Maternal Newborn Chapter 23 Sg

Front 1

What are the 7 factors being assessed during the 4th stage of labor?

Back 1

blood pressure, pulse, temperature, fundus, bladder, lochia, perineum. p. 586

Front 2

What is an LDR? What is an LDRP? What is the difference in nursing care?

Back 2

LDR: labor, delivery room
LDRP: labor, delivery, recovery, postpartum rooms
-The women is not moved from an LDRP and the nurse who provides care during the recovery period usually continues caring for the woman.

Front 3

What does the Newborns’ and Mothers’ Health Protection Act provide?

Back 3

minimum federal standards for health plan coverage for mothers and their newborns.
- all health plans are required to allow the new mother and newborn to remain in the hospital for a minimum for 48 hours after a normal vaginal birth and 96 hours after a cesarean birth unless the attending provider, in consultation with the mother, decides on early discharge.

Front 4

Maternal postpartum physical assessments include at least:

Back 4

a. 1 breasts
b. 2 uterine fundus
c. 3 lochia
d. 4 perineum
e. 5 bladder functions
f. 6 bowel functions
g. 7 vital signs
h. 8 legs

Front 5

Any estimate of Lochia flow is inaccurate and incomplete without

Back 5

__consideration of the time factor_.

Front 6

What is a nursing intervention to restore good uterine tone?

Back 6

stimulation by gently massaging the uterine fundus until it is firm. (it may cause a temporary increase in the amount of vaginal bleeding seen as pooled blood leaves the uterus. Clots may also be expelled)

Front 7

What does a full bladder do to the uterus?

Back 7

causes the uterus to be displaced about the umbilicus and well to one side of midline in the abdomen. it also prevents the uterus from contacting normally.

Front 8

What is the most frequent cause of excessive bleeding after birth, and discuss interventions for prevention.

Back 8

uterine atony- failure of the uterine muscles to constract firmly.

-2 more important interventions for preventing excessive bleeding are maintaining good uterine tone and preventing bladder distention.

-(if uterine atony occurs, the relaxed uterus distends with blood and clots, blood vessels in the placental site are not clamped off and excessive bleeding results)

Front 9

List other causes of excessive blood loss.

Back 9

excessive blood loss after childbirth may also be caused by vaginal or vulvar hematomas, unrepaired lacerations of the vagina or cervix, and retained placental fragments

Front 10

How is blood loss described subjectively? Objectively?

Back 10

subjectively: as scant, light, moderate, or heavy (produce)


objectively: measure serial H&H and weight blood clots
-know what a pad weights when its empty vs full and measure the difference

Front 11

List at least 10 nonpharmacologic interventions to promote comfort for a postpartum patient.

Back 11

-warmth
-distraction
-imagery
-therpaetuic touch
-relaxation
-interaction with the infant
-encouraging the woman to lie on her side whenever possible and to use a pillow when sitting
-application of ice pack
-dry heat
-cleansing with a squeeze bottle
-cleansing shower or tub bath

Front 12

Why is early ambulation of the postpartum patient important? What are important considerations when encouraging/assisting a woman to ambulate?

Back 12

-early ambulation is successful in reducing the incidence of thromboembolism and in promoting the woman’s more rapid recovery of strength.
-orthostatic hypotension is a condition that occurs when the woman who has recently given birth sits or stands up, first ambulates, or takes a warm shower or sitz bath. it is caused by the rapid decrease in intraabdominal pressure after birth and results in dilation of blood vessels supplying the intestines and causes blood to pool in the viscera.
-the nurse also needs to consider the baseline blood pressure; amount of blood loss; and type, amount, and timing of analgesic or anesthetic medications administered when assisting a woman to ambulate.

Front 13

Ideally infants should breastfeed in the 1st hour or two of life,-why?

Back 13

because the infant is typically in an alert state and will suckle if put to the breast

Front 14

Should women who are not breastfeeding stimulate the breasts with water in the shower? Why?

Back 14

no because that stimulates lactation

Front 15

Why must women avoid pregnancy for 1 month after receiving a rubella vaccination?

Back 15

there is a risk of teratogenic effects

Front 16

Who receives Rh immune globulin?

Back 16

if the mom is Rh negative and the baby is Rh positive

Front 17

Discharge planning begins when?

Back 17

at the time of admission

Front 18

It is possible for ovulation to occur as soon as

Back 18

__1 month after birth__

Front 19

what is the most frequent cause of excessive bleeding after birth.

Back 19

- uterine atony --it’s the failure of the uterine muscles to contract firmly.

Front 20

-the 2 more important interventions for preventing excessive bleeding are

Back 20

maintaining good uterine tone and preventing bladder distention.

Front 21

-if uterine atony occurs, the relaxed uterus distends

Back 21

with blood and clots, blood vessels in the placental site are not clamped off and excessive bleeding results

Front 22

massaging the fundus causes:

Back 22

contractions

Front 23

Promotion of nutrition

-during hospital stay, most women display a good appetite and eat well &-cultural dietary preferences must be respected

Back 23

(women may request family to bring in food)

Front 24

Promotion of nutrition

-prenatal vitamins and iron supplements are often continued until

Back 24

6 weeks postpartum or until the ordered supply has been used

Front 25

Promotion of nutrition

what is needed to heal?

Back 25

protein, encourage water, fruits, veggies

Front 26

Lactation Suppression is necessary when (2)

Back 26

the woman has decided not to breastfeed or in the case of neonatal death

Front 27

lactation
-wearing a well fitted support bra or breast binder continuiously for at least the first ____ after birth is important

Back 27

72 hours (3 days)

Front 28

-a few non-breastfeeding mothers experience severe breast engorgement, which is?? when does it occur??

Back 28

(swelling of breast tissue caused by increase blood and lymph supply to the breasts as the body produces milk –occurs 72-96 hrs after birth)


-ice packs to the breasts are helpful in decreasing the discomfort (woman should use a 15 min on and 45 off)

-fresh cabbage leaves inside her bra (cabbage leaves have been used to treat swelling)
-mild analgesic may be used

Front 29

Plan of Care and Interventions

-topics that should be included in the psychosocial plan of care include (2)

Back 29

promoting of parenting skills and family member adjustment to the newborn

Front 30

-in Asia, pregnancy is considered to be a “hot” state and childbirth results in a loss of this state so balance must be restored how?

Back 30

by hot food, hot water, and warm air.

Front 31

Infant behaviors affecting parental attachment (facilitating or inhibiting)

visually alert

Back 31

Facilitating Behaviors

Front 32

Infant behaviors affecting parental attachment (facilitating or inhibiting)

appealing facial appearance

Back 32

Facilitating Behaviors

Front 33

Infant behaviors affecting parental attachment (facilitating or inhibiting)

smiles

Back 33

Facilitating Behaviors

Front 34

Infant behaviors affecting parental attachment (facilitating or inhibiting)

crying only when hungry or wet

Back 34

Facilitating Behaviors

Front 35

Infant behaviors affecting parental attachment (facilitating or inhibiting)

sucks well, feeds easily

Back 35

Facilitating Behaviors

Front 36

Infant behaviors affecting parental attachment (facilitating or inhibiting)

enjoys being cuddled and held

Back 36

Facilitating Behaviors

Front 37

Infant behaviors affecting parental attachment (facilitating or inhibiting)

easily consolable

Back 37

Facilitating Behaviors

Front 38

Infant behaviors affecting parental attachment (facilitating or inhibiting)

activity predictable

Back 38

Facilitating Behaviors

Front 39

Infant behaviors affecting parental attachment (facilitating or inhibiting)

recognizes and prefers parents

Back 39

Facilitating Behaviors

Front 40

Infant behaviors affecting parental attachment (facilitating or inhibiting)

clings to parents

Back 40

Facilitating Behaviors

Front 41

Infant behaviors affecting parental attachment (facilitating or inhibiting)

Sleepy

Back 41

quiz) which is NOT a behavior

Inhibiting Behaviors

Front 42

Infant behaviors affecting parental attachment (facilitating or inhibiting)

Resemblance to person parent dislikes

Back 42

Inhibiting Behaviors

Front 43

Infant behaviors affecting parental attachment (facilitating or inhibiting)

Infrequent smiles

Back 43

Inhibiting Behaviors

Front 44

Infant behaviors affecting parental attachment (facilitating or inhibiting)

Crying for hours on end

Back 44

Inhibiting Behaviors

Front 45

Infant behaviors affecting parental attachment (facilitating or inhibiting)

Feeds poorly, regurges

Back 45

Inhibiting Behaviors

Front 46

Infant behaviors affecting parental attachment (facilitating or inhibiting)

Resists holding and cuddling

Back 46

Inhibiting Behaviors

Front 47

Infant behaviors affecting parental attachment (facilitating or inhibiting)


Inconsolable

Back 47

Inhibiting Behaviors

Front 48

Infant behaviors affecting parental attachment (facilitating or inhibiting)


Unpredictable feeding/sleeping

Back 48

Inhibiting Behaviors

Front 49

Infant behaviors affecting parental attachment (facilitating or inhibiting)

Shows no preference for parents

Back 49

Inhibiting Behaviors

Front 50

Infant behaviors affecting parental attachment (facilitating or inhibiting)

Seeks attention from any adult

Back 50

Inhibiting Behaviors

Front 51

Parental Behaviors Affecting Infant Attachment (facilitating or inhibiting behaviors)

Gazes at infant

Back 51

Facilitating Behaviors

Front 52

Parental Behaviors Affecting Infant Attachment (facilitating or inhibiting behaviors

Hovers, stays close

Back 52

Facilitating Behaviors

Front 53

Parental Behaviors Affecting Infant Attachment (facilitating or inhibiting behaviors

Claims infant as family member

Back 53

Facilitating Behaviors

Front 54

Parental Behaviors Affecting Infant Attachment (facilitating or inhibiting behaviors

Touch,-from fingertip to palm to encompassing

Back 54

Facilitating Behaviors

Front 55

Parental Behaviors Affecting Infant Attachment (facilitating or inhibiting behaviors

Smiles at infant

Back 55

Facilitating Behaviors

Front 56

Parental Behaviors Affecting Infant Attachment (facilitating or inhibiting behaviors

Talks to, sings, coos

Back 56

Facilitating Behaviors

Front 57

Parental Behaviors Affecting Infant Attachment (facilitating or inhibiting behaviors

Expresses pride

Back 57

Facilitating Behaviors

Front 58

Parental Behaviors Affecting Infant Attachment (facilitating or inhibiting behaviors

Ignores infant

Back 58

Inhibiting Behaviors

Front 59

Parental Behaviors Affecting Infant Attachment (facilitating or inhibiting behaviors

Back 59

Inhibiting Behaviors

Front 60

Parental Behaviors Affecting Infant Attachment (facilitating or inhibiting behaviors

Avoids infant

Back 60

Inhibiting Behaviors

Front 61

Parental Behaviors Affecting Infant Attachment (facilitating or inhibiting behaviors

Has difficulty naming, claiming

Back 61

Inhibiting Behaviors

Front 62

Parental Behaviors Affecting Infant Attachment (facilitating or inhibiting behaviors

Fails to move from fingertip to palm to encompassing

Back 62

Inhibiting Behaviors

Front 63

Parental Behaviors Affecting Infant Attachment (facilitating or inhibiting behaviors

Bland or frown

Back 63

Inhibiting Behaviors

Front 64

Parental Behaviors Affecting Infant Attachment (facilitating or inhibiting behaviors

Handles roughly, hurries feeding

Back 64

Inhibiting Behaviors

Front 65

Parental Behaviors Affecting Infant Attachment (facilitating or inhibiting behaviors

Expresses disappointment

Back 65

Inhibiting Behaviors

Front 66

Becoming a Father

-Stage I

Back 66

Expectations (kid is going to yale to play football) father has preconceptions about what life will be like after baby comes home

Front 67

Becoming a Father

-Stage 2

Back 67

Reality (is it a healthy baby? Is it the wrong sex?)

-father realizes that expectations aer not always based on fact

Front 68

Becoming a Father

-Stage 3

Back 68

-Stage III Transition to Mastery

- goal: (a competent father who can care for the child who knows their role)
-father makes conscious decision to take control and become more actively involved with the infant

Front 69

Becoming a Father

-Stage 2
what are feelings the fathers experiences:

Back 69

common feelings experienced are: Sadness, ambivalence, jealousy (how much time their wife spends with the baby), frustration, and overwhelming desire to be more involved

Front 70

Father-Infant Relationship

- the term used for the father’s absorption, preoccupation, and interest in the infant

Back 70

engrossment:

Front 71

Father-Infant Relationship

-a sense of increased self-esteem and a sense of being proud, bigger, more mature, and older are all experienced by fathers after seeing their baby for

Back 71

for the first time

Front 72

Father-Infant Relationship

-fathers spend less time than mothers with infants and fathers interactions tend to be characterized by stimulating what?

Back 72

social play rather than caretaking

Front 73

Father-Infant Relationship

what are the 3 components of the process of becoming a dad

Back 73

1) commitment
2)becoming connected
3) making room for baby

p 623

Front 74

Sibling Adaptation

positive reactions (2)
negative reactions (4)

Back 74

-positive reactions of siblings: interest in and concern for the baby and increased independence
-negative reactions of siblings: regression in toileting and sleep habits, aggression toward the baby, increased

Front 75

Sibling Adaptation

FIRST BORN
vs
OLDER CHILDREN

Back 75

-first born children seem to continue their usual routines and are more pleased with the newborns and have more understanding of the baby’s need for care than the parents predict

-the older childs goal is to maintain the lead position-the adjustment of older children to a newborn takes time

Front 76

Sibling Adaptation

-siblings demonstrate _______ behaviors with the newborn

Back 76

acquaintance

-the acquaintance process depends on the information given to the child before the baby is born and on the child’s cognitive developmental level

Front 77

Sibling Adaptation

-the initial behaviors of siblings with the newborn (2)

Back 77

include looking at the infant and touching the head

Front 78

Grandparent Adaptation,

-the extent of involvement of grandparents in the care of the newborn depends on many factors

Back 78

-the willingness of the grandparents to become involved, the proximity of the gparents, ethnic and cultural expectations of the gparents role

Front 79

Grandparent Adaptation,

-many new parents do call on their parents for help, especially the

Back 79

maternal grandmothers