genitalia would be edematous
  • Newborn females will have vernix, do not remove, it will come off by itself and we do not want to cause tissue breakdown
A

What education should be provided on newborn genitalia?

42
Q

What is physiological jaundice?

A

Appears 24 h after birth, will peak at 2 to 4 days

43
Q

What is pathologic jaundice?

A

Occurs within 24 hours, often related to maternal fetal incompatibility

44
Q

What are the two types of bilirubin?

A
  • unconjugated bilirubin: can cross blood brain barrier, risk for neurotoxicity
  • conjugated bilirubin: also known as direct bilirubin, water soluble and easily excreted in waste product
45
Q

What is a rare occurrence that jaundice is at risk of causing?

A

Kernicterus (irreversible neurological damage)

46
Q

What is the normal neonatal HR?

A

120-160 BPM

47
Q

What does persistent tachycardia (sustaining at 160 BPM or higher) indicate?

A

Anemia, hypovolemia, hyperthermia, sepsis

48
Q

What are WBCs elevated to on day 1?

A

24,000

49
Q

What do neonatal WBCs sustain at after day 1?

A

12,000

50
Q

Why are newborns at risk for bleeding?

A

Immature GI system and immature liver, they do not produce clotting factors as easily

1210 (4 decks)

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