Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

OB > Test 3 Blueprint (2) > Flashcards

Test 3 Blueprint (2) Flashcards

1
Q

What should the nurse expect when palpating the breasts of a PP client?

A

PP day 1 or 2: soft, colostrum

PP day 3 or 4: firm from milk coming in

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

When is engorgement expected?

A

3-5 days when milk comes in

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is colostrum?

A

Clear, yellowish fluid available for the first 2-3 days PP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the nutritive value of colostrum?

A

High in antibodies & protein

Low in fat & carbs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Colostrum: High protein facilitates binding of _____.

A

bilirubin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Colostrum: Laxative action encourages passage of _____.

A

meconium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Colostrum: Establishes normal _____ _____ flora in infant’s gut.

A

Lactobacillus bifidus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Colostrum: Contains ____ ____ that provides passive immunity.

A

IgA immunoglobulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Interventions to treat breast engorgement:

A
  • Apply COOL compresses BETWEEN feedings

- Apply WARM compresses/take WARM shower BEFORE feeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Nutritive sucking is associated with increased production of ____.

A

milk

the more nutritive sucking, the more milk production

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Hormone for milk PRODUCTION

Hormone for milk LET DOWN

A

(Remember the Ps & Os)
PROduction = PROlactin
Let down = Oxytocin (Oxytocin lets milk OUT)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the parameters of elevated temp indicative of infection in the PP client?

A
  • After 24, PP temp of 100.4 or higher

- Lasts for 2 consecutive days during first 10 days PP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Interventions for perineal edema in the first 24 hrs:

A
  • Ice pack (reduces edema, provides analgesia)
  • Meds (acetaminophen, NSAID, opioid)
  • Topical anesthetics (Americaine spray, Dermoplast, Tuck’s Pads…witch hazel) for hemorrhoids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What’s the difference between a laceration & an episiotomy?

A 
Laceration = tear
Episiotomy = cut made by physician
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Classify the degrees of lacerations/episiotomies:

A

1st Degree: superficial vaginal mucosa or skin of perineum
2nd Degree: deeper tissues including muscles of perineum
3rd Degree: same as 2nd but extends to the anal sphincter
4th Degree: extends through anal sphincter into the rectal mucosa
Periurethral: laceration in the area of the urinary urethra (never intentionally cut)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Interventions for perineal healing & comfort AFTER first 24 hrs:

A
  • Sitz bath at 100-104 or cooler at least 2x day
  • Ice pack
  • Analgesia (acetaminophen, NSAID, opioid)
  • Topica Anesthetics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How many calories should the LACTATING PP client consume over the recommended pregnancy calories?

A

2700 kcal/day

This is 450-500 kcal more than the non-lactating moms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Education to help prevent mastitis:

A
  • wash hands before breast feeding
  • keep breasts clean, change breast pads often
  • let nipples air dry
  • teach proper infant positioning/latching on techniques; release suction before removing baby from breast
  • completely empty breasts at each feeding to prevent milk stasis = medium for bacterial growth
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are major indicators of UTI in a prenatal or PP client?

A

frequency with overflow
incomplete emptying
dysuria
urgency…esp urgency but with incomplete emptying

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What causes frequent urination/diaphoresis PP?

A

Fluid shift as uteroplacental circulation is eliminated –> increasing circulating volume (ABOUT 3RD DAY)
Mobilization of fluid…eliminated by diuresis & diaphoresis
Output may > 3000 mL/day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

When would rubella vaccination be administered to non-immune PP client?

A

after birth & then 1 month later

22
Q

What is isoimmunity?

A

Mom’s Rh (-) blood builds antibodies to baby’s Rh(+) blood. Next baby, if Rh (+) can be negatively effected

23
Q

Behaviors of the “TAKING IN” phase:

A
  • 1st 1-2 days PP
  • Introspective and preoccupied with own needs rather than new baby
  • Passive/dependent behavior
  • Excited & talkative
  • Touches & explores infant
  • Needs to verbalize L&D experience
24
Q

Behaviors of the “TAKING HOLD” phase:

A
  • 2nd-3rd day PP, lasts 10 days to several weeks
  • Moves toward more independent behavior
  • Desires to take charge
  • More receptive to teaching –> learning readiness
25
Q

Behaviors of the “LETTING GO” phase:

A
  • 10 days to several weeks after Taking Hold phase
  • Achieves realistic independent role
  • Establishes norms for self and family
  • Mothering functions established
  • Resumption of relationship with partner
  • Resumption of sexual activity
  • Family system enters new phase of development
26
Q

The best time for teaching PP clients is in the ____ ____ phase of adjustment.

A

Taking Hold

27
Q

Symptoms of PP blues:

A
  • transient depression usually 2nd-3rd day PP or withing 2 wks
  • mood swings, anger, tearfulness, feeling let down, anorexia, insomnia
  • emotionally labile, cries for no reason
  • usually resolves spontaneously
28
Q

Symptoms of PP depression:

A

Same as blues but do no not go away or are more severe

29
Q

What is a hematoma?

A

Blood filled vesicle that develops in the perineal area following delivery. Can be very painful and doesn’t respond to pain meds. May feel like “sitting on a softball”.

30
Q

Characteristics of EARLY PP hemorrhage:

A
  • critical time is 1 hr past delivery
  • bright red blood
  • may be related to lacerations
  • indicated by continuous trickle of blood in spite of contracted uterus
31
Q

Characteristics of LATE PP hemorrhage:

A
  • 24 hrs or more after delivery
  • dark red blood
  • caused by retained fragments of placenta in the uterus
  • infection is another cause
  • why we check that the placenta is delivered intact
32
Q

How often are assessments made in recovery?

A

q15 min for 1st hr
q30 min for 2nd hr
q4 hr x 4
then every 8 hrs

33
Q

Major causes of early PP hemorrhage:

A

tears & lacerations

34
Q

Major causes of late PP hemorrhage:

A

retained placental fragments or infection

35
Q

What would be the first intervention you would perform to manage PP hemorrhage?

A

fundal massage

36
Q

S/S of PP shock:

A
  • persistent significant bleeding - peri pad is soaked within 15 min
  • lightheaded, sees stars
  • nausea
  • anxiousness, signs of air hunger
  • skin looks gray or ashen
  • skin feels cool & clammy
  • increased pulse
  • decreased BP
37
Q

When is the best time for maternal-infant bonding?

A

???

38
Q

What infant would miss the initial bonding time?

A

high risk babies taken immediately to NICU

39
Q

What is the ANTERIOR fontanel shaped like?

A

5 cm, diamond shaped

40
Q

What is the POSTERIOR fontanel shaped like?

A

smaller than anterior, triangle shape

41
Q

Sunken fontanel =

Bulging fontanel =

A

dehydrated

fluid overload

42
Q

How much vitamin K is given to a newborn?

Do you aspirate?

A

0.5-1 mg/dL

No aspiration

43
Q

What size needle is used to administer Vit K?

What muscle is it injected in?

A

5/8 in, TB syringe

vastus lateralis

44
Q

Why is vit K given to babies after birth?

When is it given?

A

Prevents hemorrhagic disorders
Newborn liver can’t synthesize Vit K
Not produced in GI tract until day 8
(Given within 1 hr after birth)

45
Q

What needs to be done before given a vit K shot to a baby of an HIV positive mom?

A

Bathe first, cleanse site with alcohol

Prevents introduction of HIV pathogens into the break in the skin

46
Q

Erythromycin ointment administered into baby’s eyes after birth…why?

A

prevents blindness that could be caused by

  • Neisseria gonorrhoeae
  • Chlamydia
47
Q

What should be done with the unused portion of a bottle of formula?

A

throw it out…risk of bacterial contamination

48
Q

What are the S/S of an infant with jaundice?

A
  • yellowish tint to skin, sclera, & mucous membranes

- starts at the head & progresses down the thorax, abdomen, and extremities

49
Q

Why does jaundice occur?

A
  • Excess breakdown of RBCs
  • Liver immaturity –> not enough of enzyme glucornyl transferase
  • Poor sucking ability –> doesn’t consume enough food to introduce intestinal flora so blilirubin not conjugated to direct form that can be excreted
  • Cold stress
50
Q

What days would you see physiologic jaundice? Pathologic jaundice?

A 
Physiologic = AFTER 24 hr of age
Pathologic = BEFORE 24 hr of age or persistent after day 7
51
Q

Why should the jaundice baby be fed early and often (every 3-4 hr)?

A

promotes bilirubin excretion in the stools (natural laxative effect of breastmilk)

OB (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions