OB test 1 Flashcards
3 periods occur when baby is born
- 1st period of activity- couple hours after birth- baby is awake, bond with baby, feed, skin to skn
- 2nd period- rest- baby sleeps for about two hours
- 3rd period of activity- awake and bonding
Newborns senses are tested before sent home
KNOW: hearing test on every baby before they go home*
What is formed in the lungs when the fetus is developing and what is its function?
The fetus produces surfactant at 24-25 weeks- this keeps alveoli open.
This is why premature babies born at this time have a chance of survival
-Babies do breath inutero but no gas exchange-
Vessels in the umbilical cord
There are 3: 2 arteries, 1 vein
Oxygen comes from the vein.
AVA
Ductus Venosus
bypasses the LIVER to get to the heart faster
Ductus Arteriosus
bypasses the LUNGS
Foramen Ovale
-shunts blood from RIGHT to LEFT atrium
Types of heat loss
Conduction- prevented by holding, touching
Convection- (air) protect from drafts of air
Radiation- sunlight
Evaporation- dry the baby off
**PRETERM BABIES HAVE A HARD TIME STAYING WARM
Heat loss in a newborn can cause 3 things. What are they?
- Respiratory distress
- Hypoglycemia
- increases oxygen demand
What is brown fat?
-area of skin that has lots of blood vessels, help keep baby warm because babies are unable to shiver. (found in back of neck)
Normal Respiration Rates for Newborn
-30-60 bpm
*periods of APNEA less than 20 seconds is NORMAL!
-See-saw resps are abnormal
Normal Temp for newborn
-97.7-99.1
Anything less than 97.7, you need to intervene.
NO rectal temps, temps are taken axillary
low temp coud be a sign of infection
S/S of respiratory distress
- nasal flaring, GRUNTS, tachypnea, retractions
- Ambu bag should be in every delivery room
What vitamin is given at birth and why?
Vitamin K is given at birth because the gut is sterile, cannot synthesize vitamin K which is needed for clotting.
First feeding
-start with 15mL and increase with next feeding
Babies first stool
*MECONIUM- black and tarry within 12-24 hours
3 causes of bowel movements that occur inside.
- post due dates
- fetal distress
- Breech positioning
When is jaundice normal? When is it not normal?
Jaundice within the first 24 hours is ABNORMAL (pathological)
Jaundice after 24 hours is normal (physiological)
Normal Blood Glucose in a Newborn
40-60mg for the first day
(Babies with diabetic mom are prone to hypoglycemia)
What are the different types of immunty and how does the baby get them?
IGG- diseae is gone- baby gets immunity from mother/placenta.
IGM- disease process is going on. Baby must have infection to get immunity.
IGA- passed only to breast fed babies
What is the Moro Reflex?
Startle reflex- make loud noise and baby becomes startled. (clap hands, raise arms and drop)
Babies hands will be in a C position
Babinski reflex
run finger upwards on sole of foot, toes expand and big toe dorsiflex.
(this is healthy for babies, not for adults)
How to tell the difference between seizure and hypoglycemia?
If baby shakes, hold them close to you. If they stop it is hypoglycemia, if they dont its a seizure
Normal heart rate in newborn
120-160 for newborn- apical for one min
110-160 for fetal heartbeat
APGAR score
2 numbers: taken at 1 MINUTE and 5 MINUTE
A-appearance
P-pulse
G-grimace
A-activity
R-Respiratory effort
(2 points for each; 10 total…. 8-10 baby is well, 4-7 some kind of intervention needed, 0-3 baby is not well.)
Is it normal for a newborn to have 10% weight loss within the first couple days?
YES
For full term babies, how much of theyre feet should have creases?
2/3 is normal - plantar creases.
Flex position
this is normal for a full term baby
Anterior suture
Diamond shaped 4-5cm
Posterior suture
Triangle shaped 0.5-1 cm (closes first)
Caput
- crosses the suture line and is fluid filled. this usually goes away fast
Cephalhematoma
does not cross suture line (one sided) and is usually blood filled
lasts for a while.
Erythema Toxicum
Newborn Rash. this is NORMA. it goes away on its own
Breast is best!! why?
- babies stop when theyre full; less chance of overfeeding
- immunity- IGA
- helps uterus contract and body get back to norm
- its convenient- no formula, no warming bottle
- decrease upset stomach, diarrhea and colic
- stimulates growth of + bacteria in the gut
- promotes bonding, proper temp
How do you tell if a baby is being fed adequately?
6-10 wet diapers a day indicate adequate nutrition
Cord care
falls off within 7-10 days.
**its okay to bathe and get the cord wet!
When can newborn be tested for PKU
after eating for 24 hours before test
Small Gestational Age (SGA)
-below 10th percentile (5lbs 8oz)
Large Gestational Age
- 90th percentile- above 8 lbs
at risk for hypoglycemia, and birth trauma
Amnioinfusion
- done during labor to prevent meconium aspiration.
LR in placenta to dilute meconium.
Tracheal suction used if baby is not crying
Post partum is when
the time they deliver till 6 weeks after
pregnancy is a state of?
WELLNESS NOT ILLNESS
Erythromicin is given how? and why
in eyes put in on like toothpaste give to protect from Viruses, STDs
Cephalopelvic disproportion (Baby >8 lbs) can cause probems what are they?
hypoglycemia, polycythemia, jaundice
pre-embyonic period
conception to day 14 of preg. ALL or NOTHING if exposed to tetragens SERIOUS
Embryonic period
day 15-last day of 8 week (56) MOST important time for exposure to tetragens
Fetal period
end of 8th week untill birth of babe
in week 3 of gestation what is developing
CNS, brain, spinal cord, heart
when does the fetus’ face begin to look human?
13th week
When is C-shaped tail formed, face, upper respiratory and when does the neural tube close? (what is vital for this neural tube to close?
4th week gestation, FOLIC ACID very important to NTD
when in utero does the heart beat @ reg rythym and paddel shaped limbs form?
5th week
when does the face fully dev in utero?
6th week
at what time is the fetus at or about the symphis pubis? (pubic bone)
12 weeks
T/F In pregnancy the blood volume increases 40-50%
TRUE
BP 1st trimester: stays same
BP 2nd Trimester: decreases
BP 3rd trimester: Goes back to normal
Pregnant moms are hypercoaguable and have increased leukocytes, this puts momma at risk for?
DVT!
N&V aka Morning sickness is very common @ 6-12 weeks due to what?
increased HCG levels
Progesterone (progestin) levels
supports endometreal lining, keeps baby inside
Levels increase during pregnancy and decrease in labor
Healthy people 2000, 2010, 2020 etc. lol
Increase proportion of pregnant women who receive early prenatal care
Neagels Rule
last period, subtract 3 months, add 7 days
ex. my last period was Jan 29th, subtract 3 months = October, add 7 days = NOVEMBER 5th
- Anonymus
GTPAL?
G- Gravida (# of times pregnant)
T- Babies carried 38+ weeks (TERM)
P- Preterm (20-37 and 6/7 weeks)
A- Abortions (any baby lost miscarried aborted etc) before 20 weeks
L- Living kids
In most hospitals we just use G/P
Gravida = Pregnancies
P- number or preg that ended at 20+ weeks (para)
AFP or quad screening
not a diagnostic test! they all SCREEN for NTD and genetics, follow with an amniocentesis
Chronic Villus sampling (CVS)
after 10 weeks , genetic counseling (ex. 42 year old pregnant girl), never do before 10 weeks can cause limb defects in unborn fetus
Non-stress test (NST) is to see if baby can react under non-stress we put 2 monitors on momma to monitor HR what do we want?
we want it to be reactive!!! so if baby is moving their HR increases this means the CNS of babe is intact
Biophysical profile what are levels
8-10 good! 4-7 BAD <4 Horrible outcome
(same as APGAR)
Normal Hematological dilution w/ pregnancy
H&H decreases
Rubella (Measels) if mom gets the vaccine after she delivers?
tell her wait 1 month to get pregnant again (KEEP EM CLOSED OR USE PROTECTION)
-Anonymus
A couple things to tell mom to aviod when pregnant
no douching (Ew) no skiing (DUH) they can excersice light no body building
Urinary Freq.
Comes @ beginning and end of preg!
lower abdominal pain accompanied by shoulder pain may be indicative of what?
ECTOPIC PREGNANCY :(
Pain in calf can be indicative of what?
DVT
Preeclampsia may occur in 3rd trimester what are some s/s
sudden weight gain, periorbital or facial edema
4 stages of labor
1st stage- 3 parts (onset of labor till fully (10 cm) dilated
- LATENT phase 0-3 sonometers dilated (calm mood)
- Active: 4-7 cm dilated
- TRANSITION 8-10 cm dilated (they dont think here) WATCH OUT
2nd stage- 10 cm dilated to birth of baby (Actively pushin)
3rd stage- after birth of baby———>delivery of placenta
4th stage- from delivery of placenta till 1-4 hrs after (post partum)
the four p’s for how the baby gets thru
passage (pelvis)
passenger (Baby)
Powers (Contractions=Primary) Secondary=Pushing)
Psyche (attitude)
Most common positions of baby (also most preferred)
LOA and ROA, (when baby is born, head is down)
most favorable pelvis shape and best outcome for baby if mom has?
Gynecoid (true pelvis) perfect for fitting baby thru, its wide and round