Postpartum and newborn Flashcards
Pertussis
can be passed onto the baby, and can be deadly for a newborn
3 processes of uterine involution
contraction of muscle fibers, catabolic processes-autolysis of endometrial cells, regeneration of uterine epithelium
How does the site of placental attachment heal
by the process of exfoliation, leaves the endometrium smooth and without scars
How is involution evaluated
measuring the descent of the uterus, decreases 1 cm per day, should no longer be palpable after 14 days
Why are contractions necessary
to achieve hemostasis at the placental site
What are contractions stimulated by
oxytocin
Lochia
vaginal discharge after birth, immediately following delivery
Lochia rubra
red or reddish brown, bloody, day 1-3
What should lochia be like for up to 2 hours after birth
a heavy menstrual period
Lochia serosa
pink or brown, serosanguinous, day 4-10
Lochia alba
white or cream or yellow, day 11-16 weeks
What does the lochia reflect
regeneration of the endometrium
How are perineal lacerations classified
in degrees to describe the amount of tissue involved
First degree laceration
involving the superficial vaginal mucosa
Second degree laceration
involving the vaginal mucosa, perineal skin, and deeper issues, may include fascia and muscles of the perineum
Third degree laceration
same as second degree laceration but involves the anal sphincter
Fourth degree laceration
extends through the anal sphincter into the rectal mucosa
Periurethral area
a laceration in the area of the urethra, may cause difficulty with urination
What is common after birth
large output of 3,000 ml of urine a day, profuse diaphoresis (especially at night)
Diastasis recti
abdominal wall muscles separate
Postpartum warning signs
fever greater than 100.4, foul-smelling lochia, large blood clots, large volume of bleeding, severe headaches, blurred vision, calf pain, shortness of breath, depression, extreme mood swings, UTI
Bonding
the initial attraction and relationship felt by the parents and an infant
Attachment
the process by which an enduring bond to a child is developed through pleasurable satisfying parent-child interactions
En face
putting a newborn in front of face
Fingertipping
using the tips of fingers to touch the baby
Enfolding
holding a baby and taking it in
Claiming/binding in
psychological change, high-pitched voice talking to the baby
Puerperal phases
taking in, taking hold, letting go
taking in phase
mother is focused on her own need for food and sleep, passive behavior for 1-2 days, birth is a reality
taking hold phase
becomes more independent and concerned for her self-care, shifts attention to the newborn, teaching is best here
letting go phase
relinquishes to previous roles, adjusting to disappointments, letting go of ideals, bonding is starting, new roles are identified
AGPAR
appearance, pulse, grimace (reflex irritability), activity, respiration
When is AGPAR assessed
1 and 5 minutes after birth
AGPAR scores
if at 5 minutes the score is less than 7, continue assessment every 5 minutes for 20 minutes
What is given after birth
eye prophylaxis, vitamin k, hepatitis B vaccine
Why is vitamin K given
to help with clotting because the newborn has no intestinal flora to help produce vitamin K
What does eye prophylaxis do
prevent ophthalmia neonatorum
How soon should a mom start to breastfeed
within an hour of birth
First period of reactivity
birth to 30 minutes/2 hours after birth
the newborn is alert/moving/may appear hungry
Period of decreased responsiveness
30 to 120 minutes old, sleeping or decreased activity
Second period of responsiveness
2 to 8 hours, newborn awakens and shows an interest in stimuli
What is normal for a newborn after birth
to lose weight, no more than 10% of weight
What does surfactant do
helps to prevent alveolar collapse
Respiration rate of newborn
30 to 60 breaths per minute
Convection
loss of heat to the cooler air currents
Radiation
transfer of body heat to a cooler solid object nearby
Evaporation
loss of heat through conversion of a liquid to a vapor
Conduction
loss of heat to a cooler surface by direct skin contact
Lanugo
newborn hair growth
Newborn screening after 24 hours
bilirubin testing, metabolic screen, hearing screening, CCHD
Metabolic screening
identifies errors of metabolism, drop of blood obtained from baby’s heel 24-48 hours after birth
what is the #1 birth defect in newborns
hearing
CCHD screening
identifies cardiac defects not diagnosed during pregnancy, pulse ox is placed on right hand and either foot, should be greater than or equal to 95
Hypoglycemia in newborns
<40
Jaundice occurrence
60% of term babies, 80% of preterm infants
