Test 3 week 6 #3 slides

Question 1

newborn stomach capacity

Answer 1

day 1- cherry, 5-7ml
day 3- walnut, 23-27ml
week 1- peach, 45-60ml
1mo- egg, 80-150ml

Question 2

caloric needs

Answer 2

breast milk is 20cal/oz, 110 cal/kg/day

Question 3

what to feed newborns

Answer 3

on milk for first 6 mo

Question 4

breastmilk vs formula

Answer 4

breast- water, fat, lactose, protein, vit, minerals, DHA, lipase, oligosaccharides, enzymes, growth factors, anti parasites, allergies, viruses, hormones, antibodies
formula- first 7, vit d, iron

Question 5

colostrum components

Answer 5

growth factors, immunity factors, protein, carbs, energy, vitamins

Question 6

benefits of breastfeed to mom

Answer 6

decrease in type 2 dm, pp depression, breast cancer, ovarian cancer, endometrial cancer, osteoporosis, arthritis, heart disease

Question 7

benefits of breastfeed to baby

Answer 7

decrease stomach upset, diarrhea, colic, NEC, allergies, ear infections, asthma, SIDS, obesity, promotes passive immunity and development

Question 8

benefits of formula

Answer 8

baby feeds less often, others can feed baby, mom doesnt have to change diet

Question 9

LATCH scale

Answer 9

L- latch, can the suck
A- audible swallow, should be spontaneous
T- type of nipple, should be everted
C- comfort, no pain
H- hold, no assist

Question 10

formula donts

Answer 10

always discard leftover formula from bottle, follow formula expiration dates, use leftover formula from feed in 2 hours, refrigerate formula <24hr

Question 11

1st phase of reactivity

Answer 11

1-2hr after birth, awake and alert baby, good for bonding and breastfeed

Question 12

2nd phase

Answer 12

time of sleep, several hours

Question 13

transition to extrauterine life

Answer 13

chemical - cord clamped triggers hypoxic state which stimulates breathing
mechanical - squeeze thru birth canal to clear fluid in lungs
thermal - goes from warm liquid environment to cool and dry stimulates breathing

Question 14

respiratory distress in newborn s/s

Answer 14

nasal flaring, retractions (subcostal in base of ribs, intercostal is between all ribs, suprasternal at top of sternum), grunting, tachypnea, seesaw breathing, periods of apnea >20 sec/HR <90/O2 <90, stridor, head bobbing

Question 15

respiratory distress nursing interventions

Answer 15

sniffing position (lay flat with neutral spine, no chin tucked in), bulb or stomach suction, chest percussion with mask to cup, blow by O2

Question 16

first bath

Answer 16

VS need to be stable, 4-24hr after birth

Question 17

monitor VS after birth

Answer 17

q4 for first 24hr, then q8 for next 24hr

Question 18

weight after birth

Answer 18

normal to lose 10% after birth, will regain by 10-14 days

Question 19

newborn metabolic screen

Answer 19

first done 24hr after birth and have to eat prior, second one 10-14 days after birth

Question 20

where to poke for metabolic screen

Answer 20

on sides of heel

Question 21

hyperbilirubinemia screen

Answer 21

physiological jaundice is common and goes away on its own, kernictus is high levels of biliruben causing brain damage, screen with transcutaneous bilirubin, pathologic is jaundice of skin, high biliruben and needs treatment

Question 22

CCHD screening

Answer 22

put O2 monitor on right hand for pre ductal read, another O2 monitor on either foot for post ductal read. dont want>3% difference in readings.

Question 23

postpartum hemorrhage (PPH) blood loss

Answer 23

1000ml +

Question 24

risk factors for PPH

Answer 24

high parity (5+ birth), previous hx, uterine overdistention, chorioamnionitis, placental anomalies, prolonged labor, forceps or vacuum, laceration, IUFD

Question 25

causes of PPH

Answer 25

tone - uterine atony, overdistention, inflammation, prolonged labor, placenta accreta tissue- retained products like placenta, amniotic sac, missed abortion trauma - bleeding from injury, lacerations, hematoma thrombin - underlying clotting pathology, DIC

Question 26

mgmt of PPh

Answer 26

fundal massage, frequent VS, O2 via mask, IV fluid bolus, measure blood loss, rx like oxytocin, methylergonovine, carboprost, misoprostol, TXA. provider does bimanual massage, UA, devices like bakri, repair, D&C, uterine artery embolization, hysterectomy.

Question 27

risk factor for DVT

Answer 27

hypercoagulable state, positioning during labor, decreased activity, htn, multiples, cesarean

Question 28

DVT prevention

Answer 28

avoid long time in lithotomy position, do position changes, wear SCDs, ambulate asap

Question 29

DVT tx

Answer 29

heparin then warfarin, bed rest, elevate legs, analgesic

Question 30

endometritis risk factors

Answer 30

prolonged rupture of membrane or labor, frequent SVE, instrument delivery, manual extraction of placenta, retained POC, cesarean

Question 31

s/s endometritis

Answer 31

fever, abd tenderness, foul smelling lochia, flu s/s

Question 32

tx for endometritis

Answer 32

abx, pain rx, rest, fluids and nutritions, surgery D&C

Question 33

Mastitis s/s

Answer 33

pain, redness, hardened area, malaise, fever, flu s/s

Question 34

mastitis mgmt

Answer 34

abx, pain rx, warm compress, continue breastfeeding, monitor for abscess

Question 35

clogged duct

Answer 35

blockage of milk, s/s is painful lump that decrease after feeding, tx with warm pack, massage, feed on affected side first

Question 36

PP blues

Answer 36

first 2 wks, s/s are irritability, anxiety, fluctuating mood, emotional reactivity

Question 37

PP depression

Answer 37

after 2 wks, s/s are guilt, anxiety, depressed, insomnia, suicidal, fatigue

Question 38

PP psychosis

Answer 38

in first 3 mo, s/s are mixed, agitation, delusions, hallucinations, disorganized behavior.

Question 39

risk factors for PP mood disorders

Answer 39

HX of depression, complication of pregnancy or birth, life stresses, no social support, low socioeconomic status, IPV

Question 40

TX for PP mood disorder

Answer 40

therapy, antidepressant