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OB: Mom And Baby > Test 1 Information > Flashcards

Test 1 Information Flashcards

1
Q

The most critical adaptations for a neonate to make when getting adjusted to extruterine life

A

establishment of effective respirations

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2
Q

what factors cause the initiation of breaths from a newborn

A

chemical, mechanical, thermal, and sensory factors

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3
Q

post partum period

A

interval in between birth and the return of reproductive organs to their normal nonpregnant state

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4
Q

puerperium

A

another word for postpartum

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5
Q

involution

A

the return of the uterus to a nonpregnant state after giving birth and begins immediately after expulsion of the placenta with contraction of the uterine smooth muscle

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6
Q

Uterus location at the end stage of labor

A

uterus should be midline approx. 2cm below the umbilicus

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7
Q

uterus location within 12 hours of birth

A

the fundus can raise to be 1 cm above the umbilicus

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8
Q

uterus location by 24 hours after birth

A

the uterus is about the same size as it was 20 weeks gestation

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9
Q

how much does the uterus shrink every 24 hours

A

the fundus descends 1 to 2cms per 24 hour period

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10
Q

uterus location at the 6th day after birth

A

fundus is normally located halfway between the umbilicus and the symphysis pubis

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11
Q

uterus location at 2 weeks after birth

A

should not be palpable

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12
Q

uterus location at 6 weeks

A

should have returned to its non pregnant location

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13
Q

subinvolution

A

the failure of the uterus to return to a non pregnant state due to ineffective uterine contractions

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14
Q

most common cause of subinvolution

A

retained placental fractions and infection

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15
Q

lochia

A

uterine discharge after birth

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16
Q

how long does lochia last after birth

A

4 to 6 weeks after birth

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17
Q

what will increase the flow of the lochia

A

walking and breastfeeding will increase the flow of the lochia

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18
Q

Lochia rubra

A

first 3-5 days after birth, dark/bright red blood

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19
Q

lochia serosa

A

5-8 days after birth, light pink with RBCs, WBCs, and tissue in it

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20
Q

lochia alba

A

2-6 weeks after birth, white/yellow with WBCs

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21
Q

When is the first period of reactivity?

A

lasts up to 30 mins after birth

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22
Q

How does the infant react during the first period of reactivity?

A

Heart Rate Increases to 160 to 180 bpm, but grdually decreases after 30 minutes

the infant is alert

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23
Q

when is the period of decreased responsiveness?

A

lasts from 60 to 100 minutes

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24
Q

how does the infant react during the period of decreased responsiveness

A

newborn either sleeps or has a marked decrease in motor activity

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25
Q

when is the second period of reactivity?

A

occurs 2 to 8 hours after birth and lasts from 10 minutes to several hours

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26
Q

how does the infant react during the second period of reactivity?

A

Tachycardia, tachypnea occur
increased muscle tone
improved skin color
mucous production
meconium finally passed

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27
Q

Chemical Factors that initiate the respiratory system

A

activation of chemoreceptor in the carotid arteries and aorta results from the relative state of hypoxia associated with labor

decreased levels of oxygen and increased levels of carbon dioxide seem to have a cumulative effect that is involved in initiating neonatal breathing by stimulating the respiratory center in medulla

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28
Q

Mechanical Factors that initiate the respiratory system

A

stimulated by changes in intrathoracic pressure resulting from the compression during vaginal birth

crying increases the distribution of air in the lungs and promotes expansion of the alveoli. the positive pressure of crying keeps the alveoli open

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29
Q

Thermal Factors that initiate the respiratory system

A

the extrauterine world is typically colder than the intrauterine world and the shock to the system, i.e. the sudden drop in temperature, stimulates the respiratory center in the medulla

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30
Q

sensory factors that initiate the respiratory center

A

handling by the OB team
suctioning mouth and nose
drying by the nurses
environmental factors (light, sounds, smells) also initiate the respiratory system

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31
Q

Normal or Potential problem: Infant has 36 respirations per minute, they are irregular, and shallow

A

Normal

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32
Q

Normal or Potential Problem: Episodic Apnea lasting 5 to 10 seconds

A

Normal; any apenic episodes lasting longer than 20 seconds needs to be checked out by the doctor

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33
Q

What airway do infants breath out of the most?

A

Their nose

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34
Q

When do infants develop the reflex to switch from nose breathing to mouth breathing when the nose is plugged?

A

3 weeks

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35
Q

What happens if a 1-3 week infant’s nose is clogged?

A

cyanosis and asphyxia can occur because they lack the ability to switch to breathing through their mouth

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36
Q

Lung Sounds for infants

A

loud, clear, and seem very near because there is very little chest mass to interfere

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37
Q

Normal or Potential Problem: Crackles on Auscultation of the lungs immediately following birth

A

Normal: fine rales are normal within the first few hours

38
Q

signs of respiratory distress in neonates

A
  1. nasal flaring
  2. intercoastal or subcoastal retractions
  3. grunting with respirations
  4. changes in infant color(Late sign of respiratory distress)
39
Q

Signs of upper airway obstruction in neonate

A

suprasternal or subclavicular retractions with stridor or gasping

40
Q

What can happen to the baby if mom gets analgesics or anesthetics during labor and birth

A

slowed, depressed or absent breathing

41
Q

causes of apneic episodes in neonates

A
  1. rapid increase in body temperature
  2. hypothermia
  3. hypoglycemia
  4. sepsis
42
Q

causes of tachypnea in neonates

A
  1. inadequate clearance of fluid in the lungs
  2. respiratory distress syndrome
43
Q

When should the newborns skin color change from blue to pink?

A

3 to 5 mins (APGAR score)

44
Q

acrocyanosis

A

bluish discoloration of hands and feet is a normal finding in the first 24 hours after birth

45
Q

TTN

A

Transient Tachypnea of the Newborn

46
Q

TTN presentation

A
  1. signs of respiratory depression
  2. tachpnea up to 100bpm
  3. intermittent grunting
  4. nasal flaring
  5. mild retractions
47
Q

Treatment for TTN

A

Supplemental oxygen

48
Q

When should TTN resolve?

A

48 to 72 hours

49
Q

normal heart rate range for neonates

A

120 to 160 bpm

50
Q

full term infant heart rate

A

80 to 100 bpm during sleep and up to 180 bpm when the infant cries

in between (100 and 160bpm)

51
Q

Normal or Potential Problem: irregular heart rate or sinus dysrhythmia

A

normal in the first few hours of life but as the foramen ovale closes

52
Q

Normal or Potential Problem: Murmur heard in the neonatal period

A

Normal and have no pathological significance, more than half of them disappear within 6 months

if the baby has other signs such as not tolerating feeds, cyanosis, or pallor with a murmur the baby needs to have follow up done

53
Q

factor affecting BP in neonates

A
  1. gestational age
  2. postconceptional age
  3. birth weight

BP values rise as these values rise

54
Q

What should the MAP be equal to in neonates

A

the neonates gestational age

55
Q

Normal or potential problem: drop in systolic blood pressure in first hour of life

A

normal

56
Q

Normal or Potential problem: Jaundice right after birth

A

Potential problem, it is a problem for the baby to come out jaundice (pathologic jaundice), but it is normal for them to develop jaundice(Physiologic jaundice)

57
Q

When should newborn pass meconium stool?

A

meconium should pass within in teh first 24 hours

58
Q

desquamation

A

peeling of the skin

59
Q

Normal or Potential Problem: Desquamation of the feet

A

Normal Finding in some newborns, especially those who are born late or post-term gestation.

60
Q

interventions for desquamation on the feet of a neonate

A

moisturizers can be applied, but usually it fixes itself

61
Q

what is the average newborn head circumference

A

13-14in or 33 to 35 cm

62
Q

Postterm infants are born at

A

over 42 weeks

63
Q

Normal or Potential Problem: deep plantar creases over entire sole of the foot in a postterm gestational baby

A

Normal

64
Q

Normal or Potential Problem: Dry, cracked, and peely skin, especially on the hands and feet of postterm gestational baby

A

Normal

65
Q

Normal or Potential Problem: Abudnant Scalp hair and long fingernails in postterm gestational baby

A

Normal

66
Q

Normal or Potential Problem: Minimal to absent vernix caseosa in a postterm gestational age baby

A

Normal

67
Q

vernix caseosa

A

protective, white, waxy substance on the skin of a neonate

68
Q

Lanugo

A

fine, downy hair that covers the fetus early in gestation and begins to disappear around 32 weeks gestation; it is normaly no present in term or postterm babies

69
Q

1st stage of labor

A

break of water to dilated 10 cm

70
Q

transition phase of labor

A

8 to 10 cm dilated

71
Q

Maternal signs of the transition phase

A

N/V, increased pain, trembling, fear, irritability, anxiety, and self doubt in the ability to birth

72
Q

how often should you breastfeed?

A

every 2-3 hours and on baby’s demmand as they demonstrate their reflexes

73
Q

position of teh newborn for breastfeeding

A

tummy to tummy with mouth infront of nipple and head in line with the body

74
Q

proper latch for breastfeeding

A

nippe and part of areola in the mouth

75
Q

how long should you breast feed for?

A

15 to 20 mins per breast or until the newborn seems satisfied

76
Q

how fast is too fast for saturating a pad after a vaginal birth

A

in less than an hour

77
Q

signs of oral candidiasis on newborn

A

white, adherent, patches on the tongue and palate

78
Q

erythema toxicum

A

firm, white, or yellow papules or pustules surrounded by erythema. This idiopathic rash, which closely resembles flea bites appears in the first few days after birth and resolves within 5-7 days

79
Q

epstein pearls

A

small white, cysts found on the hardpalate of newborns. These are considered normal findings and they disappear a few weeks after birth

80
Q

how much to dress neonates in?

A

dressing newborns in no more than one additional layer of clothing than an adult requires. A wearable blanket can provide wormth and prevent the head from being covered.

81
Q

what should the baby be wearing when getting phototherapy

A

fully exposed expect for diaper and eye shields. Mainting skin integrity is important becuase the breakdown of bilirubin can cause frequent loose stools and produce skin excoriation and breakdown.
Lotions and ointements should not be applied becuase they absorb heat and cause burns

82
Q

clinical manifestations of spinabifida in a newborn

A

tuft of hair, a hemangioma, a nevus, or a dimple along the base of the spine

83
Q

caput succedaneum(CS)

A

CS- crosses suture, edema of the soft tissue of the scalp due to prolonged pressure of the presenting part against the cervix during labor

84
Q

NAS

A

Neonatal Absitence Syndrome

85
Q

neonatal abstinence syndrome

A

potentially life-threatening condition affecting noewborns exposed in utero to physiologically addictive substances.

86
Q

manifestations of NAS in newborn

A

irritabiliyt, inconsolability, hig-pitched/shrill cry, neuromuscular irritability

87
Q

interventions for baby with NAS

A

environmental stimuli should be minimized, and the nurse should swaddle the newborn in a flexed position and gently rock the newborn to provide comfort and decrease irritability

88
Q

What position should an infant who has NAS be put in after feedings?

A

they should be held in an upright position and regurgitation is common in newborns with NAS

89
Q

what type of environment should a baby with NAS be kept in?

A

quiet, dimly ilt, environment, cluster care, and minimize stimulation to prevent seizure activity

90
Q

treatment for breast engorgement

A

applying ice packs to both breasts for 15 to 20 minutes every 3-4 hours to reduce blood flow and swelling

apply chilled, fresh cabbage leaves to both breasts, replacing with fresh leaves after they wilt.

Take antiinflammatory analgesic as directed to reduce pain

maintaining firm breast support until milk flow is diminished

91
Q
A

OB: Mom And Baby (6 decks)

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