Study Guide Flashcards
This medication Purpose:
Prophylactic treatment for newborns to prevent neonatal conjunctivitis, particularly from infections like gonorrhea or chlamydia
Erythromycin Ophthalmic Ointment
Erythromycin Ophthalmic Ointment
Purpse in New borns
Purpose: Prophylactic treatment for newborns to prevent neonatal conjunctivitis, particularly from infections like gonorrhea or chlamydia
A ribbon of 0.5% erythromycin ointment is applied to each eye, usually within the first 1-2 hours of life.
Purpose?
Prevent Neonatal Conjunctivitis
Esp from Chalmidia or Ghonnrhea
Administer 1 mg (0.5 mL) intramuscularly (IM) into the vastus lateralis (thigh) muscle for full-term infants, usually within the first 1-2 hours after birth.
This prevents bleeding disorders in new borns
Vitamin K
Isotonic fluid used for hydration and fluid resuscitation in laboring women or postpartum patients.
It helps restore blood volume, maintain electrolyte balance, and prevent dehydration during labor, delivery, and postpartum recovery.
Used during cesarean sections and for fluid boluses during hemorrhage or hypotension.
Lactated Ringers
For routine hydration in labor, LR is infused at rates typically ranging from ____ mL/hour (maintenance fluids) to higher rates for fluid replacement during active labor or postpartum bleeding.
For fluid bolus (e.g., during hypotension or to improve uterine perfusion), rates may range from _____ rapidly infused.
125 mL
500-1000 mL
This hormone is used to stimulate uterine contractions for labor induction or augmentation, as well as to manage postpartum hemorrhage.
It promotes rhythmic uterine contractions, aiding in both cervical dilation during labor and uterine involution after delivery to reduce the risk of hemorrhage.
Oxytocin
Colostrum produced until 2 - 5 days after giving birth contains these properties that prevent infection
Antibodies and white blood cells
Acts as a natural laxative, helping your baby pass their first stool (called meconium), which helps get rid of bilirubin and prevents jaundice.
Colostrum
How much colostrum is produced
A few tablespoons at a time
VS
HR
RR
OxSat
Temp
HR: 110 - 160
RR: 30 - 60
OxSat > 95
Temp 36.5 - 37.5 / 97.7°F–99.5°F
Describe the relationship between hypothermia & hypoglycemia in infants
Hypothermia causes the newborn to burn more glucose for warmth, which can lead to hypoglycemia.
Hypoglycemia, in turn, makes it difficult for the newborn to generate heat, worsening hypothermia.
Normal:
Soft, flat anterior fontanel (diamond-shaped) and posterior fontanel (triangle-shaped).
Fontanelles
Normal:
Slight overlapping of skull bones may be present due to birth canal passage.
Molding
Normal
Caput Succedaneum:
Soft, generalized swelling of the scalp (resolves in a few days).
Normal
Collection of blood under the scalp, does not cross suture lines (resolves over weeks).
Cephalohematoma
Strabismus (crossed eyes) may be present due to underdeveloped ocular muscles.
Normal or abnormal finding
Normal
Reflex (Startle): Baby throws arms outward and then pulls them in when startled.
AKA
Morro
Reflex: Toes fan outward when the sole is stroked.
Babinski
Fine hair on the back, shoulders, and forehead (more common in preterm infants)
Lanugo
Vernix Caseosa:
White, cheesy substance present in skin folds (normal).
Vernix Caseosa:
White, cheesy substance present in skin folds (normal).
Milia
: Small white spots on the nose or chin (normal).
Mongolian Spots
: Blueish-gray marks usually on the lower back or buttocks (common in darker-skinned babies).
Stork Bites
Red or pink patches usually on the nape of the neck, eyelids, or forehead (fade over time).
Erythema Toxicum:
Newborn rash with red spots and possibly small white bumps (benign and resolves on its own).
Weight: 2,500–4,000 grams (5.5–8.8 pounds).
Length: 45–55 cm (18–22 inches).
Head Circumference: 33–35 cm (13–14 inches).
Probably not needed
Hypoglycemia Causes
SGA infants may struggle to maintain ____ levels, while LGA infants may experience hypoglycemia due to high ____ levels
glucose / insulin
Jaundice Monitoring:
Both SGA and LGA infants are at risk of developing jaundice due to different physiological factors
SGA (liver immaturity).
LGA polycythemia
Where to insert bulb syringe to suction fluids
Mouth in the cheeks
Bilirubin is a byproduct of _____ breakdown, and newborns, especially preterm ones, are prone to developing elevated bilirubin levels (hyperbilirubinemia) due to their immature liver function.
RBC
Physiological Jaundice:
Occurs:
Causes: The newborn’s liver is not fully developed, so it cannott efficiently process bilirubin.
Duration:
Peaks around 3-5 days and resolves within 1-2 weeks as the liver matures.
Pathological Jaundice:
Occurs….
Causes: May be due to blood type incompatibility (Rh or ABO), infection, liver disease, or excessive breakdown of red blood cells (hemolysis).
Which is dangerous….
Physiological
Occurs After the first 24 hours of life (usually 2-3 days post-birth).
Pathological
Occurs: Within the first 24 hours of life or persists beyond 2 weeks.
Pathological is Dangerous
Interventions for Jaundice (3)
From least to most Jaundice level
Feeding poops the bilirubin out
Blue light therapy
Exchange Transfusion:
Indication: If bilirubin levels are dangerously high (risk of ), a blood exchange transfusion may
Kernicterus: A serious complication of untreated severe hyperbilirubinemia, where bilirubin enters the brain, causing permanent neurological damage. Signs include extreme lethargy, high-pitched crying, poor feeding, and arching of the back.
Serious
bilirubin enters the brain, causing permanent neurological damage.
Signs include extreme lethargy, high-pitched crying, poor feeding, and arching of the back.
When to Seek Medical Attention Jaundice
First 24 hours after birth.
Excessively sleepy, difficult to wake, or refuses to feed.
If jaundice worsens (progresses down the body) or persists beyond 2 weeks.
Summary of Nursing Care for
Breastfeeding releases ____ in the mother, which helps with the contraction of the uterus after delivery and strengthens the emotional connection with the baby.
oxytocin
Reduced risk of Sudden Infant Death Syndrome (SIDS). From breastfeeding
T or F
T
Breastfeeding Helps with uterine involution (the return of the uterus to its pre-pregnancy size) and reduces postpartum bleeding.
T or F
T
Explain difference in feeding schedule for breastfeeding or bottle feeding
Breast 2/3
Bottle 3/4
Signs of complications like preeclampsia
(elevated blood pressure, severe headache, visual disturbances)
Screen for postpartum depression how?
Open-ended question
Edinburgh Postnatal Depression Scale (EPDS) or the Postpartum Depression Screening Scale (PDSS).
Difference between baby blues and postpartum depression
Baby blues <2weeks
PP Depression >2weeks
Fundal involution
Immediately after birth
12hrs
24hrs
1 week
2 weeks
Immediately post birth.
At Umbilicus, firm, and midline
12hrs
Rises 1cm above Umbilicus
24hrs
Descended 1 cm daily
1 week
Halfway from Umbilicus & pubis symphysis
2 weeks
No longer palpable
6 weeks
Returns to prepregancy size - in pelvic cavity
Uterine Atony:
A boggy uterus that does not contract properly, often leading to postpartum hemorrhage.
Interventions: ….
Fundal massage
administration of uterotonic drugs (e.g., oxytocin, misoprostol),
bladder emptying.
Subinvolution:
The failure of the uterus to return to its normal size at the expected rate. This can be caused by retained placental fragments, infection, or uterine atony.
Signs: Persistent lochia rubra, larger-than-expected uterus upon palpation.
Interventions:
Pharmacologic treatment (oxytocin, methylergonovine), antibiotics if infection is suspected, and D&C (dilation and curettage) for retained placenta.
Postpartum Hemorrhage (PPH):
Defined as blood loss of more than 500 mL after a vaginal delivery or 1000 mL after a cesarean section.
Risk Factors: Uterine atony, trauma, retained placental fragments, and coagulopathy.
Interventions: .
Fundal massage, medications (oxytocin, misoprostol, methylergonovine), and in severe cases, surgical interventions like uterine artery ligation or hysterectomy
Endometritis:
Infection of the uterine lining. This often occurs if placental fragments are retained or due to bacterial infection.
Symptoms: Fever, uterine tenderness, foul-smelling lochia.
Interventions:
Broad-spectrum antibiotics, monitoring for signs of sepsis.
Displaced Uterus:
A uterus that is deviated to the side (often due to ____) can interfere with normal involution. Immediate intervention is required to help the patient void and reposition the uterus.
full bladder
Excessive Lochia or Large Clots:
Heavy bleeding or passing large clots can indicate uterine atony or retained placental fragments. Clots larger than ___ are a cause for concern.
Golf ball / maybe fist
Uterus Above Expected Level:
If the uterus is higher than expected (e.g., above the umbilicus beyond 12 hours postpartum), this may suggest (3)
Subinvolution, retained fragments, or infection.
Newborns typically feed ___ times per day.
8-12
Cluster feeding
New born feeding often which stimulates breast milk p
Newborns typically take ___ ounces of formula per feeding in the first few days
1-2
Write daily Wet Diapers from notes
H
Orange uric crystals are normal and not dangerous. But if they are still present two days after birth, it may be a sign that your baby….
not drinking enough.
Stool Output:
Days _____: Meconium (thick, black, tarry stools).
Day ___: Transition stools appear (brown or greenish).
By Day ____: Breastfed babies pass yellow, seedy stools, while formula-fed babies tend to have more formed, yellow-brown stools.
1 & 2
3&4
5
New borns can lose up 8% body
Most newborns should regain their birth weight by ___ days of life.
A steady weight gain of about 20-30 grams (0.7-1 oz) per day is expected after that.
10 - 14
Cord care
Avoid which type of baths
Immersion
Sponge baths preferred
cord stump remains attached after birth and typically falls off within _____
Proper care of the cord during this time is important to prevent infection (omphalitis) and to ensure that the area heals properly.
1-3 weeks
APGAR
Explain scoring system
Appearance (Skin Color)
0 Blue/pale all over
1Body pink, extremities blue Acrocyanosis
2Completely pink
Pulse (Heart Rate)
0Absent
1Less than 100 bpm
2 100 bpm or higher
Grimace (Reflex Irritability)
0 No response to stimulation
1 Grimace or weak cry with stimulation
2 Active cry, pulls away, coughs, or sneezes with stimulation
Activity (Muscle Tone)
0 Limp, no movement
- Some flexion of extremities
- Active motion, well flexed
Respirations (Breathing Effort)
- Absent Slow
- Iirregular, weak cry
- Good, strong cry, regular breathing
APGAR
____: Indicates the newborn is in good health. Routine post-delivery care is usually sufficient.
____: Indicates moderate difficulty in adapting to extrauterine life. Newborn may need some assistance, such as stimulation and oxygen support.
___: Indicates severe distress and requires immediate resuscitation efforts such as positive pressure ventilation and possibly advanced resuscitation.
7-10
4-6
0-3
Describe LATCH Scoring system
Latch
0No latch at breast
1 Repeated attempts, holds nipple in mouth but sucks weakly
2Grasps breast, tongue down, rhythmic sucking
A: Audible Swallowing
- None heard
- A few with stimulation
- Spontaneous and intermittent swallowing heard
T: Type of Nipple
- Inverted
- Flat
2.Everted (after stimulation)
C: Comfort (Breast/Nipple)
- Engorged, cracked, bleeding, or severe discomfort
- Mild to moderate discomfort, reddened, blisters
- Soft, non-tender breast, no pain
H: Hold (Positioning)
- Full assist needed
- Minimal assist (staff holds infant at breast)
- No assist from staff, mother able to position and hold infant
Consider ____ if necessary to encourage latch if nipples are the problem
Nipple shields
