Self and Baby Care

Question 1

Expectations for right after birth

Answer 1

• Shaking in mother (can be severe)
• Blood loss from placental site (may require fundal massage or other measures)
• Repair of perineum
• Hold and bond with baby (skin to skin)
• Initiate breastfeeding
• Walk, drink, eat when ready

Question 2

First hours and days

Answer 2

• Transfer to PP room
• Continued bleeding
• Continued contractions/cramping that lessen after 1-2 days
• Feeling weak or unsteady
• Sore muscles esp. if you labored or pushed for a long time
• Exhaustion and excitement
• Swelling and tenderness in perineum

Question 3

BUBBLE-HEE

Answer 3

Breasts
Uterus
Bladder
Bowels
Lochia
Episiotomy/Perineum
Homans' sign
Extremity edema
Emotional status

Question 4

Homans’ Sign

Answer 4

• Support patient’s thigh with one hand and foot with other
• Bend leg slightly at knee then dorsiflex ankle
• Deep calf pain = Homans’ sign

Question 5

Lochia Rubra

Answer 5

• Dark red
• Lasts 3-4 days
• Contains blood, cervical discharge, part of placenta, fetal membrane, vernix, meconium

Question 6

Lochia Serosa

Answer 6

• Pinkish brown
• Lasts 4-10 days
• Thin, watery, tinged
• Contains cervical mucus, exudate, fetal membrane, microorganisms, WBCs

Question 7

Lochia Alba

Answer 7

• Whitish yellow
• Lasts 10-28 days
• Purulent discharge
• Contains cholesterol, epithelial cells, fat, microorganisms

Question 8

Documenting Lochia

Answer 8

• Scant: 1 inch stain
• Light: 1-4 inch stain
• Moderate: 4-6 inch stain
• Heavy: saturate pad in 1 hour

Question 9

Tips to speed body’s recovery

Answer 9

• Replenish fluids/electrolytes/energy by drinking and eating ASAP
• Continue to eat well-balanced meals at frequent, regular intervals
• Continue taking prenatal vitamins and minerals (magesium and iron)
• Sleep as much as possible

Question 10

Following days and weeks

Answer 10

• Breast tenderness or nipple soreness
• Possible profuse sweating
• Continued tenderness in perineum
• Continued lochia
• Possible hair loss
• Continued exhaustion
• Gas, bloating, constipation
• Paunchy belly as muscles return to pre-pregnancy size over time
• Possible leaking urine due to stretching of pelvic floor muscles

Question 11

Newborn Care Practices at birth

Answer 11

• Suctioning: baby’s nose and mouth suctioned with bulb syringe
• Cord clamping and cutting: immediate or 3-5 minute delay
• Skin to skin

Question 12

APGAR - Activity

Answer 12

0: absent
1: arms and legs flexed
2: active movement

Question 13

APGAR - Pulse

Answer 13

0: absent
1: below 100 bpm
2: over 100 bpm

Question 14

APGAR - Grimace

Answer 14

0: flaccid
1: some flexion of extremeties
2: active motion

Question 15

APGAR - Appearance

Answer 15

0: blue/pale
1: body pink/extremities blue
2: completely pink

Question 16

APGAR - Respiration

Answer 16

0: absent
1: slow, irregular
2: vigorous cry

Question 17

APGAR Score

Answer 17

0-3: severely depressed
4-6: moderately depressed
7-10: excellent condition
- If score is 5 or less at 5 min, repeat at 10 min

Question 18

Normal Newborn Happenings

Answer 18

• Some gagging in 1-2 days as baby clears mucus and fluids
• Frequent hiccups and sneezing
• Jerky, quivering, spastic movements
• Black, tar like stool 1-2 days shifting to more yellow/mustard seedy stool
• Frequent stools (up to 10-12 day)
• Bruising or puffiness form birth
• Babies lose 7-10% of birth weight and regain by 10-14 days
• Spitting up

Question 19

Newborn Abilities

Answer 19

• Sees faces best at 8-14 inches
• Recognize scent
• Developed taste buds
• Recognize voice
• Self attachment at breast

Question 20

Newborn Reflexes

Answer 20

• Grasp
• Plantar toe
• Babinski toe
• Rooting
• Moro or startle
• Stepping/walking

Question 21

Newborn Appearance

Answer 21

• Swelling
• Vernix
• Head molding
• Stork bites
• Lanugo
• Swollen genitals
• Blue hands and feet
• Blotchy skin or rash
• Milia

Question 22

Newborn Needs

Answer 22

• Warmth: blanket/hat/skin
• Food: breast or bottle Q1-3 hours or more
• Sleep: short increments 16+ hours a day
• Soothing/love/comfort
• Clean and dry

Question 23

Umbilical Cord

Answer 23

• Will fall off 2 weeks after birth
• Keep it dry and clean
• Infection: swelling, redness, bleeding, pus, oozing, foul smelling discharge

Question 24

Sleeping

Answer 24

• Co sleeping: baby in bed
• Room sharing: baby in room
• Own room: monitor

Question 25

Call doctor if baby:

Answer 25

• Has temp of 100.4 or higher or 97.8 or lower
• Has breathing difficulties
• Cries frequently
• Has foul smelling/mucus/bloody bowels
• Is lethargic or dehydrated
• Has mucus in eyes/umbilical/circumcision
• Develops jaundice

Question 26

Call doctor if you:

Answer 26

• Persistent vomiting/fever/flu-like symptoms
• Heavy bright vaginal bleeding with clots or soaks through a pad in 2 hours or less
• Vaginal itching or foul smelling lochia
• Burning/difficulty urinating
• Persistent faintness or dizziness
• Pain, swelling, tenderness, redness in legs