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Maternal-Newborn (Josh) > T3 - Advance Organizers (Josh) > Flashcards

T3 - Advance Organizers (Josh) Flashcards

1
Q

Patient education r/t circumcision:

A

do NOT clean off yellow exudate

watch for gauze that could wrap around and cut off circulation

not bath until heals

Plastibell will fall off in diaper

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2
Q

What happens during the first period of reactivity?

A

HR increases then falls back to b/t 100-120

RR is 60-80

Audible grunting, nasal flaring, and chest retractions (should clear within 1 hr)

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3
Q

Vacuum assisted birth babies can have a — that crosses suture lines.

A

Caput Succedaneum

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4
Q

An infant may normally lose up to — of birthweight.

A

5-10%

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5
Q

What happens during the second period of reactivity?

A

Tachycardia

Tachypnea

Increased muscle tone (Jumpy)

Increased mucous production (monitor for chocking/gagging)

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6
Q

What are characteristics of postterm newborn?

A

deep sole creases

skin dry and cracked

long nails

meconium staining of skin, nails and cord

loss of subq fat and muscle mass

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7
Q

Normal bilirubin levels?

A

direct bilirubin at birth = 0-1 mg/dL

**cord blood bilirubin should be

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8
Q

The baby’s head will be — than his chest.

A

0.5 in larger

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9
Q

PP blues start around — and last —

A

PP day 2-3

2 wks

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10
Q

REEDA stands for:

A 
Redness
Edema
Echymosis
Drainage
Approximation
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11
Q

Normal newborn heart rate is —

Normal newborn respiratory rate is —

A

120-140

30-60

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12
Q

Interventions to decrease perineal edema?

A

Ice Pack (first 24 hrs)

Sitz Bath (after 24 hrs)

Blot dry, wipe from front to back

Apply new pad after each void

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13
Q

What could be a possible cause of a high-pitched cry?

A

hypoglycemia

***obtain blood glucose (

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14
Q

What does the posterm newborn’s skin look like?

A

dry and cracked

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15
Q

The baby’s head will be — than his chest.

A

0.5 in larger

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16
Q

Nursing care for baby just circumcised?

A

Hold feeding until procedure

Document first voiding post procedure

Not tub bath until heals

Check for healing or drainage

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17
Q

— causes milk production

— causes milk letdown.

A

Prolactin

Oxytocin

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18
Q

Most common symptom of perineal hematoma is —

A

pain

***retroperitenial hematoma can be life-threatening b/c of tear in hypogastric artery

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19
Q

Which glucose level require intervention?

A
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20
Q

Breasts:

What should they feel like on PP day 1-2?

What should they feel like on PP day 3-4?

A

soft (ear)

filling (nose)

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21
Q

An infant loses heat via — when they are covered with a wet gown or AF.

A

evaporation

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22
Q

SGA =

LGA =

AGA =

A

SGA = 90th %

AGA = 10th-90th %

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23
Q

What constitutes a dangerous level of bilirubin?

A

15 mg/dL at any time

***kernicterus (irriversable)

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24
Q

Why is erythromycin given on eyes?

A

prophylactic protection from blindness caused by gonorrhea

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25
Q

What should we teach about Rubella vaccine?

A

Two doses

Avoid pregnancy for 1 mth after each dose

Safe for breastfeeding
***May cause rash if allergic to duck eggs

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26
Q

The client is best receptive to teaching during which phase?

A

Taking Hold Phase

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27
Q

Best prevention for thrombus formation is —

A

early ambulation

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28
Q

Best time for bonding is —

A

breastfeeding

***NICU baby will miss this due to being in taken immediately to NICU

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29
Q

— is a collection of blood b/t skull and peritosteum that does NOT cross suture lines

A

Cephalhematoma

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30
Q

When would Rhogam be administered?

A

within 72 hrs after delivery

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31
Q

Scant lochia =

Light lochia =

Moderate lochia =

A

10 cm

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32
Q

How can mastitis be prevented?

A

wash nips w/ water only

air dry for 20 mins

apply expressed milk or non-alcohol cream to prevent drying/cracking

empty engorged breasts

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33
Q

Circumcision:

—- requires no ointment

—- is bloodless and requires petroleum jelly or antibiotic ointment.

A

Plastibell

Yellen Mogen clamp

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34
Q

An infant loses heat via — when they remain uncovered in a cold room.

A

convection

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35
Q

What is a good APGAR score?

A

7-10

***less than 3-4 will require resuscitation

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36
Q

How much Vit. Ka is given and which size needle?

A

0.5 - 1 mg

5/8 in needle

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37
Q

What does cold stress lead to?

A

Cyanosis (uses up O2)

Jaundice/Kernicterus (due to buildup of bilirubin levels)

Hypoglycemia (due to use of glucose for heat production)

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38
Q

S/S of PP shock

A

Tachycardia

Tachypnea

BP decreases

Skin cool, clammy with pallor

Restlessness and Dyspnea

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39
Q

What is important about the process of exfoliation?

A

tissue regeneration at site of implantation w/out scar tissue formaion

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40
Q

What is a good APGAR score?

A

7-10

***less than 3-4 will require resuscitation

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41
Q

Normal newborn RR

A

30-60 w/ short periods of apnea (

42
Q

When is the first period of reactivity?

When is the second period of reactivity?

A

First = Birth to 30 mins

Second - 2-8 hrs after birth and lasts 10 mins to several hrs

43
Q

What will we see as unconjugated bilirubin is broken down under phototherapy?

A

stools become more frequent and loose and change color as bilirubin is broken down

urine will be darker as bilirubin is broken down

44
Q

What is heavy lochia?

A

one pad within 2 hrs

45
Q

Which type of jaundice is caused by increased levels of uncongjugated bilirubin?

A

Pathologic

***within 24 hrs

46
Q

Late PPH is after — and blood looks —

A

24 hours

darker red

***retained placental fragments

47
Q

Normal WBC value during PP period?

A

20,000 - 25,000 mm3 (slightly elevated)

48
Q

When is the first period of reactivity?

When is the second period of reactivity?

A

First = Birth to 30 mins

Second - 2-8 hrs after birth and lasts 10 mins to several hrs

49
Q

Oxytocin is released from the — pituitary

A

posterior

50
Q

Normal blood glucose is —

Treatment is required if blood glucose falls below —

A

60-70 mg/dL

45 mg/dL

51
Q

What do the sole creases look like in postterm newborn?

A

deep sole creases

52
Q

How is congenital hip dislocation identified?

A

Positive Ortoloni test

Asymmetry of gluteal folds

Limited hip abduction

Apparent shortening of femur

53
Q

Interventions for episiotomy discomfort?

A

warm sitz bath after 24 hrs

anesthetic spray

witch hazel pads

peri hygiene

54
Q

Where should fundus be after birth?

A

firm, midline, and 1-2 cm below umbilicus

***rises in first 12 hrs before dropping 1-2 cm every 24 hrs

55
Q

Which phase?

a. Focused on forward mvmt of family as a unit w/ interacting members
b. Reassertion of relationship w/ partner
c. Resumption of sexual intimacy
d. Resolution of individual roles

A

Letting Go Phase

56
Q

Afterpains are more common with — and —

A

multigravidas

breastfeeders

57
Q

Late PPH is after — and blood looks —

A

24 hours

darker red

***retained placental fragments or infection

58
Q

Normal cord blood bilirubin

A
59
Q

What is number one cause of a boggy uterus?

A

full bladder

60
Q

An infant loses heat via — when they come into direct contact w/ a cold scale.

A

conduction

61
Q

When should postpartum assessments be done?

A

q15 * 4
q30 * 2
q1hr * 4
q8hr

62
Q

Which type of jaundice is self-limiting (resolves in 1-2 wks) and occurs after 24 hrs (peaks at days 3-5)?

A

Physiologic

63
Q

When is PKU screening done?

A

after ingesting sufficient milk

***phenylalanine is an essential amino acid found in milk

64
Q

Normal newborn HR

A

120-140

***4th ICS MCL

65
Q

Normal cord blood HGB and HCT

A

HGB = 17 g/dL

HCT = 55%

66
Q

— jaundice occurs after 24 hrs

— jaundice occurs within 24 hrs

A

Physiologic (self-limiting and self-resolves)

Pathologic (requires phototherapy, etc)

67
Q

Which enzyme is necessary to conjugate (breakdown) bilirubin?

A

glucornyl transferase

***newborn liver is immature and doesn’t produce enough

68
Q

What is number one cause of excessive bleeding?

A

uterine atony

69
Q

Sign of Down’s Syndrome

A

low set ears

simian hand crease

palpable fissures of eyes

70
Q

What happens during the second period of reactivity?

A

Tachycardia

Tachypnea

Increased muscle tone (Jumpy)

Increased mucous production (monitor for chocking/gagging)

71
Q

S/S of DVT

A

Reddened, warm area over affected vein

Pain/Tenderness on ambulation

72
Q

What is the priority intervention when a PP client is bleeding excessively or if they pass a clot?

A

check consistency and location of fundus

73
Q

Diffuse swelling that crosses suture lines is —-

Swelling from blood confined within suture lines (doesn’t cross) is —-

A

Caput succedaneum

Cephalhematoma

74
Q

What are risk factors for a PP thrombosis?

A

Increased clotting factors

Immobility

Sepsis

Maternal age > 35

Multiparity

Smoking

History of CVD or Diabetis

75
Q

When would the fundus be nonpalpable?

A

by 2 wks

76
Q

What bilirubin levels will lead to staining of body?

A

4-6 mg/dL

***starts first in head and face then progresses to trunk

77
Q

Which phase?

a. First 1-2 days
b. Introspective and preoccupied w/ own needs rather than baby
c. Passive/dependent behavior
d. Excited & talkative
e. Touches and explores infant
f. Needs to verbalize L&D experience

A

Taking In Phase

78
Q

Which glucose level require intervention?

A
79
Q

An infant loses heat via — when they are placed too close to a cool wall.

A

radiation

80
Q

What would breast fed baby stool look like?

What about bottle fed?

A

breast fed = seedy, mustard colored, loss and aromatic

bottle = pale yellow to brown; more firm

81
Q

Normal WBC levels in newborn

A

9,000 - 30,000 (slightly elevated)

82
Q

Early PPH is with — and blood looks —

A

24 hours

bright red

***lacerations

83
Q

If Lochia reverts to previous state or lasts longer than should, what do we suspect?

A

uterine infection

  • foul odor as well
84
Q

Normal newborn heart rate is —

Normal newborn respiratory rate is —

A

120-140

30-60

85
Q

Normal WBC value during PP period?

A

20,000 - 25,000 mm3 (slightly elevated)

86
Q

What does cold stress lead to?

A

Cyanosis (uses up O2)

Jaundice/Kernicterus (due to buildup of bilirubin levels)

Hypoglycemia (due to use of glucose for heat production)

87
Q

Why suction mouth before nose?

A

to prevent infant from inhaling pharyngeal secretions by gasping as the nares are touched

88
Q

Nursing interventions for afterpains

A

NSAIDs before breastfeeding

Self-resolves in 3-7 days

Good sign that uterus is contracting

89
Q

What maternal labs are drawn 12-24 hrs post delivery?

A

Hgb and HCT

Urinalysis sometimes

Rubella and Rh if unknown

90
Q

What days?

Lochia Rubra =

Lochia Serosa =

Lochia Alba =

A

Days 1-3

Days 4-9

Days 10 and up

91
Q

What are parameters for infection in the PP client?

A

eleveated temp of 100.4 or more 2 SUCCESSIVE DAYS during first 10 PP days

***Not counting first 24 hrs

92
Q

How can a Cephalhematoma lead to increased bilirubin?

A

as RBCs in the bruise break down, they increase bilirubin levels

93
Q

What happens during the first period of reactivity?

A

HR increases then falls back to b/t 100-120

RR is 60-80

Audible grunting, nasal flaring, and chest retractions (should clear within 1 hr)

94
Q

What stools are a sign of sickness?

A

constipation or diarrhea

95
Q

A newborn needs — cal /day

A

110 cal/day

96
Q

Treatment for DVT

A

Bedrest

Moist heat

Heparin

97
Q

What is initial treatment of hypoglycemia?

A

feeding (breastmilk)

bottle feeding (D5W)

98
Q

Calories for lactating mom

A

2700 total

***450-500 more than recommended pregnancy calories

99
Q

Suction — before —

A

mouth

nose

100
Q

When is Sitz Bath given for episiotomy care?

A

after first 24 hrs

TID for 20 mins

101
Q

What could be a possible cause of a high-pitched cry?

A

hypoglycemia

***obtain blood glucose (

102
Q

What maternal labs are drawn 12-24 hrs post delivery?

A

Hgb and HCT

Urinalysis sometimes

Rubella and Rh if unknown

Maternal-Newborn (Josh) (29 decks)

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