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NURSING 210 > Test 2 > Flashcards

Test 2 Flashcards

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1
Q

what is the gate control theory

A

gate theory of pain asserts that non-painful input closes the “gates” to painful input, which prevents pain sensation from traveling to the CNS

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2
Q

why do we prefer epidural anesthesia as opposed to general

A

general passes through to the baby, epidural does not

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3
Q

what are the side effects of epidural anesthesia

A

maternal hypotension
fetal bradycardia
inability to feel the urge to void
loss of bearing down reflex
itching
cerebral spinal headache(biggest risk)

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4
Q

what is the cause of a cerebral spinal headache

A

epidural fluid leaks into the back of your skull

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5
Q

what are nursing interventions with epidural anesthesia

A

give iv fluids
encourage side lying
coach pt in pushing
monitor maternal bp & pulse
assess fetal hr
assess for orthostatic hypotension
assess bladder for distention; catheterize as needed

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6
Q

benefits of nitric oxide

A

low intervention
no need for iv access or catheter
no need for continuous monitoring
continued ability to move
self administered medication

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7
Q

what is included in the maternal assessment during labor and birth

A

vaginal exam to assess the amount of
-cervical dilation & effacement
-fetal descent and presenting part
-rupture of membranes
-amniotic fluid
-analysis of fetal hr

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8
Q

what is stage one in labor

A

begins with onset of labor and ends when the cervix is 100% effaced and completely dilated to 10 cm
the average length for a first time mother is 10-14 hours

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9
Q

what is stage 2 of labor

A

pushing stage
begins with complete effacement and dilation of the cervix and ends with delivery of baby
average length for first time mothers is 1-2 hours

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10
Q

what is stage 3 of labor

A

begins with birth of baby and ends with delivery of placenta
average length is 5-15 minutes

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11
Q

what are the three phases of stage 1 of labor

A

latent
active
transition

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12
Q

what is the latent phase in first stage of labor

A

0-6 cm dilation
cervical effacement of 0-40%
contraction frequency every 5-10 min

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13
Q

what is the active phase of stage 1 of labor

A

6-10cm dilation
cervical effacement of 40-100%
contractions stronger every 40-60 seconds and every 2-5 minutes
true discomfort
contraction intensity moderate to strong to palpation

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14
Q

what happens in the third stage of labor

A

delivery of placenta
gush of blood
lengthening of the cord
uterus is globular and firm
check to be sure it is intact
should happen within 30 min of delivery

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15
Q

why do we not want a contraction over 90 seconds

A

no relaxation for the baby

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16
Q

what is crowning

A

when the head is in the perineum but not being retracted back in

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17
Q

the fetal heart rate pattern is an indirect marker of what

A

fetal cardiac and central nervous system responses to change in bp, blood gases, and acid-base status

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18
Q

when is the largest complication for the mother and what is it

A

during the 3rd stage of labor and due to postpartum hemorrhage

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19
Q

in the fourth stage of labor the uterus should be

A

firm well contracted and located between umbilicus and pubic symphysis

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20
Q

why is acid base status is important

A

they need to correct balance in order to start breathing out of the womb

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21
Q

what is electronic fetal monitoring

A

used to establish a baseline of fetal hr
(most clearly heard through fetal back)

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22
Q

what must happen for internal fetal monitoring to occur

A

the membranes must be ruptured

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23
Q

what is IUPC

A

intrauterine pressure catheter placed inside the uterine cavity to monitor frequency, duration and intensity of contractions

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24
Q

what is a normal fetal heart rate

A

110-160 bpm

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25
Q

what does veal chop stand for

A

Variable Cord compression

Early deceleration Head compression
Acceleration Okay
Late deceleration
Placental insufficiency

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26
Q

what is absent or undetectable variability

A

not reassuring

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27
Q

what is minimal variability

A

greater than undetectable but less than 5/min

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28
Q

what is moderate variability

A

6-25 /min

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29
Q

what is marked variability

A

greater than 25/ min

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30
Q

what is variability

A

increases and decreases from baseline fetal heart rate

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31
Q

what is a variable deceleration

A

abrupt slowing of 15 or more BPM for at least 15 seconds, has an unpredictable shape (u, v, w), associated with cord compression

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32
Q

nursing actions for variable decelerations

A

change moms position(knee to chest), may give O2, stop pitocin, increase fluids

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33
Q

what actions are taken for early deceleration

A

no action required as long as it turns back to base line

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34
Q

NADIR means

A

the lowest point that the fetal heart rate reaches

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35
Q

when do late decelerations of fetal heart rate occur

A

after the peak of the contraction

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36
Q

what can cause late decelerations of fetal heart rate

A

abruption, previa, gestational diabetes

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37
Q

what is involved in category I of the FHR interpretation system

A

Normal
baseline fhr 110-160
baseline fhr variability:moderate
accelerations: present or absent
early decelerations: present or absent
variable or late decelerations: absent

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38
Q

what are the signs that the body is preparing for labor

A

effacement&dilation
lightening (when presenting part begins to descend into the true pelvis)
increased energy level(nesting)
bloody show
braxton hicks contractions
spontaneous rupture of membranes

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39
Q

what is the bishop score used to determine

A

maternal readiness for labor by evaluating whether the cervix is favorable
( dilation, effacement, consistency, position, station of presenting part)

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40
Q

what does a bishop score of 0 entail

A

dilation(cm)-closed
position- posterior
effacement (%)- 0-30%
station- -3
consistency- firm

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41
Q

what does a bishop score of 1 entail

A

dilation(cm)- 1-2
position- mid position
effacement (%)- 40-50%
station- -2
consistency- medium

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42
Q

what does a bishop score of 2 entail

A

dilation (cm)- 3-4
position- anterior
effacement (%)- 60-70%
station- -1- 0
consistency- soft

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43
Q

what does a bishop score of 3 entail

A

dilation(cm)- 5-6
position——
effacement (%)- 80%
station- +1, +2
consistency———–

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44
Q

what is nitrazine paper

A

used to check the pH of the fluid to determine if the fluid is amniotic fluid or urine after rupture of membranes (the paper will turn very dark blue when amniotic membranes are ruptured)

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45
Q

what is the vaginas pH vs the amniotic fluid pH

A

vagina- 4.5-5.5 (turns paper yellow)
Amniotic fluid- 7-7.5 (turns paper blue)

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46
Q

what are 3 characteristics of amniotic fluid

A

should be clear or straw colored
odor should NOT be foul
meconium staining could indicate some level of fetal distress

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47
Q

what do we assess with an apgar score

A

heart rate
respiratory effort
muscle tone
reflex irritability
color

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48
Q

what does an apgar score of 0 in each category mean

A

heart rate- absent
respiratory effort- no spontaneous respirations
muscle tone- limp
reflex irritability- no response to stimulation or suction
color- blue or pale

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49
Q

what does an apgar score of 1 in each category mean

A

heart rate- below 100
respiratory effort- slow; weak cry
muscle tone- minimal flexion; sluggish
reflex irritability- grimace or minimal response
color- body pink; extremeties blue

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50
Q

what does an apgar score of 2 in each category mean

A

heart rate- 100 beats or greater
respiratory effort- spontaneous strong cry
muscle tone- active flexed posture
reflex irritability - prompt response
color- completely pink; lack of cyanosis

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51
Q

at what times do you take an apgar

A

1 min & 5 min; may take at 10 mins if babys previous scores were very low

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52
Q

what vitals of the neonate should the nurse report

A

temp greater than 100.4
apical pulse less than 110 or greater than 160 bpm
respirations greater than 60 or less than 30
noisy respirations
nasal flaring or chest retractions
grunting
blood glucose less than 40

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53
Q

what do we assess with the babies head

A

feel for separation of fontanels
feels for bumps
presence of caputs

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54
Q

what is a caput succedaneum

A

localized swelling of the soft tissue of the scalp that may be caused by pressure on the head during labor and is an expected finding

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55
Q

what is a cephalohematoma

A

a collection of blood between the periosteum and the skull bone that covers it; does NOT cross the suture line, usually resolves spontaneously in 3-6 weeks

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56
Q

what do we assess with the baby’s face

A

eyes- inspect eye structures
ears- draw an imaginary line from inner to outer canthus of newborns eye; the eye should be even with the upper tip of the pinna
nose- newborns are nose breathers
mouth- assess for palate closure and strength of sucking

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57
Q

What are the 5 P’s of the birthing process?

A

Passageway (birth canal)
Passenger (fetus and
placenta)
Powers (contractions)
Position (maternal)
Psychological response

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58
Q

When is the fetal head “engaged”

A

When it reaches “0” station

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59
Q

How to calculate fetal stations

A

-Station is the measurement of fetal
descent (in cm) with station 0 being level
with the ischial spines.
-Minus number is given if above the spines
-Plus number is given if below the spines

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60
Q

Types of different fetal head presentaions

A

-cephalic
-face
-vertex
-brow

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61
Q

Types of fetal breech presentation

A

-Frank (butt first)
-complete breech
-footling breech (foot first)

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62
Q

what is fetal lie?

A

The relationship of
the maternal
longitudinal axis
(spine)to the fetal
longitudinal
access(spine)
-transverse lie and longitudinal lie are the two types

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63
Q

Uterine contractions: Frequency

A

beginning of one contraction to the beginning of the next contraction (in minutes)

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64
Q

Uterine contractions: Duration

A

Beginning to end of one contraction (in minutes)

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65
Q

Uterine contractions: Strength/Intensity

A

strength of the contraction at its peak described as mild, moderate or strong

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66
Q

Placenta Previa

A

Placenta previa occurs when the placenta abnormally implants in the
lower segment of the uterus near or over the cervical os.
Abnormal implantation results in bleeding in the 3rd trimester as the cervix begins to dilate and efface

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67
Q

Placental Abruption

A

-Normal implantation of the placenta
-Premature separation of the placenta from the uterus which can be partial or complete detachment
-Significant maternal and fetal morbidity and mortality
-Leading cause of maternal death

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68
Q

Ectopic pregnancy: subjective data

A

•Unilateral pain in the lower abdominal quadrants
•+/- bleeding
•Referred shoulder pain if rupture with peritoneal cavity irritation
•Faintness, dizziness from blood loss

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69
Q

Ectopic pregnancy: objective data

A

•Signs of hemorrhage and shock
•Ruptured ectopic pregnancy would be a medical emergency

70
Q

What is an ectopic pregnancy?

A

Ectopic is abnormal implantation of fertilized ovum (zygote) outside
the uterine cavity, usually the fallopian tube

71
Q

Treatment of an ectopic pregnancy?

A
  1. No action
  2. Treatment with methotrexate IM to inhibit cell division (stop folic acid)
  3. Surgery to remove pregnancy from the tube
    • Salpingostomy by laparoscope to save tube
    • Salpingectomy by laparoscope with removal of the tube
72
Q

Methods of heat loss

A

EVAPORATION – heat loss through wet skin
CONVECTION – heat loss from cooler air when exposed
CONDUCTION – heat loss through direct through direct
contact with a cold surface (e.g. scales, un-warmed
mattress)
RADIATION – heat loss from heat moving towards a cooler surface

73
Q

Nonshivering thermogenesis

A

NEWBORN’S PRIMARY METHOD OF HEAT PRODUCTION!

Brown fat is oxidized in response to cold exposure

74
Q

Characteristics that predispose newborns to heat loss (thermoregulation)

A

• Thin skin with blood vessels close to the surface
• Increased skin permeability to water
• Lack of shivering ability to produce heat until 3 months old
• Limited stores of metabolic substrates (glucose, glycogen, fat)
• Limited use of voluntary muscle activity or movement to produce heat
• Large surface area-to-body mass ratio
• Lack of subcutaneous fat, which provides insulation
• Inability to change position , adjust clothing, or communicate if cold

75
Q

what is lochia?

A

Vaginal discharge that occurs after birth and may continue 4-6 weeks postpartum

76
Q

Different types of lochia?

A

• Rubra -Bright red, lasts 3-5 days.
• Serosa- Pinkish/brown and lasts 3-10 days.
• Alba- Creamy white or light brown, occurs from 10-14 days, but can last 10-14 days but is still normal if it lasts 3-6 weeks.

77
Q

Phases of maternal role attainment: Dependent (taking in phase)

A

•First 24 to 48 hours
•Focus on meeting personal needs
•Rely on others for assistance
•Excited, talkative and need to review birth experience with
others.
•May not have slept well in hospital

78
Q

Phases of maternal role attainment: Interdependent (letting go phase)

A

• Focus on family as a unit
• Resumption of role (intimate partner, individual)

79
Q

Phases of maternal role attainment: dependent/independent (taking hold phase)

A

-begins day 2-3
-Focus on baby
care and improving
competency of baby care
-Wants to take
charge but needs
acceptance of
others
-Wants to learn and practice

80
Q

Postpartum hemmorhage meds

A

Oxytocin(Pitocin)
• Promotes uterine contractions(dose specific)
Methergine(ergot alkaloid)
• Controls postpartum hemorrhage
• *Monitor BP- can cause hypertension
Misoprostol (Cytotec) synthetic prostaglandin E2
• Controls postpartum hemorrhage (dose specific)

81
Q

what do we assess postpartum in the first 2 hours

A

vitals q15 min & PRN
fundus tone & position
lochia
perineum
hemorrhoids q 15 min
bladder; encourage voiding
listen to lungs & bowels
assess sensation of anesthesia

82
Q

what do we assess the epidural site for

A

redness & draining

83
Q

what does it mean if the uterus is boggy

A

it is not contracted; could mean bleeding

84
Q

what can we expect postpartum in relation to the cardiovascular system

A

decrease in blood volume
diaphoresis and diuresis during first 2-3 days
coagulation factors and fibrinogen levels increase during pregnancy and remain elevated 2-3 weeks postpartum
bp unchanged
increase in temp during first 24 hours from dehydration

85
Q

what warrants further investigation postpartum, bradycardia or tachycardia

A

tachycardia; bradycardia is ok

86
Q

where should the fundus be immediately after delivery

A

at the midline of the umbilicus

87
Q

how often do we assess the fundus postpartum

A

q8h during the recovery after childbirth while in the hospital

88
Q

what do we always ask patients to do before a uterine assessment

A

empty her bladder

89
Q

what are the risk factors for postpartum hemorrhage

A

uterine atony
previa or abruption during pregnancy
precipitous delivery (less than 3 hours of labor)
lacerations and/or hematomas
retained placental fragments
prolonged labor

90
Q

what are the risk factors for retained placenta

A

excessive traction on the umbilical cord
placental tissue abnormally adherent to the uterine wall

91
Q

what are physical findings of retained placenta

A

uterine atony
excessive bleeding
return to lochia rubra after progressing to alba
foul odor
elevated temp
clots bigger than an egg

92
Q

what are the risk factors for postpartum lacerations and/or hematomas

A

operative birth(vacuum or forceps)
precipitous birth
cephalopelvic disproportion (CPD)
macrosomic infant
woman who have light skin;especially red heads

93
Q

what are symptoms of postpartum blues

A

irritability, anxiety, fluctuating mood, and increased emotional reactivity

94
Q

what are symptoms of postpartum depression

A

excessive guilt, anxiety, anhedonia, depressed mood, insomnia/hypersomnia, suicidal ideation, & fatigue

95
Q

what are the symptoms of postpartum psychosis

A

mixed or rapid cycling, agitation, delusions, hallucinations, disorganized behavior, cognitive impairment, and low insight

96
Q

when teaching a patient when to call their provider postpartum what would you include

A

fever greater than 100.4
changes in vaginal discharge with increased amount, large clots, or foul odor
episiotomy site increased pain
abdominal or pelvic pain
breast pain, tenderness, or redness
calf pain
burning with urination

97
Q

what are some postpartum disorders

A

hemorrhage
DVT
infection
retained placenta
lacerations/hematomas

98
Q

what is considered early term

A

between 37 weeks 0 days and 38 weeks 6 days

99
Q

what is considered full term

A

between 39 weeks 0 days and 40 weeks 6 days

100
Q

what is considered late term

A

between 41 weeks 0 days and 41 weeks 6 days

101
Q

what is considered post term

A

42 weeks and beyond

101
Q

what is considered post term

A

42 weeks and beyond

102
Q

when are newborns most alert

A

1st period of reactivity- begins at birth and lasts 30 minutes to 2 hours

103
Q

when is a good time to first breastfeed

A

within the 1st period of reactivity when the baby is super alert

104
Q

what happens in the period of decreased responsiveness

A

baby is very tired, muscles are relaxed, difficult to arouse, no interest in feeding

105
Q

the higher the serum bilirubin level the greater risk of…..

A

neurological damage

106
Q

what is physiological jaundice

A

most common cause of newborn jaundice and occurs in more than 50% of babies

107
Q

what is breast milk jaundice

A

occurs in 1-2% of breastfed babies
caused by a special substance that some mothers produce in their breast milk
(not harmful)

108
Q

a bilirubin increase of what requires careful investigation

A

5 mg/dl in 24 hours

109
Q

what is the treatment of newborn jaundice

A

phototherapy

110
Q

when do testes descend into the scrotum

A

before birth

111
Q

whether or not a family decides to circumsize their child or not, we must teach them

A

proper cleaning techniques

112
Q

what is our first intervention if a newborn is showing signs of hypoglycemia

A

heal stick to get an accurate blood glucose reading

113
Q

how do we first supply glucose to a hypoglycemic newborn

A

glucose gel on our finger and rub it on the inside of their cheeks

114
Q

what is tachysystole?

A

uterine hyperstimulation that may occur with or without FHR changes and is defined as:

4 or more contractions in 10 minutes over a 30 minute period OR contractions lasting more than 2 minutes in duration OR contractions of normal duration occurring within 60 seconds of each other

115
Q

What are nursing interventions for tachysystole?

A

immediately turn off oxytocin infusion (to prevent fetal anoxia and uterine rupture), turn women on left side (to improve fetal placental blood flow), increase primary IV rate to 200ml/hr unless contraindicated (to provide adequate intravascular volume, support maternal bp, and IV route for emergency use), notify MD prn if does not resolve

116
Q

What can happen with tachysystole?

A

it can reduce fetal oxygenation by interrupting maternal blood flow to the placenta during contractions and can cause uterine rupture

117
Q

What is the fourth stage of labor?

A

2-3 hours after birth; starts with delivery of the placenta and lasts until vital signs stable

118
Q

What is the major goal in the fourth stage of labor?

A

preventing pp hemorrhage

119
Q

What to assess in postpartum period- first 2 hours?

A

BP, HR, RR, maternal O2 sat (every 15 minutes and prn); temperature (x1 and prn q 4hrs); assess fundus tone and position, lochia, perineum, hemorrhoid (q 15 minutes and prn); maternal bladder (encourage voiding prn); sensation of anesthesia if epidural; facilitate bonding with baby; assist with skin to skin and breastfeeding; encourage food and hydration

120
Q

what is the average blood loss after birth?

A

500ml or less for vaginal, up to 1000ml for C-section

121
Q

what increases during pregnancy and remains elevated until 2-3 weeks pp?

A

coagulation factors and fibrinogen levels (increases risk for hemorrhage pp)

122
Q

what warrants further investigation pp?

A

tachycardia (impending sign of something else) and temp over 100 degrees

123
Q

Immediately after delivery, what should fundus be like?

A

firm and at midline at level of umbilicus

124
Q

how often do you assess fundus while patient is in hospital?

A

at least q 8

125
Q

where should fundus be by day 6 and by day 10?

A

day 6- halfway between umbilicus and symphysis pubis;
day 10- true position

126
Q

always ask the patient to what before uterine assessment?

A

empty bladder

127
Q

what are risk factors for pp hemorrhage?

A

uterine atony, complications during pregnancy (previa orr abruption), precipitous delivery, lacerations and/or hematomas, retained placental fragments, increased risk for pp hemorrhage with multiple babies, prolonged labor

128
Q

nursing care for pp hemorrhage?

A

vital sign assessment; assess fundus; assess lochia; assess for signs of bleeding from lacerations, episiotomy, or hematoma; assess for bladder distention

129
Q

What are the physical findings that need to be reported to MD for pp hemorrhage?

A

clots larger than a quarter or the size of an egg; pad soaked through in less than 15 minutes; tachycardia and hypotension (hypovolemic shock); oliguria

130
Q

normal pregnancy placenta

A

the placenta attaches to a temporary layer in the uterus thats shred at delivery

131
Q

placenta accreta

A

when the placenta attaches too deeply into the uterine wall; has to be C section in OR

132
Q

placenta increta

A

when the placenta attaches into the uterine muscle

133
Q

placenta percreta

A

when the placenta goes completely through the uterine wall, sometimes invading nearby organs like the bladder

134
Q

nursing interventions for pp period (cervix, vagina, and perineum)

A

observe for erythema, edema, or hematoma; assess episiotomy site or tear for approximation, drainage, quantity and quality of bleeding, and stitches; promote measures to soften stool; educate on use of peri bottle and patting dry perineum from front to back; sitz bath with epsom salts

135
Q

when does the pp chill happen?

A

first 2 hours pp

136
Q

Decreased estrogen pp is associated with what?

A

breast engorgement and diuresis of extracellular fluid

137
Q

where is prolactin released from and what does it do?

A

anterior pituitary gland and initiates breast milk production

138
Q

what to teach for breast care when breastfeeding?

A

tight, supportive bra 24/7; cabbage leaves for engorgement/mastitis; nipple cream applies often to help with cracks/pain; avoid exposing breasts to direct warm water when engorged; avoid stimulating breasts, tylenol for discomfort; ice to breasts and axilla

139
Q

symptoms of mastitis?

A

usually unilateral, flu like symptoms with temp, sudden onset, swollen and inflamed tissue, may be a hard lump on breast (clogged duct)

140
Q

what is BUBBLEH?

A

maternal assessment-
B- breast size, shape, and engorgement
U- uterus: firm or boggy
B- bladder: tender or distended
B- bowel movement
L- lochia: amount, odor, color, clots
E- episiotomy location, stitches, edema, and redness
H- homans signs (DVT indication)

141
Q

What 3 things does an infant have to do before being discharged from nicu?

A

ability to maintain a normal body temp fully clothed in an open bed with normal ambient temperature;
ability to coordinate suckle feeding, swallowing, and breathing while ingesting an adequate volume of feeding;
ability to grow at an acceptable rate

142
Q

urine output for babies with immature kidneys?

A

1-3 ml/kg/hr

143
Q

manifestations of respiratory distress syndrome (RDS)?

A

can take up to several hours after birth to manifest;

respirations increase to 60 breaths/min or higher; tachypnea may be accompanied by gruntlike sounds, nasal flaring, cyanosis, and intercostal and sternal retractions; edema and apnea occur as condition worsens

144
Q

tx for RDS?

A

betamethasone (if L/S ratio shows lung immaturity and this can be given 2 days before delivery to stimulate lung maturity); surfactant can be administered via ET tube at birth or when symptoms occur

145
Q

when is improvement seen with RDS after surfactant is given?

A

generally seen within 72 hours, but immediate improvement is most common… second dose will be given after 12 hours is not improved

146
Q

nursing care of infant with RDS?

A

monitor vs, minimal handling of infant to help conserve energy, IV fluids are prescribed, monitor I&O, oxygen therapy (monitor pulse oximetry), infant on oxygen is at high risk for oxygen toxicity

147
Q

what is bronchopulmonary dysplasia?

A

toxic response of lungs to oxygen therapy- can result in “chronic lung”

148
Q

major signs of sepsis in preterm infant?

A

low temp, tachypneic, bradycardic

149
Q

how is retinopathy of prematurity classified?

A

5 stages, stage 1 (mild abnormal blood vessel growth) to stage 5 (completely detached retina and end stage of disease)

150
Q

what is neonatal abstinence syndrome?

A

fetal exposure to drugs in utero;

many illicit drugs cross the placental barrier, therefore an infant born to a woman who is an addict will suffer differing degrees of drug withdrawal after birth

151
Q

symptoms of NAS?

A

hyperirritability (primary sign), wakefulness, diarrhea, poor feeding, sneezing, yawning

152
Q

tx of NAS?

A

swaddling, quiet environment, morphine, methadone, fentanyl, buprenorphine

153
Q

what are the methods of heat loss?

A

evaporation, convection, conduction, radiation

154
Q

what is conduction?

A

heat loss by conduction occurs when a baby is placed on a cooler surface or touching them with cool objects or hands

155
Q

what is convection?

A

when heat is transferred to the air surrounding the infant. If AC is kept on or when people move around the infant, increase of heat loss occurs

156
Q

What is evaporation?

A

heat loss through wet skin; dry infant immediately after birth and immediately after bathing

157
Q

what is radiation?

A

loss of body heat to cooler, solid surfaces that are not indirect contact; neonates lose heat to walls of incubators even if surrounding air is warm- incubators need to be double walled and should be placed away from walls and windows

158
Q

how can an infant be infected with HIV?

A

transplacentally, through contact with infected maternal secretions at birth, or through breast milk (NO breastfeeding)

159
Q

what should a pregnant women with HIV do?

A

take HIV medications to reduce the risk of mother to child transmission of HIV and to protect their own health

160
Q

How does hydrocephalus look?

A

-Increase in size of head
-Cranial sutures separate to accommodate enlarging mass
-Scalp is shiny
-Veins are dilated
-Eyes deviated downward

161
Q

Treatment for hydrocephalus?

A

-Medications to reduce production of CSF
-Surgery to place a shunt

162
Q

Signs of increasing intracranial pressure

A

-Increased blood pressure
-Decrease in pulse rate
-Decrease in respirations
-High-pitched cry
-Unequal pupil size or response to light
-Bulging anterior fontanelle
-Irritability or lethargy
-Poor feeding

163
Q

What is the most common spina bifida?

A

Spina bifida cystica (sac or cyst). It is the most severe form and can accompany with other abnormalities.

164
Q

What is a meningocele?

A

spinal canal remains open along several vertebrae in the lower or middle back in spina bifida. VERY high risk of infection

165
Q

What do you do immediate after a baby with spina bifida is born?

A

-put it in an incubator
-lay baby on side or belly
-place a moist sterile dressing on the opening/sac to keep wet

166
Q

clubfoot treatment for a nurse?

A

follow up and start range of motion ASAP after birth. It is very important to treat immediately

167
Q

what treatment is used for hip dysplasia?

A

a Pavlik harness

168
Q

treatment for a patient with a tracheal esophageal fistula?

A

Surgical repair is essential for survival. The baby will not survive without surgery

169
Q

Usual immunizations for newborns

A

-Hep B
-Vitamin K (not immunization)
-erythromycin for eyes (also not immunization)

NURSING 210 (5 decks)

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