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83 Cards in this Set
- Front
- Back
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CHAPTER TWENTY-ONE and TWENTY-TWO
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(Ignore this card)
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PP infections may occur up to how many days following birth
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28 days
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A fever of 38C may indicate infection if it occurs during the first
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10 days PP
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Endometritis
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An infection of the uterine lining or endometrium
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Endometritis usually begins on what day
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2nd-5th PP day
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Mastitis may progress to
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an abscess
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Mastitis most commonly occurs in
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Mothers breastfeeding for the first time and well after the establishment of milk flow, which is usually 2-4 weeks after delivery
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The most common infecting organism causing mastitis is
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Staph aureus
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A risk factor for infection r/t pH is…
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alkalinity of amniotic fluid, blood, and lochia which decreases the acidity of the vagina
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A risk factor for mastitis r/t breastfeeding frequency is
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decreasae in breasfeeding frequency due to supplementation with bottle feeding
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What happens to RBC sedimentation rate with infection?
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distinctly increased
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When a patient has mastitis, which breast should she begin breastfeeding with?
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the unaffected breast to inititate the letdown reflex in the affected brast that is distended or tender
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Clindamycin (Cleocin) is an antibiotic for infections. You should notify the healthcare provider if
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watery, bloody diarrhea develops
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Epidural anesthesia is a risk factor for what bladder complication?
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UTI
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The client with a UTI is encouraged to flush her bladder by drinking how much fluid/day?
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3000 mL/day
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PPD generally continues for
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10 days
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PP psychosis develops within the first how many weeks PP?
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2-3 weeks
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What is a major risk factor/etiology for PPD?
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hormonal changes with a rapid decline in estrogen and progesterone levels
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CHAPTER TWENTY-THREE
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(Ignore this card)
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What is the New Ballard Scale used for?
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gestational age assessment
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0-3 on an APGAR indicates
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severe distress
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4-6 on an APGAR indicates
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moderate distress
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7-10 on an APGAR indicates
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no distress
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An APGAR is based on rating what five areas
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heart rate, respiratory rate, muscle tone, reflex irritability, and color
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Draw the APGAR table
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Check on page 297
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Normal neonate length is
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45-55 cm / 18-22 in
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Normal neonate head circumference is
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32-36.8 cm / 12.6-14.5 in
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Normal neonate chest circumference is
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30-33 cm / 12-13 in
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Describe the New Ballard Scale
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A newborn maturity rating scale that assesses neuromuscular and physical maturity. Each individual assessment parameter displays at least siz ranges of development along a continuum. Each range of development within an assessment is assigned a number value from -1 to 5. The totals are added to give a maturity rating in weeks gestation
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ON the New Ballard Scale, a score of what indicates 38 weeks gestation
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35
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What 6 areas are assessed when assessing neuromuscular maturity for the New Ballard Score?
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(1) posture - ranging from fully extended to fully flexed; (2) square window formation with the neonate's wrist; (3) arm recoil - where the neonate's arm is passively extended and spontaneously returns to flexion; (4) popliteal angle - the degree of the angle to which the newborn's knees can extend; (5) scarf sign - crossing the neonate's arm over the chest; (6) heel to ear - how far the neonate's heels reach to her ears
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What 6 areas are assessed when assessing physical maturity for the New Ballard Scale
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(1) Skin texture - ranging from sticky to transparent, to leathery, to cracked, and wrinkled; (2) Lanugo presence and amount - ranging from none, sparse, abundant, thinning, bald, or mostly bald; (3) Plantar surface creases - ranging from < 40-50 mm, to creases over the entire sole; (4) breast tissue amount - ranging from imperceptible, to full areola with a 5-10 mm bud; (5) eyes and ears for amount of eye opening and ear cartilage present; (6) gentalia development - ranging from flat smooth scrotum to pendulous testes with deep rugae for males, and promiment clitoris with flat labia to the labia majora covering the labia minora and clitoris for females
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The newborn respiratory rate increasaes from 30 to 60 breaths/minute with short periods of apnea occuring most frequently when
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during REM sleep
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Newborn heart rate should be
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100-160 bpm
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The pediatric stethascope head should be placed on
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the 4th or 5th intercostal space at the left midclavicular line
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B/P of the neonate should be
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SBP - 60-80; DBP - 40-50
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Temperature of the neonate should be
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97.7-98.9 (36.5-37.2) axillary
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Erythema toxicum
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a pink rash that appears suddenly anywhere on the body of a term newborn during the first 3 weeks. This is frequently referred to as newbon rash. No Tx needed.
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The newborn's head circumference should be how much greater than chest circumference?
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2-3 cm greater
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A newborn head circumference that is __ cm or more larger than chest circumference may indicate
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4 cm
hydrocephalus (excessive CSF) |
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A newborn head circumference less than __ cm may be an indication of ___________
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32 cm
microcephaly |
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The posterior fontanel is
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smaller and trianguler
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Bulging fontanels may indicate
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increased intracranial pressure, infection, or hemorrhage
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Depressed fontanels may indicate
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dehydration
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Does caput cross the suture line
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No
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Caput succedaneum
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Localized swelling of soft scalp tissue caused by pressure on head during labor
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Caput usually resolves in
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3-4 days
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Cephalohematoma
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collection of blood between periosteum and skull bone
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Does cephalohematoma cross the suture lin
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No
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When does cephalohematoma appear
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in the first 1-2 days after birth and simultaneously resolves in 2-3 weeks
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Ears that are low set can indicate
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a chromosome abnormality such as Down syndrome or a renal disorder
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Lack of ear cartilage indicates
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prematurity
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Newborns do not learn to breathe through the mouth until
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3 weeks after birth
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Excessive newborn saliva may indicate
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tracheoesophageal fistula
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Epstein pearls
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small white cysts found on the gums and at the junction of the soft and hard palates
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Are epstein pearls normal in the newborn?
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Yes
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What do epstein pearls result from
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accumulation of epithelial cells
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What happens to epstein pearls
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disappear a few weeks after birth
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A protruding newborn tongue may be a sign of
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Down syndrome
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Absence of newborn head control may indicate
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prematurity or Down syndrome
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What blood vessels should the umbilical cord have?
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2 arteries and 1 vein
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When should the newborn void?
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In the first 24 hours
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When should the newborn defecate?
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In the first 24 hours
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The sucking and rooting reflex lasts
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birth to 4 months
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The palmar grasp reflex lasts
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birth to 6 months
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The plantar grasp reflex lasts
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birth to 8 months
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The moro reflex lasts
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birth to 4 months
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The tonic neck reflex lasts
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birth to 3-4 months
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The Babinski reflex lasts
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birth to 1 year
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The stepping reflex lasts
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birth to 4 months
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Describe newborn vision
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should be able to focus on objects 9-12 inches from his face; prefers birth colors and patterns
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Describe newborn hearing
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Similar to that of an adult once the amniotic fluid drains from the ears
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Describe newborn tast
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Prefers sweet tastes
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Describe newborn smell
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a highly developed sense of smell, prefers sweet smells, can recognize the smell of mother
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Newborn HMG
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14-24
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Newborn HCT
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44-64%
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Newborn RBC count
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4.8-7100k
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Newborn WBC count
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9-30 k
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Newborn PLT count
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150-300 k
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Newborn glucose count
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40-60
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Newborn bilirubin on first day
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0-6 mg/dL
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Newborn bilirubin on second day
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8 or less mg/dL
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Newborn bilirubin on third day
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12 or less mg/dL
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