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Ob > Ob Exam 3 > Flashcards

Ob Exam 3 Flashcards

1
Q

Normal Newborn vitals

A

110-160 = normal

85-100 sleeping

180 = crying

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2
Q

Temp newborn

A

97.7 - 99-5

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3
Q

Newborn RR

A

30-60

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4
Q

Pathological jaundice

A

Underlying diseases like infection or blood incompatibility
Appears before 24 hours of age

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5
Q

Pathological Tx

A

Phototherapy

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6
Q

Physiologic Jaundice

A

Considered benign

Increased bilirubin lvls 72-120 hours after birth w/ rapid decline to 3mg/dL 5-10 days after birth

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7
Q

Physiologic jaundice cause

A

Hyperbilirubinemia

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8
Q

Physiologic jaundice TX

A

Increasing feeding

Monitor that bilirubin too I’d assume

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9
Q

Jaundice findings and cause

A

Typically see yellow sclera which means maternal newborn blood is incompatible

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10
Q

Worst blood comparability

A

Mom O- and baby A+

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11
Q

Jaundice lab tests

A

Monitor serum bilirubin test Q4 hrs
Assess blood compatablity
Review HGB + HCT

Coombs tests reveals presence of antibody coated RH positive RBCs in newborn

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12
Q

Coombs Test

A

reveals presence of antibody coated RH positive RBCs in newborn

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13
Q

Phototherapy

A

Check electrolytes for DHD?

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14
Q

Thermoregulation

A

Critical to survival
Hypothermia is very common and bad
Know the types of heat loss

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15
Q

Heat loss types

A

Convection

Conduction

Radiation

Evaporation

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16
Q

Convection

A

Heat loss through air currents so like the ac vent or in direct line of fan

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17
Q

Conduction

A

Heat loss through DIRECT contact of another surface

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18
Q

Radiation

A

Loss of heat from cool surface NEARBY

So like windows and ac vents nearby

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19
Q

Evaporation

A

Heat loss through evaporation of moisture on skin

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20
Q

Preventing Convection

A

Place bassinet out of direct like of a fan
Swaddle infant and keep head covered
Procedures should be done under radiant heat source
Room temp should be 72-78 degrees

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21
Q

Preventing Radiation

A

Keep newborn and examination tables away from windows and air conditioner

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22
Q

Evaporation prevention

A

Rub infant dry with warm sterile blanket

Expose only one body part at a time when bathing

No bath until body temperature is 97.7 degrees

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23
Q

Conduction Prevention

A

Pre heat radiant warmers
Warm stethoscope before applying
Pad a scale before weighing
Place newborn directly on parent’s chest

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24
Q

Hypoglycemia

A

< 40 mg/dL during first 3 days of life

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25
Q

Normal Newborn Glucose

A

40-60 mg/dL

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26
Q

Newborn hypoglycemia Risk factors:

A

■ Maternal DM
■ Preterm infant
■ LGA or SGA
■ Stress at birth (cold stress, asphyxia)

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27
Q

most important intervention to prevent baby from hypothermia

A

Head cap is most important to keep heat in

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28
Q

HYPOGLYCEMIA S/S IN INFANTS:

A

Jitteriness/tremors
BG < 40
Cyanosis + apnea
weak cry
Flaccid muscle tone
poor feed

*CAN be asymptomatic

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29
Q

Hypoglycemia Nursing Care:

A

Heel Stick for glucose monitoring
initiate early feedings - frequent PO or gavage
IV dextrose (glucose) for symptomatic/ unstable newborn

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30
Q

Phototherapy nurses role

A

placed under the light with eye mask
newborn undressed
NO lotions or ointments
Baby must have pulse oximeter on incase goggles slip down
reposition Q2 hours
Check lamp energy w/ photometer

Remove from phototherapy q 4 h and unmask newborns eyes

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31
Q

NEC

A

Necrotizing Enterocolitis (NEC)

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32
Q

S/S of NEC

A

Abdominal tenderness/bloating (LARGE STOMACH)

*BLOODY STOOL, VOMITING, ABDOMINAL DISTENTION

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33
Q

How to reduce NEC?

A

Breastfeeding reduces risk

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34
Q

What causes NEC

A

complication of preterm infants
formula can cause this

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35
Q

describe NEC

A

necrosis & perforation of bowel –> bowel death– especially high risk if given formula–r/t immature gut

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36
Q

S/S of NEC? test Q

A

BLOODY STOOL, VOMITING, ABDOMINAL DISTENTION

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37
Q

NEC TX

A

Stop feedings
Inserting an NG tube
IV fluids and nutrition to replace breast milk/formula
IV ABX
Monitoring w/ x-rays, CBC, blood gas
Isolation precautions
Surgery to remove dead intestinal tissue

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38
Q

Newborn medications given after birth

A

Hep-B

Erythromycin

Vitamin K

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39
Q

Hep B Requirements

A

Vaccine with parental consent

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40
Q

Vitamin K Requirements

A

Single IM injection in vastus lateralis to ensure proper start of coagulation cascade

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41
Q

Erythromycin Requirements

A

eye ointment within 1-2 hours of birth (mandatory in the US, apply 1-2 cm ribbon in lower lids of eyes)

If born preterm with eyes shut, wait until eyes open

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42
Q

Vitamin K purpose

A

prevents bleeding

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43
Q

Erythromycin eye ointment purpose

A

prevents eye infections

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44
Q

Hep B vaccine big to know

A

NEEDS MOTHER’S CONSENT

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45
Q

What is NAS

A

Neonatal Abstinence Syndrome

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46
Q

CNS S/S of Neonatal Abstinence Syndrome

A

o High-pitched, shrill cry
o Seizures
o Hypertonic muscles
o Stiffness

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47
Q

CNS S/S test Q of NAS

A

TREMOR, EXCORIATIONS ON THE SKIN, HIGH PITCHED CRY, VOMIT

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48
Q

NAS: S/S of Metabolic/Resp/Vasomotor

A

o Nasal congestion w/ flaring
o Sneezing

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49
Q

NAS GI S/S?

A

o Poor feeding
o Regurgitation/projectile vomiting
o Diarrhea

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50
Q

when does POSTPARTUM DIURESIS occur?

A

Diuresis occurs within 12 hours after birth

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51
Q

What is POSTPARTUM DIURESIS?

A

Diaphoresis and diuresis occur within the first 2-5 days after delivery; rid the body of excess fluid during the last part of the pregnancy

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52
Q

POSTPARTUM DIURESIS times

A

Weight loss due to lochia, delivery, and diuresis of about 19lb during the first 5 days after delivery

increased urinary output begins within 12 hrs

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53
Q

Normal postpartum diuresis

A

Urine output of 3000 mL or more each day for first 2-3 days (NORMAL)

Profuse diaphoresis (sweating) nightly for first 2-3 days (NORMAL)

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54
Q

POSTPARTUM DIURESIS - complication?

A

Urethral swelling and decrease bladder tone
= high risk for urinary retention

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55
Q

What happens if the bladder is distended?

A

Can push the uterus UP and to the SIDE, leading to excessive bleeding (postpartum hemorrhage, boggy fundus)
–> KEEP THAT BLADDER EMPTIED

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56
Q

Breastfeeding and how it affects hormones

A

Oxytocin can promote bonding and calmness during BF (love hormone)

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57
Q

HICH HORMONE IS PRODUCED DURING BREASTFEEDING FOR MILK PRODUCTION?

A

Prolactin - stimulates milk production
Stimulated by baby sucking

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58
Q

POSTPARTUM FUNDUS AND HOW IS IT MEASURED:

A

Level of umbilicus 12 hrs after birth

1 finger breadth or cm per day

if it doesn’t go down consider hemorrhage

if it’s to the side, have them empty their bladder

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59
Q

Fundus is to the side

A

EMPTY BLADDER

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60
Q

fondus doesn’t go down

A

probs hemorrhage

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61
Q

Fondus height after delivery?

A

1 hour after delivery, the fundus (top portion of the uterus) should rise to the level of the umbilicus

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62
Q

UTERINE INVOLUTION

A

Involution occurs with contractions of the uterine smooth muscles; returning the uterus to its pre-pregnant state

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63
Q

UTERINE SUBINVOLUTION

A

Subinvolution is a medical condition in which the uterus DOES NOT return to its normal size

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64
Q

HOW LONG IS THE POSTPARTUM PHASE:

A

6 weeks (when mother’s body has returned to its pre-pregnant state)

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65
Q

Lochia?

A

post-birth uterine discharge that contains blood, mucus, and uterine tissue

Amount is similar to a heavy menstrual period about 2 hrs post-delivery and will decrease gradually at a consistent rate

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66
Q

Stages of Lochia

A

o Lochia Rubra
o Lochia Serosa
o Lochia Alba

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67
Q

Lochia Rubra

A

dark red color - can last 2-3 days after delivery

bloody consistency, fleshy odor, can contain small clots, transient flow increases during BF and upon rising, can last 2-3 days after delivery

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68
Q

Lochia Serosa

A

pinkish brown color –> lasts approx. 2 weeks after delivery

serosanguineous consistency, can contain small clots and leukocytes

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69
Q

Lochia Alba

A

yellowish white cream color that lasts up to 6 weeks

fleshy odor, can consist of mucus and leukocytes

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70
Q

Assessing Lochia

A

Amount
color, odor, and consistency

Pads can be weighed to give better estimate

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71
Q

Amounts of Lochia

A

Scant: less than 2.5 cm
Light: 2.5- 10 cm
Moderate: more than 10 CM
Heavy: one pad saturated within 2 h

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72
Q

Abnormal amount of Lochia

A

Excessive blood loss: one pad saturated in 15 min or less, or pooling of blood under buttocks

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73
Q

Lochia foul odor

A

abnormal indicates infection

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74
Q

C section amount of bleeding

A

C-Section: amount of bleeding will be decreased

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75
Q
A
76
Q

Complications of meconium-stained Amniotic fluid?

A

Fetal asphyxia
Respiratory Distress Syndrome
Aspiration

77
Q

why does meconium-stained Amniotic fluid happen?

A

fetal stress (hypoxia or infection)
insufficient placenta
>40 weeks
post-dates
large gestational age leading to maturation of intestinal tract

78
Q

Newborn skin findings

A

Acrocyanosis
Millia
Mongolian Spots
Vernix

79
Q

Acrocyanosis

A

Hand and feet turn cyanotic (bluish color)
Normal

80
Q

Millia

A

Small raised pearly or white spots on the nose, chin or forehead

81
Q

Millia Education

A

These spots disappear without treatment

Educate parents not to squeeze them

82
Q

Mongolian spots

A

Spots of pigmentation that are blue, black, brown or gray.

More common in those who have dark skin
can be linked to genetics.

Document location and presence.

83
Q

Vernix

A

Protective thick cheesy covering
Amounts vary
More present in creases and skin folds
more likely to see on preterm baby

84
Q

CAPUT vs CEPHALOHEMATOMA

A

Caput - crosses suture line

CephaloHEMATOMA - does not cross suture line

85
Q

Caput Succedaneum:

A

Edema of the scalp

Usually over occiput (back of head)

Goes away within days

86
Q

CephaloHEMATOMA

A

Blood between skull bone and periosteum

Spontaneously resolves within 3-6 weeks

Can cause hyperbilirubinemia

87
Q

RDS meaning

A

Respiratory distress syndrome

88
Q

What is Respiratory Distress Syndrome?

A

decreased surfactant in alveoli occurs, regardless of a newborn’s birth weight

89
Q

RDS Characterizations

A

poor gas exchange and ventilatory failure

Surfactant assists in alveoli expansion and keeps the alveoli from collapsing allowing gas exchange to occur

90
Q

Atelectasis

A

(collapsing of a portion of lung) increases the work of breathing

91
Q

Respiratory Distress Syndrome S/S

A

tachypneic or cyanotic *

Nasal flaring & Retractions

Expiratory grunting & Fine crackles

92
Q

Respiratory Distress Syndrome Meds

A

Artificial lung surfactant through a tube in the windpipe

93
Q

Lung Surfactant - nursing care

A

Perform a respiratory assessment before and after administration

Provide suction to the newborn prior to administration

Assess endotracheal tube placement

Avoid suctioning of the endotracheal tube for 1 hr after administration

94
Q

ACTIONS IMMEDIATELY FOLLOWING BIRTH FOR MOTHER AND INFANT:

A

Rub and stimulate baby, dry baby off, make them cry
Listen with stethoscope
Get vitals

Bulb syringe, suction mouth first (M before N) don’t go straight back –> they will gag

APGAR
Skin to skin
reflexes

95
Q

PPH MEDICATIONS

A

Oxytocin
Methylergonovine (Methergine)
Misoprostol
Carboprost tromethamine

96
Q

Oxytocin

A

SAFTEST MED TO GIVE IF PT HX IS UNKNOWN
A/E: water intoxication (lightheaded, NVH, ill)
o Promotes uterine contractions

97
Q

Methergine

A

DO NOT ADMIN TO PATIENTS WHO HAVE HTN - AE = HTN + N/V/H

98
Q

All the PPH meds have the following effects

A

o Uterine stimulant
o Controls PPH
o Assess uterine tone and vaginal bleeding

99
Q

What medication is given to
rh - mothers of rh + infants?

A

Rho(D) immune globulin = RhoGAM

100
Q

RhoGAM

A

Prevents the mother’s antibodies from reacting to the baby’s Rh-positive RBCs

Given during the 2nd trimester if father is Rh positive or his blood type is unknown

Second dose given 72 hr after delivery if baby is Rh positive

101
Q

How do we determine if infant is getting enough input

A

Gaining weight
Voiding 6 or more wet diapers/ day
Baby is breastfeeding often, 8-12x a day
Content between feedings

BM are soft, yellow, and formed

Breastfed infants may have 3 or more bowel movements a day

102
Q

Formula fed infants …

A

will have less bowel movements

103
Q

NEWBORN REFLEXES

A

Sucking and Rooting
Palmar
Plantar
Moro
Tonic Neck (fencing)
Babinski
Stepping

104
Q

Which reflex assists with latching

A

Sucking and Rooting: Elicit by stroking the cheek or edge of the mouth. Newborns turn the head toward the side that is touched and starts to suck

105
Q

Palmar

A

place finger in the palm of the newborn’s hand. baby’s fingers curl around the finger

106
Q

Plantar

A

place finger at the base of newborn’s toes. Newborn will respond by curling toes down

107
Q

Moro “startle”

A

Hold infant in semi sitting position, allow head and trunk to fall backward to angle of 30 degrees with support OR place infant supine on flat surface and perform sharp hand clap symmetric abduction & extension of arms, fingers fan out, slight tremor may be noted

108
Q

Babinski (plantar)

A

stroke upward along lateral aspect of sole then move finger across the ball of the foot
all toes hyperextend with dorsiflex of big toe

109
Q

SGA versus LGA

A

LGA - Large for gestational age: above
90th percentile

SGA - Small for gestational age: below 10th percentile

110
Q

SGA complications

A

perinatal asphyxia, meconium aspiration, hypoglycemia, polycythemia, and instability of body temperature

111
Q

LGA babies are at risk for

A

birth injuries - fractures, shoulder dystocia, intracranial hemorrhage, CNS injury

112
Q

What causes LGA babies

A

Uncontrolled hyperglycemia during pregnancy

113
Q

LGA findings

A

Respiratory distress syndrome findings
hypoxia -> tachypnea, retractions, cyanosis, nasal flaring, and grunting

114
Q

what happens to LGA babies when born

A

Hypoglycemia: Sluggishness, hypotonic muscles, & hypoactivity

Tremors from hypocalcemia

115
Q

SGA Test Q - we Monitor for what?

A

perinatal asphyxia, meconium aspiration, hypoglycemia, polycythemia, and instability of body temperature

116
Q

POSTTERM BABY THAT IS 42 WEEKS AND 5 LB is considered

A

small for gestational age

117
Q

Test Q - LGA weight

A

weigh above the 90th percentile or > 4000 g (8.8lb)

monitor for birth injuries

118
Q

Define post-partum Hemorrhage

A

the client loses more than 500 mL blood after a vaginal birth

more than 1,000 mL blood after a cesarean birth

119
Q

Actions to take for postpartum hemorrhage?

A

massage the fundus*
Give blood products - anemia*
Provide O2 and monitor sat for shock patients
Elevate the client’s legs to a 20-30 degree
IV fluids to replace fluid volume loss

Provide oxygen and monitor oxygen saturation - hypovolemic shock*

120
Q

postpartum hemorrhage more actions

A

indwelling catheter -assess kidney function and obtain an accurate measurement of urinary output
o Assess for source of bleeding
o Assess bladder for distention

121
Q

oxytocin effects

A

prevents excessive bleeding and hemorrhage.

122
Q

Two complications that can occur following postpartum hemorrhage include?

A

hypovolemic shock and anemia

123
Q

Test Question I don’t know

A

PATIENT 2 HR PP SATURATED 2 PADS IN 30 MINS —-> CHECK FUNDUS

124
Q

Instructions for bulb syringe

A

Airway maintenance

Squeeze air out of bulb first
suction mouth then nose (M then N) towards sides- never straight back due to gag

125
Q

Ballard score and what it is used for

A

gestational age associated with newborn morbidity and mortality

Accurate on newborns as early as 20 weeks’ gestation

Complete w/n the first 48 hrs to be accurate

126
Q

Review signs and symptoms of newborn sepsis

A
127
Q

Review TORCH infections

A

Toxoplasmosis - raw meats + cat litter
Other infections- Heps, syphilis, HIV, zoster
Rubella -
Cytomegalovirus - mono like S/S
Herpes simplex -

128
Q

Cytomegalovirus

A

no treatment exists; prevent exposure by frequent hand washing before eating and after handling infant diapers and toys

129
Q

Herpes simplex

A

Transmission to the fetus is greatest during vaginal birth: C section if active herpes

130
Q

what is Torch?

A

Mother to fetus/newborn infections
result in fetal loss, illness, or malformations because fetus has limited capacity to fight infections

131
Q

Love hormone

A

Oxytocin

132
Q

Benefits of Breastfeeding

A

perfect for baby w/ nutrients & antibodies
Promotes appropriate growth pattern
Crucial to brain development
Promotes mother-infant attachment
Antiviral and antibacterial factors

133
Q

Breastfeeding decreases risk of

A

Obesity
Sudden infant death syndrome (SIDS)

Preterm infants:
Necrotizing enterocolitis
sepsis
Retinopathy of prematurity
Metabolic syndrome

134
Q

Breastfeeding teaching

A

Initiate feedings within an hour of birth
Avoid any supplemental feedings or pacies
^Pay attention to latch
Allow feeding at first breast until baby stops, then burp, go to other breast. No time limits.
Feed 10 – 12 times per day (every 1 to 3 hours

135
Q

Storing Breast Milk

A

Keeps in refrigerator for up to 8 days

Keeps in average freezer up to 6 months

Keeps in deep freeze up to 12 months

Never re-freeze thawed milk

136
Q

Overview of Immediate care

A

Keep warm/dry

Monitor first cry (airway & breathing)

Assess heart rate (auscultate for 6 seconds over left chest and multiply by 10)

Apgar scoring at 1 and 5 minutes

Initial head to toe assessment & weight

Medications

Identification/security

137
Q

Transition to Life: First period of reactivity

A

Lasts about 30 minutes after birth

Elevated HR up to 180/min., respiratory rate up to 80/min.

Infant is alert, may cry

Fine crackles + grunting + Nasal flaring + retraction

138
Q

Newborn weight

A

2500 - 4000g OR 5.5 - 8.8lbs

139
Q

Assessment of neonatal pain

A

Neonatal Infant Pain Scale:

Crying

Whimper

Grimacing

Eyes squeeze

Taut tongue

140
Q

DO APICAL PULSE!!!

A

4th ICS left of MCL

LISTEN for a FULL MINUTE (irregular!)

Murmurs common at first, especially open ductus arteriosus

141
Q

Cephalohematoma can cause what?

A

hyperbilirubinemia

142
Q

Breast Assessment

A

Shape

Firmness

Redness

Symmetry

Engorgement (fullness)

143
Q

Urethral swelling & decreased bladder tone causes what?

A

high risk for urinary retention!

144
Q

Uterine atony results from

A

inability of the uterine muscle to contract adequately after birth

145
Q

Hyperbilirubinemia

A

Elevation of serum bilirubin levels resulting in jaundice.

Jaundice normally appears on the head (especially the sclera and mucous membranes)

146
Q

Pathologic jaundice main cause

A

blood incompatibility

147
Q

A nurse is performing a fundal assessment for a client who is 2 days postpartum and observes the perineal pad for lochia. The pad is saturated approximately 12 cm with lochia that is bright red and contains small clots. Which of the following findings should the nurse document?

A

Moderate lochia rubra

148
Q

During ambulation to the bathroom, a postpartum client experiences a gush of dark red blood that soon stops. On assessment, a nurse finds the uterus to be firm, midline, and at the level of the umbilicus. Which of the following findings should the nurse interpret this data as being?

A

A normal postural discharge of lochia

149
Q

A nurse is assessing a postpartum client for fundal height, location, and consistency. The fundus is noted to be displaced laterally to the right, and there is uterine atony. The nurse should identify which of the following conditions as the cause of the uterine atony?

A

Urinary retention

150
Q

A nurse is providing education to a client who is 2 hr. postpartum and has perineal laceration. Which of the following information should the nurse include? (SATA)

A

Use a perineal squeeze bottle to cleanse the perineum

Apply a topical anesthetic cream or spray to the perineum

Apply cold or ice packs to the perineum

151
Q

A nurse is caring for a client who is 1 day postpartum. The nurse is assessing for maternal adaptation and parent-newborn bonding. Which of the following behaviors by the client indicate a need for the nurse to intervene

A

Demonstrates apathy when the newborn cries

Views the newborn’s behavior as uncooperative during diaper changing

152
Q

apathy

A

lack of interest

153
Q

A nurse concludes that the parent of a newborn is not showing positive indications of parent-infant bonding. The parent appears very anxious and nervous when asked to bring the newborn to the other parent. Which of the following actions should the nurse use to promote parent-infant bonding

A

Provides education about infant care when the parent is present

154
Q

A client in the early postpartum period is very excited and talkative. They repeatedly tell the nurse every detail of the labor and birth. Because the client will not stop talking, the nurse is having difficulty completing the postpartum assessments. Which of the following actions should the nurse take?

A

Give the client time to express feelings!

155
Q

A nurse in the delivery room is planning to promote parent-infant bonding for a client who just delivered. Which of the following is the priority action by the nurse?

A

Position the neonate skin-to-skin on the client’s chest

156
Q

A nurse is conducting a home visit for a client who is 1 week postpartum and breastfeeding. The client reports breast engorgement. Which of the following recommendations should the nurse make?

A

“Apply cold compresses between feedings.”

157
Q

A nurse is providing discharge instructions for a client. At 4 weeks postpartum, the client should contact the provider for which of the following clients?

A

Sore nipple with cracks and fissures

158
Q

A nurse is providing discharge teaching for a nonlactating client. Which of the following instructions should the nurse include in the teaching?

A

“Wear a supportive bra continuously for the first 72 hours.”

159
Q

A nurse is providing care to four clients on the postpartum unit. Which of the following clients is at greatest risk for developing postpartum infection?

A

does not wash their hands between perineal care and breastfeeding

160
Q

A nurse is teaching a client who is breastfeeding and has mastitis. Which of the following responses should the nurse make?

A

“Completely empty each breast at each feeding or use a pump.”

161
Q

A nurse is completing a newborn assessment and observes small pearly white nodules on the roof of the newborn’s mouth. This finding is a characteristic of which of the following conditions

A

Epstein’s pearls cause its in mouth

162
Q

A nurse is assessing the reflexes of a newborn. In checking for the Moro reflex, the nurse should perform which of the following?

A

Hold the newborn in a semi-sitting position, then allow the newborn’s head and trunk to fall backward.

163
Q

A nurse is completing an assessment. Which of the following data indicate the newborn is adapting to extrauterine life? (SATA)

A

Apnea for 10-second periods

Obligatory nose breathing

164
Q

A nurse is teaching a newly licensed nurse how to bathe a newborn and observes a bluish brown marking across the newborn’s lower back. The nurse should include which of the following information in the teaching?

A

“This is more commonly seen in newborns who have dark skin.”

165
Q

A nurse is preparing to administer prophylactic eye ointment to a newborn to prevent ophthalmia neonatorum. Which of the following medications should the nurse anticipate administering?

A

Erythromycin ointment

166
Q

A newborn was not dried completely after birth. This places the infant at risk for which of the following types of heat loss?

A

Evaporation

167
Q

A nurse is caring for a newborn immediately following birth. Which of the following nursing interventions is the highest priority?

A

Covering the newborn’s head with a cap

168
Q

A nurse is giving instructions to a parent about how to breastfeed their newborn. Which of the following actions by the parent indicates understanding of the teaching?

A

When latched on, the infant’s nose, cheek, and chin are touching the breast

169
Q

A nurse is caring for the newborn. Which of the following actions by the newborn indicates readiness to feed?

A

Attempts to place their hand in their mouth

170
Q

A nurse is reviewing breastfeeding positions with the parent of a newborn. Which of the following positions should the nurse discuss

A

Cradle

171
Q

A nurse is caring for a newborn immediately following a circumcision using a Gomco procedure. Which of the following actions should the nurse implement

A

Apply petroleum gauze to the site

172
Q

A nurse is reviewing care seat safety with the parents of a newborn. Which of the following instructions should the nurse include in the teaching regarding car seat position?

A

Back seat; rear facing

173
Q

post mature baby appearance

A

leathery skin

174
Q

A nurse is caring for an infant who has a high bilirubin level and is receiving phototherapy. Which of the following is the priority finding in the newborn?

A

Sunken fontanels

175
Q

. A nurse is teaching a newly licensed nurse about neonatal abstinence syndrome. Which of the following statements by the newly licensed nurse indicate understanding of the teaching?

A

“The newborn will have a continuous high-pitched cry.”

176
Q

A nurse is assessing a client who is 14 hr. postpartum and has a third-degree perineal laceration. The client’s temperature is 37.7°C (100°F), and her fundus is firm and slightly deviated to the right. The client reports a gush of blood when she ambulates and no bowel movement since delivery. Which of the following actions should the nurse take?

A

Assist the client to empty her bladder

177
Q

A nurse is reviewing the electronic medical record of a newborn. Which of the following maternal factors may increase the risk of pathologic hyperbilirubinemia in the newborn?

A

Infection

178
Q

A nurse is assisting a client who is 4 hr postpartum to get out of bed for the first time. The client becomes frightened by a gush of dark red blood from her vagina. Which of the following statements should the nurse make in response?

A

“Blood pools in the vagina when you are lying in bed.”

179
Q

A nurse is assessing a 12-hour-old newborn and notes a respiratory rate of 44/min with shallow respirations and periods of apnea lasting up to 10 sec. Which of the following actions should the nurse take?

A

Continue routine monitoring - normal

180
Q

Which of the following newborns is at the greatest risk of hypoglycemia?

A

Newborn who is large for gestational age

181
Q

A nurse is evaluating a client who has just received instructions about breastfeeding. Which of the following statements should the nurse identify as an indication that the client understands how to prevent mastitis?

A

“I should avoid waiting too long between feedings.”

182
Q

mastitis

A

infection of the breast tissue resulting in pain, swelling, warmth and redness.

183
Q

A nurse is providing teaching for a postpartum client who is breastfeeding. Which of the following statements indicates an understanding of the teaching?

A

“I should feed my baby 8-12 times a day, based on feeding cues.”

184
Q

Which patient do you see first type question

A

A newborn whose axillary temperatures is 96.9°F = to low

185
Q

A nurse is caring for a newborn who has neonatal abstinence syndrome. Which of the following clinical findings should the nurse expect?

A

Exaggerated reflexes

186
Q

A nurse is determining an Apgar score for a newborn who was born 1 minute ago. For which of the following findings should the nurse assign a score of 1?

A

Weak cry

187
Q
A

Ob (1 decks)

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