Nursing 107 Final Flashcards
What is the order of the cardinal movements that the baby undergoes during labor and delivery?
- Descent
- Flexion
- Internal Rotation
- Extension
- Restitution
- External Rotation
- Expulsion
What complications are most likely for the infant of a diabetic mother after birth?
Hypoglycemia
What are the s/s of hypoglycemia in neonates?
Tremors Irritability Lethargy Apnea Seizures Poor feeding, suck Pallor, cyanosis Hypothermia Hypotonia High pitched cry
What is the appropriate treatment of hypoglycemia in a neonate?
Immediate feeding, either breast, formula or both
If <25mg/dl, may require D10 IV infusion
Follow up CBGs to monitor status.
What is the measurement of fetal station and descent during labor?
A measurement of the presenting part of the baby to the ischial spines of the mother’s spine. (-5, 0, +5).
Define postpartum hemorrhage?
Blood loss greater than 500ml in the 24 hours following delivery. There can also be late pp hemorrhage 7-14 day’s after delivery.
What are the causes of pp hemorrhage?
Uterine atony: most common cause Lacerations Hematoma Retained placental fragments Inversion of the uterus Disseminated intravascular clotting
What are the s/s of pp hemorrhage?
Signs of shock
Bleeding can be slow, steady or perfuse
Large, boggy uterus
Clots
What is the management of pp hemorrhage
Assist the uterus to contract: massage, Rx
Monitor bleeding: weigh pads
Maintain fluid balance
Monitor vital signs
Admin O2
Physician may need to assess for retained placenta
What are the nursing management of a laboring pt and rationales related to each?
During transition: do not leave laboring pt alone
Pain management in labor inc:
Non-pharmacologic methods: effleurage, massage, water therapy, aroma therapy, hypnosis
Pharmacologic methods: Iv narcotic, admiin, epidural anesthesia, spinal, local, and general anesthesia
Evaluate bladder q 2hrs: bladder must be emptied to avoid inhibiting descent of the presenting part and to prevent bladder trauma from increased pressure
Frequent checks of fundus to determine if contracted
What are the health screenings done to a newborn at birth and at time they are discharged?
Phenylketonuria: PKU Cystic fibrosis Galactosemia: disorder how the body process sugar Congenital hypothyroidism Sickle cell trait Hearing screening
What are the meds given at birth and time frame for admin
Erythromycin ophthalmic ointment: one dose at birth
Vit K: one time dose at birth unless mom has been on anticoags then a second dose may be ordered
Hep B: admin within 12hrs of birth.
Identify antenatal testing and why each would be performed?
?
What is the normal rate of blood volume expansion during pregnancy?
45% increase in blood volume and pulse increases 10-15 beats/min
What is the difference between postpartum blues, depression, and psychosis?
?