OB: SIR AKZ Flashcards
What enters the placenta:
Nutrients:
-Glucose
-Thyroxine (T4)
Ilnnesses:
-T-O-R-C-H
Placenta side ;attached to the uterus
Duncan
Manuever to deliver placenta by applying pressure on lower abdomen
Crede’s Manuever/ Fundal Pressure
Protective structure of umbilical cord from trauma
Wharton’s Jelly
Position of choice Cord Proplapse:
1st: Knee Chest
2nd: Trendelenburgs
-Prevents compression to umbilical cord
-Small passages that direct blood needs to be oxygenated
-To bypass the lungs & liver. be not fully work until afterbirth.
Fetal Shunts
Diagram of Fetal Shunts
PLACENTA
↓
Umbilical Vein
↓
Ductus Venosus (Liver)
↓
Inferior Vena Cava
↓
Right Atrium
↓
Foramen Ovale between Right & Left Atrium
↓
Left Atrium
↓
Pulmonary Artery
↓
Ductus Arteriosus
↓
AORTA
-Flexible for movement of crianial bone
-Growth of the brain
Suture
Normal, when crying
Abnormal, when not crying/ ↑ICP
Bulging Fontanel
Early closure of fontanel
early closure is x/sx of abnormality
General measurements
Head: 33-35cm/ 13 -14 inches
Abd & Chest: 30-33 cm
Length/ ht: 46-54 cm
Weight: 2.5-4.5 kg
Cranial Bone of Newborn
1: Frontal
1: Occipital
2: Parietal
2: Temporal
Overall= 6
0Hormone for brain development in fetus
-Iodine forms this hormone
Thyroxine (T4)
GOOD TO KNOW!
-No intermingling of maternal & fetal blood occurs in the placenta.
-Mixing of blood of mother and fetus occurs by 3rd stage of labor
-Spaces between bone of skull
-allow molding during birth
Fontanel
B-A-D Fontanel
Big/Bregma
Anterior
Diamond
(12-18 months)
L-P-T fontanel
Liit/Likod/ labda
Posterior
Triangle
(3rd month; 1st to close)
Suture that divides 2 halves of frontal bone
Metopoic
Suture that extends across the skull between parental & frontal bone
Coronal
Suture between two parietal bones
Sagittal
Suture between occipital and two parietal bone at the back of skull
Lamboidal
-Birth defects, skull joined too early before brain fully formed
-Premature closure of cranial suture
-2 y.o., before brain becomes developed
Craniosynostosis
Softening of skull one.
Rickets, HYper vitamins, congenital syphilis, pathologic conditions, hydrocephalus
Craniotabes
-Change in skull, Distinctive boxlike
“Square Headed”
-Frontal Bossing
Caput Quadratum
10% of weight loss in the 1st week is
Physiologic Weight loss
Important indicator of nutritional Status of child?
Weight
Doubles= 6 mons
Triples= 12 mons
Quadrupule= 24 mons
When the dorsum of the foot is drawing under the edge of a table top it results in Flexion followed by Extension of the leg.
Disappers by: 2-3 months
Placing Reflex
Which among the two develop first? Fine motor or Gross Motor?
Gross Motor
Good to know!
Colostrum is high in Vitamin A
-Prevents Xeropthalmia
Good to know!
*Drying stimulates breathing
*Prone position= SIDS
*Hypoglycemia= Comatose
Cold stress diagram
COLD
↓
↑O2 consumption
↓
↑Respiratory Rate
↓
Pulmonary Vasoconstriction
↓
↓O2 uptake by lungs
COLD
↓
↑O2 consumption
↓
↑Respiratory Rate
↓
Peripheral Vasconstriction
↓
↓O2 to tissue (Hypoxia)
↓
↑Anaraeobic glycolysis
↓
↓in PO2 and Ph
↓
Metabolic Acidosis
Rooming in refers to?
Newborn & mother in the same room
NSVD: within 30 minutes
CS: 3-4 hours
good to know
E-coli— Vit. K— Liver
=Clotting
Good to know
Crying= Breathing
Shrill Cry= Abnormal
↑ICP= Lusty: 2
Shrill: 1
↑Vernix Caseosa, ↑Lanugo
Preterm
serves as a thermoregulator
Vernix Caseosa
Bluespots
Mongolian Spot
Reddish-purple Blood vessel
Nevi/ stork bites
Jaundice
-normal
- occurs after 24 hours
-due to immature liver; small/gradual rise in bilirubin
MANAGEMENT: Brrastfeeding
Physiologic Jaundice
Jaundice
-Abnormal
-occurs within or less than 24 hours
-RBC destruction/ Hemolysis
-↑ Amount of bilirubin
MANAGEMENT: Phototherapy, Drop light, Bili light
Nursing Alert: PHOTOTHERAPY
-Turning of sides
-Don’t expose eyes & genitals
Pathologic Jaundice
Brain damage from increase level of bilirubin in the newborn’s brain
Kernicterus
Heart defect
Right to Left Shunt
Cyanotic Heart Defect
Tetralogy of fallot
Truncus Arteriosus
Transposition of greater aorta
Hypoplastic left heart Syndrome
Heart defect
Left to Right Shunt
Acyanotic Heart Defect
Ventricular septal defects
Atrial Septal Defects
Patent Ductus Arteriosus
4 structural defects
V-P-O-R
-Ventricular Septal defect; hole in septum
-Pulmonary stenosis; narrowing
-Right Ventricular hypertrophy; positioned to ventricular septal instead of left ventricle
-Overriding aorta; Overworked Right Ventricle
TETRALOGY OF FALLOT
Most critical disorder among the 4 defects?
Pulmonary Stenosis
-Early detection, to undergo surgery
-More narrowed=More severe
Complications of TOF:
-Hypercyanotic spells (tet spells)
-Right ventricular dysfunction
-Bacterial endocarditisi
-Polycythemia
-Death
Assessment for TOF:
-cyanosis (tet spells)
-clubbing of fingers
-polycythemia
-tripod position to reduce SOB
-Position of Choice: Knee chest/Tripod
Dx test for TOF
C-Xr: Boot-shaped cardiac silhouette
ECG: Right Ventricular Hypertrophy
Republic Act of breastfeeding
RA 10028
Breastfeeding month
August
Milk code
EO 51
RA 7600
Rooming in Law (Old)
RA 10028
Rooming in law (new)
NSVD: w/in 30 mins
CS: w/in 3-4 hours
A-B-C’s of Breastfeeding
AWARENESS:
-watch for sx of hunger
-feeding on demand (every 3 hours)
-8-10x day
BE PATIENT:
-dont hurry the infant through feeding
-10-15 mins per breast (complete emptying)
COMFORT
-relax while breastfeeding (let-down reflex); oxytocin
-avoid stress
Properties of BF
-Antiviral: interferon
-Anti-infective: IgA
-Enhance Iron absorption: Casein ↑ formula milk
-Lactalbumin (whey): Enahnce iron absorption ↑BF
-Lacto Bifidus: GI protection
easy to digest
↑BF
Whey
Hard to digest
↑formula milk
Casein
TYPE OF BREASTMILK
C-T-M
Colostrum: 4 days
:Rich in antibodies Vit. A
Transitional: 4-9 days
Mature: 10 day
: Free milk: Beginning of feeding water w/ nutrition
: Hind milk: End of feeding highly fatty
BF should be:
Early: Within 1 hour after birth
Exclusive: Breastfeeding only for 6 months
: Except Meds
Extended: up to 2 years
BF Problems
Cracked & sore nipples
-Air drying, lanolin, sterile water, no soaping
Breast engorgement
-Ice pack & hot water (Warm shower) alternate
Mastitis
-Antibiotics if with puss, no breastfeeding
-If no puss, Breastfeeding
Hormone in breat milk
Prolactin
Hormone on let down reflex
Oxytocin
Breastfeeding Contraindication:
G-U-C-H-I
Galactosemia
Untreated active TB
Chemotherapy pt.
HIV positive
Illegal Drugs (Cocaine, Marijuana)
Proper Latching
Mouth: Wide Open
Lips: Lower Lip Outward
Chin: Raised on breast
Areola: Above is visible
Sucking: Deep with pause, blowing
Body: Straight
BF Position
Cross cradle position
Football hold
Cradle Position
Side lying
Laid back positions
Arms holds the majority of the baby with other arm, gently hold their bottom as they are lying comfortably perpendicular to the breast
Cross-cradle Position
One hand free option: using arm on the same side as nursing breast, fully support baby, allowing leg to dangle.
-large breast or after C-section
Football hold
Cuddle baby into crook of your arm, using that arm support their back & head. other arms, gently hold their bottom so they are comfortably lying perpendicular to your breast.
Cradle position
lying down on your side allows your baby to do the same when side lying, the surface on your baby up, and they can nurse without a lot of support. if necessary, you can use your arm to support their neck or back.
Side lying
If yore wanting to lay down during a nursing sessions, cradle your baby in the arm on the same side as the nursing breast, using good care to support their neck.
Laid back positions
