Ob Midterm.1

Front 1

1st assessment after baby is born?

Back 1

APGAR

Front 2

WHen is APGAR performed?

Back 2

1 min and 5 min

Front 3

What does the APGAR determine the need for?

Back 3

resuscitation or other intervention

Front 4

What does the APGAR consist of?

Back 4

Infant scored on HR, respiratory effort, muscle tone, reflex ability and color.

Front 5

What scale score is APGAR based on?

Back 5

0 to 2 in each category and total 1 out of 10 (5 categories)

Front 6

Where is HR taken for APGAR?

Back 6

taken at the cord and skin junction

Front 7

How to score newborn HR with APGAR?

Back 7

child gets #0 if absent; a#1 if slow or below 100

Front 8

How to score newborn Respiratory with APGAR?

Back 8

0 absent and child has apnea; 1 slow –irregular, 2 good crying. A mature newborn usually cries spontaneously at about 30 seconds after birth and by 1 minute the baby is maintaining regular, rapid respirations.

Front 9

How to score newborn muscle tone with APGAR?

Back 9

degree of flexation and resistance to straightening Give: 0 flaccid 1: flexion of extremities, 2: active motion;

Front 10

How to score newborn reflex irritability with APGAR?

Back 10

reflex use to be how the newborn responds to suction or nares to having feet slapped now that is felt to be to vigerous so it is evaluated by drying the infant or rubbing his feet. Given a 0 for no response; #1for grimace and 2 for a cry

Front 11

How to score newborn color with APGAR?

Back 11

looking for palor and cyanosis. #0 pale blue, #1 body pink, blue extremities, #2 completely pink; at the moment of birth all infants appear cyanotic but they pink up quickly after the first breath.

Front 12

Is acrocyanosis normal at birth?

Back 12

Yes- Most infants demonstrate acrocyanosis which is blue extremities with a pink body.

Front 13

What does APGAR score 7-10 mean?

Back 13

7-10 good may only need nasopharynx suctioned and 02 by face

Front 14

What does APGAR score 4-7 mean?

Back 14

needs stimulation

Front 15

What does APGAR score below 4 mean?

Back 15

indicates resuscitation.

Front 16

When is the second newborn assessment (after APGAR) performed and what is evaluated?

Back 16

It is done in first 1 to 4 hours (can do up to 24 hrs)

IT SHOULD be done within 2 hours after birth. brief physical examination to estimate gestational age and evaluate the newborn’s adaptation to extrauterine life

Front 17

What is the third assessment that is done before discharge and who performs it?

Back 17

24hrs before discharge a certified nurse-midwife, physician, or nurse practitioner will carry out a behavioral assessment and complete physical examination to detect any emerging or potential problems.

Front 18

Where is newborn taken if there are complications?

Back 18

To the nursery for further evaluation and intervention

Front 19

Who performs the second assessment on the newborn?

Back 19

Nursery nurse

Front 20

Why should the second newborn assessment be performed within the first 24 hrs?

Back 20

The accuracy of gestational age assessment decreases when performed more than 24hrs after birth

Front 21

What are the names of the assessments/evaluations done in the second newborn assessment?

Back 21

Dubowitz and Ballard

Front 22

What are the two parts to the Gestational Age Assessment?

Back 22

External physical characteristics
Neurologic characteristics

Front 23

The common physical characteristics included in the gestational age assessment are:

Back 23

Skin
Lanugo
Sole (plantar) creases
Breast tissue
Ear form and cartilage distribution
Evaluation of genitals

Front 24

The Neuromuscular components to the evaluation of gestational age include:

Back 24

posture
square window sign
popliteal angle, arm recoil
heel-to-toe extension
scarf sign

Front 25

After assessing gestational age of newborn the nurse will identify the newborn in one of three categories:

Back 25

small for gestational age (SGA), appropriate for gestational age (AGA), or large for gestational age (LGA) and prioritizes needs

Front 26

What does the gestational age score determine?

Back 26

This score determines how well the infant has grown for the amount time spent in utero.

Front 27

The infant who is appropriate for gestational age falls between the __th and the __th percentile

Back 27

10th and 90th

Front 28

The infant who Large for Gestational age is above the __th percentile

Back 28

90th

Front 29

SGA is below the __th percentile

Back 29

10th

Front 30

Dubowitz and Ballard are...

Back 30

gestational assessment tools

Front 31

Newborn gestational physical assessment- Skin

Back 31

in the preterm newborn appears thin and transparent, with veins prominent over the abdomen early in gestation. As the newborn approaches term, the skin appears opaque because of increased subcutaneous tissue.

Front 32

Newborn gestational physical assessment- Resting posture

Back 32

full term gestational age babies will have extremities flexed but preterm newborns will have a more flaccid and passive posture

Front 33

Newborn gestational physical assessment- Lanugo

Back 33

a fine hair covering, decreases as gestational age increases. The amount of lanugo is greatest at 28 to 30 wks and then disappears, first from the face, then from the trunk and extremities

Front 34

Newborn gestational physical assessment- Sole (plantar) creases

Back 34

are reliable indicators of gestational age in the first 12hrs of life. Later, the skin of the foot begins drying, and superficial creases appear

Front 35

Newborn gestational physical assessment- Areola

Back 35

gently palpates the breast bud tissue by applying the forefinger and middle finger of the breast area and measuring the tissue between them in cm or mm

Front 36

Newborn gestational physical assessment- Ear form and cartilage

Back 36

distribution develop with gestational age

Front 37

Newborn gestational physical assessment- Male genitals

Back 37

are evaluated for size of the scrotal sac, the presence of rugae (wrinkles and ridges in the scrotum), and descent of the testes.

Front 38

Newborn gestational physical assessment- Female genitals

Back 38

appearance depends in part on subcutaneous fat deposition and therefore relates to fetal nutritional status

Front 39

Newborn gestational physical assessment- Vernix caseosa

Back 39

whitish cheeslike substance, covers the fetus while in utero and lubricates the skin of the newborn.

Front 40

Newborn gestational physical assessment- Hair

Back 40

of the preterm newborn has the consistency of matted wool or fur and lies in bunches rather than in the silky, single strands of the term newborn’s hair

Front 41

Newborn gestational physical assessment- Skull firmness

Back 41

increases as the fetus matures

Front 42

Newborn gestational physical assessment- Nails

Back 42

appear and cover the nail bed at about 20wks gestation. Nails extending beyond the fingertips may indicate a postterm newborn

Front 43

Newborn gestational neuromuscular evaluation- Square window sign

Back 43

is elicited by flexing the baby’s hand toward the ventral forearm until resistance is felt

Front 44

Newborn gestational neuromuscular evaluation- Recoil

Back 44

is a test of flexion development. Because flexion first develops in the lower extremities, recoil is first tested in the legs.

Front 45

Newborn gestational neuromuscular evaluation- Popliteal angle

Back 45

degree of knee flexion

Front 46

Newborn gestational neuromuscular evaluation- Scarf sign

Back 46

is elicited by placing the newborn supine and drawing an arm across the chest toward the newborn’s opposite shoulder until resistance is met

Front 47

Newborn gestational neuromuscular evaluation- Head log (neck flexors)

Back 47

measured by pulling the baby to a sitting position and noting the degree of head lag

Front 48

Newborn gestational neuromuscular evaluation- Ventral suspension (horizontal position)

Back 48

is evaluated by holding the newborn prone on the examiner’s hand

Front 49

Some maternal conditions such as __________, __________, and maternal _______ and ________, may affect certain gestational assessment components and warrant further study.

Back 49

preeclampsia, diabetes, and maternal analgesia and anesthesia

Front 50

Maternal diabetes, although it appears to accelerate fetal physical growth, seems to ________ _______

Back 50

retard maturation

Front 51

Maternal hypertension states, which retard fetal physical growth, seem to _______ _________.

Back 51

speed maturation

Front 52

Acrocyansosis

Back 52

Dusky bluish color to the hands and feet of the newborns present soon after birth, which persists for a few days. The circulation through the skin capillaries is not fully developed.

Front 53

Mottling

Back 53

a lacy pattern of small reddish and pale areas - make sure child not cold

may be related to chilling, prolonged apnea, sepsis, or hypothyroidism

Front 54

Harlequins sign

Back 54

(clown) color change is occasionally noted. A deep color develops over one side of the newborn’s body while the other side remains pale, so that the skin resembles a clown’s suit Vasomotor disturbance. Onside dilates and one side constricts. Last 1 to 20 minutes. Transient and has no clinical significance.

Front 55

Erythemia Toxicum

Back 55

is an eruption of lesions in the area surrounding a hair follicle that are firm, vary in size from 1 to 3 mm. It is often called “newborn rash” or “flea bite” dermatitis.

Front 56

Milia

Back 56

Exposed sebaceous glands-characterized by pinpoint, raised spots on the face especially across the nose.

Front 57

Capillary Hemangioma- Telangiectatic nevi (Stork bites)

Back 57

appear as pale pink or red spots and are frequently found on the eyelids, nose, lower occipital bone, and nape of the neck

Front 58

Mongolian spots

Back 58

blue spots are macular areas of bluish black or gray-blue pigmentation found on the dorsal area and the buttocks- MUST document to avoid false abuse accusations

Front 59

Port-Wine Stains (Nevus flammeus)

Back 59

a Capillary angioma directly below the epidermis. Flat reddish to purplish. Common on face. Do not decrease in size, those above the bridge of nose may fade but others less likely to fade and so it is permanent. Removed by lasers

Front 60

Newborn head circumference should be what in relation to size of chest?

Back 60

Head circumference should be 2 cm greater than chest circumference

Front 61

What to assess on newborn head?

Back 61

Assess fontanelles and sutures – observe for signs of hydrocephalus and evaluate neurologic status

Front 62

What is normal head circumference of newborn?

Back 62

32-37 cm

Front 63

How to take head circumference measurement?

Back 63

Measurement is taken just above the eyebrows and the most prominent part of the occiuput

Front 64

Small pearl white bodies toward the back of the palate of newborns, which disappear in a few weeks. No treatment is necessary.

Back 64

Bohn’s Pearls

Front 65

Cavernous Hemangioma

Back 65

Involves both the skin and the underlying tissues. They are soft, compressible and bluish in appearance. Overlying the cavernous hemangioma may be a capillary or strawberry hemangioma. Some may resolve spontaneously and should be watched for a time before deciding upon treatment.

Front 66

Hemangiomas

Back 66

Birthmarks

Front 67

A capillary hemangioma. It is raised, clearly delineated, dark red, rough-surfaced birthmark commonly found in the head region

Back 67

Nevus vasulosus (strawberry mark)

Front 68

Breast Engorgement

Back 68

Engorgement of the breasts noticeable a few days after birth and due to the maternal hormones which cross the placenta into the baby. Milk may be secreted (witch’s milk). The swelling disappears within a few days.

Front 69

Edematous swelling of the soft tissue of the scalp. Extravasation of serum into the scalp tissue – caused by prolonged pressure on the head before the cervix is dilated.

Back 69

Caput Succedaneum

Front 70

Localized swelling along the side of the head usually at the back. May not be present at birth but appears a few days later. Caused by bleeding beneath the scalp. May be present on both sides of the head. It disappears in a few weeks. In some, calcium is deposited and the swelling may persist for several months.

Back 70

Cephalohematoma

Front 71

The side of the head can be indented with the finger like a derby or table tennis ball. The indentation springs back into place

Back 71

quickly.Craniotabes

Front 72

(Newborn hives, Flea bites)-Benign skin condition seen frequently in newborn infants lasting only a few days. Splotchy red areas on the trunk and extremities. Some may contain a raised yellow blister in the center. Their cause is unknown.

Back 72

Erythema Toxicum

Front 73

Fontanel

Back 73

(Soft spot)-The anterior fontanel is located at the top of the head and to the front. It is a diamond-shaped opening covered by a tough thick membrane. Posterior closes completely with bone between 2-3 months. Anterior closes completely with bone by 18 months.

Front 74

Funnel Chest (pectus excavatum)-

Back 74

Hollow-like depression in the lower end of the chest bone (sternum). Mild ones require no treatment. The more occasionally severe cases may require surgical correction at a later age

Front 75

Gravida

Back 75

number of pregnancy that a woman is in. Ex: in her second pregnancy a woman is said to be gravida two

Front 76

With the infant lying on one side, the upper half of the body may appear reddened and the lower half pale. There is a demarcation of color in the midline. When the infant is placed on his back the color changes disappear quickly.

Back 76

Harlequin Color Change

Front 77

A swelling in the scrotum due to the collection of fluid surrounding the testicles. It is fairly common in newborn males and disappears within a few months

Back 77

Hydrocoele

Front 78

Jaundice (Physiological)

Back 78

Yellow discoloration of the skin, eyes and membranes of the mouth seen in 50% of full term and 80% of premature infants. Due to the products released from the destruction of red cells in the newborn period and to immaturity of the liver. It appears about the second day of life and begins to disappear before the fifth day. It is usually gone before the end of the second week.

Front 79

A fine downy growth of hair prominent over the back, shoulders, forehead and face. It is more noticeable in premature babies. It disappears in the first few weeks

Back 79

Lanugo

Front 80

The infant makes a loud crowing noise on inspiration. It is common in infancy and is due to a flabby epiglottis or weak laryngeal structures. The condition disappears in 6 to 18 months.

Back 80

Laryngeal Stridor

Front 81

Obstructed sweat and oil sebaceous glands, which appear as pinhead-sized white spots on the nose, cheeks and chin of newborns and disappear spontaneously within a few weeks.

Back 81

Milia

Front 82

Areas of bluish-gray pigmentation found over the lower back, particularly in babies with dark skin. In some cases they may be more widespread and found elsewhere on the body. They tend to disappear within one to two years.

Back 82

Mongolian Spots

Front 83

An accessory nipple, which is present, just below the regular breast and may occur on one or both sides. They do not develop breast tissue and have no functional significance.

Back 83

Nipples, Supernumerary

Front 84

number of living children resulting from pregnancy gravida

Back 84

Para

Front 85

Periodic Respiration

Back 85

Irregular, rapid, often shallow respiration for several seconds followed by periods lasting only a few seconds of which there is no breathing. Common in premature babies but may be seen in some full-term infants.

Front 86

Pilonidal Dimple

Back 86

An indentation of the skin covering the lower end of the spine. (may be indicator for Spina Bifida as wellas tuft of hair at same spot) In later life, these impressions may become infected.

Front 87

Pseudoptosis

Back 87

The eyelids in the newborn may operate independently. One eye may be open and the other partially or completely closed. This lasts only a short time.

Front 88

Grasp reflex

Back 88

Touching the palm of either of the infants hands with a finger results in his grasping of the finger vigorously.

Front 89

Moro reflex

Back 89

(Startle reflex)-In response to loud noises or sudden changes in position both upper extremities are extended outward and together. With the infant on his back on a flat surface, raising him a short distance and suddenly releasing him elicits the startle reflex.

Front 90

Rooting reflex

Back 90

When the cheek is stroked gently, the baby’s head turns toward that side of the face with the mouth open in readiness for suckling.

Front 91

Suckling reflex

Back 91

Vigorous sucking movements follow when the lips are lightly touched

Front 92

Tonic neck reflex

Back 92

(Fencing position)-With the infant on his back the head is turned to one side, causing the baby to extend the arm and leg on that side the head is turned to and flex the opposite upper and lower extremities.

Front 93

Meconium

Back 93

Term given to the newborn’s bowel movements during the first few days of life. The stools are greenish-black in color and of slimy consistency. About 70% of infants will have their first bowel movement within 12 hours and 95% within 24 hours.

Front 94

Thin, loose yellowish-green bowel movement seen from the third to fifth day of life. They contain mucus, curds of milk and remnants of meconium.

Back 94

Transitional stool

Front 95

Subconjunctival

Back 95

Small red spot of blood noticed in the white part of the eyes due to pressure changes across the infant's body during childbirth.

Front 96

Hemorrhage

Back 96

rupture of a blood capillary during the birth process. It resolves quickly.

Front 97

Sucking Callous

Back 97

A small blister visible in the center of the upper lip of sucking infants. Condition lasts only a short time.

Front 98

Umbilical Cord Vessels

Back 98

(3)- The cut end of the umbilical cord is examined carefully at birth for the number of blood vessels. The normal number is three – two arteries and a vein.

Front 99

The presence of a single umbilical artery...

Back 99

should make the physician suspicious of some congenital abnormalities, particularly of the kidney.

Front 100

Newborn Vaginal Discharge

Back 100

A white discharge from the vagina common in newborns which lasts a few weeks.

Front 101

Pseudomenstration

Back 101

Vaginal bleeding may occur related to maternal hormones which cross the placenta into the baby.

Front 102

Cheese-like material, which covers the skin of newborns and is thought to protect the infant against superficial infections.

Back 102

Vernix Caseosa

Front 103

Where are the two fontanels palpated on a newborn?

Back 103

Anterior fontanel at coronal and sagittal suture

Posterior at lamboidal and sagittal suture

Front 104

What shape is the anterior fontanel on a newborn?

Back 104

Diamond

Front 105

What shape is the posterior fontanel on a newborn?

Back 105

Triangle

Front 106

When does the anterior fontanel close up?

Back 106

At 18 months

Front 107

When does the posterior fontanel close up?

Back 107

Closes in 8 to 12 weeks.

Front 108

What happens to the fontanels when the child cries or strains for BM?

Back 108

the fontanel swells slight and sometimes you can note pulsations in the fontanel which are normal.

Front 109

What can happen to the sutures of newborn skull during childbirth?

Back 109

Molding and Overriding

Front 110

What is a cephalohematoma?

Back 110

collection of blood between cranial bone and periosteal membrane. Appears first and second day of life and disappears after 2-3 weeks and up to months

Front 111

What is caput succedaneum?

Back 111

Collection of fluid- edematous swelling of scalp. Present at birth and reabsorbed in about 12hrs to several days after birth, localized, occurs after vacuum extraction

Front 112

Which crosses suture lines, cephalohematoma or caput succedaneum?

Back 112

caput succedaneum

Front 113

Which may have jaundice as it resolves, cephalohematoma or caput succedaneum?

Back 113

Cephalhematoma

Front 114

When does baby's true eye color occur?

Back 114

After 6 months of age

Front 115

What is low set ears a sign of?

Back 115

Down syndrome

Front 116

What are we visually assessing in newborns in relation to lungs/chest?

Back 116

Examine appearance and size of chest
Note if there is funnel chest, barrel chest, unequal chest expansion
respiratory efforts – evaluate color for pallor or cyanosis

Front 117

When should a newborn void?

Back 117

Voids within 3 hours of birth or at time of birth

Front 118

What is phimosis in male newborns?

Back 118

the inability to fully retract the foreskin (or prepuce) over the glans penis due to a narrow opening.

Front 119

What is brachial palsy (Erb-Duchenne paralysis, Erb's Palsy) in newborns?

Back 119

a loss of movement or weakness of the arm that occurs when the collection of nerves around the shoulder are damaged during birth.

Front 120

How to check for developmental dysplasia of the hip in newborns?

Back 120

perform Ortolani’s maneuver or Barlow’s maneuver

Front 121

Barlow’s maneuver

Back 121

performed by adducting the hip (bringing the thigh towards the midline) while applying light pressure on the knee, directing the force posteriorly. If the hip is dislocatable the test is considered positive.

Front 122

Ortolani’s maneuver

Back 122

It relocates the dislocation of the hip joint that has just been elicited by the Barlow maneuver.
First flex the hips and knees of a supine infant to 90 degrees, then place anterior pressure on the greater trochanters, gently and smoothly abducting the infant's legs using the thumbs.
Positive sign is a 'clunk' which can be heard and felt as the femoral head relocates anteriorly into the acetabulum

Front 123

Without any manipulation, how can we visually assess for Developmental Dysplasia of the Hip?

Back 123

Look to see if there are equal posterior thigh folds

Front 124

Talipes Equinovarus

Back 124

"clubfoot" a congenital deformity involving one foot or both. The affected foot looks like it has been rotated internally at the ankle.

Front 125

_______ ________ can cause feet to appear to turn inward – “positional” clubfoot

Back 125

Intrauterine positions

Front 126

How can a nurse determine if there is true clubfoot present?

Back 126

nurse moves foot to midline – if resists, it is true clubfoot

Front 127

How do we assess newborn temperature?

Back 127

Can be assessed by axillary skin method, continuous skin probe, rectal route, tympanic – axillary temperature is preferred method

Front 128

What is temperature instability in a newborn be a sign of?

Back 128

Infection

Front 129

What is a normal axillary temperature range for a newborn?

Back 129

36.1 to 37.2°C (97.5 to 99°F)

Front 130

Newborn heart rate range?

Back 130

120 to 160 beats per minute

Front 131

Newborn respiration rate range?

Back 131

30 to 60 respirations per minute

Front 132

Newborn blood pressure range

Back 132

80-60/45-40 mm Newborn blood pressure range

Front 133

Best places to check for newborn pulses?

Back 133

Brachial and femoral

Front 134

What is a reason to take an axillary temp over a rectal temp for a newborn?

Back 134

imperforate anus or anorectal malformations

Front 135

Normal newborn weight range?

Back 135

2500 to 4000 g (5 lb, 8 oz to 8 lb, 13 oz), weight dependent on maternal size and age

Front 136

Normal newborn length range?

Back 136

46 to 56 cm (18 to 22 in)

Front 137

Normal newborn Head circumference range?

Back 137

32 to 37 cm (12.5 to 14.5 in)

Front 138

Three initial signs of healthy neurological status in a newborn?

Back 138

State of alertness- alert
Resting posture- flexed
Cry- good and vigorous
Quality of muscle tone
Motor activity

Front 139

What are newborn protective reflexes?

Back 139

blinking
yawning
coughing
sneezing
drawing back from pain

Front 140

What are newborn reflexes that assist with feeding?

Back 140

rooting
sucking

Front 141

Babinski Reflex

Back 141

Elicited by stroking the lateral sole of the infants feet from the heel forward across the ball of the foot. This cause the toes to flare outward and the big toe to dorsiflex

Front 142

What age should the Babinski Reflex go away?

Back 142

By 24 mos, if it continues past then, it is abnormal

Front 143

Stepping reflex

Back 143

seen when you place the infant in standing position and hold onto him. He will make stepping motion.

Front 144

When does the stepping reflex go away?

Back 144

Disapperars between 4 and 8 weeks

Front 145

How many hours a day will a newborn sleep for first 2 weeks?

Back 145

16-20 hours a day

Front 146

Is weight loss normal for infant after birth?

Back 146

Yes- usually 5-10% weight loss in first few days, and is regained within 10-14 days

Front 147

What does it mean if the newborns fontanels are sunken?

Back 147

It is a sign of dehydration

Front 148

What muscles are used for infants to breathe?

Back 148

Diaphragmatic and abdominal muscles

Front 149

Are infants nose or mouth breathers?

Back 149

Nose breathers

Front 150

How to take chest measurements

Back 150

should be taken with the tape measure at the lower edge of the scapulas and brought around anteriorly directly over the nipple line

Front 151

Average chest measurement on a newborn?

Back 151

32cm (12.5in), range: 30-35 cm (12-14 in.)

Front 152

When does the moro reflex disappear?

Back 152

within 6 months

Front 153

How to elicit the blinking reflex?

Back 153

Light flash, eyelids will close

Front 154

What is the newborn abdominal reflex?

Back 154

Tactile stimulation or tickling will cause abdominal muscles to contract

Front 155

What is the newborn withdrawal reflex?

Back 155

slight pinprick on sole of feel will cause the leg to reflex

Front 156

What is the newborn plantar or toe grasping reflex?

Back 156

Pressure applied with fingrs against the ball of the infants feet causes plantar flexion of all toes

Front 157

When does the plantar or toe grasping reflex disappear?

Back 157

By the end of the first year

Front 158

What is the newborn Trunk incurvation or Galant reflex?

Back 158

If stroke the newborn spine, the spine causes the pelvis to move to the stimulated side

Front 159

What is done to assist newborn expel the mucous and amniotic fluid from lungs and airway?

Back 159

Bulb syringe- first nostrils and then mouth

Front 160

Can the umbilical cord stump get wet?

Back 160

No- so do not give bath until the cord falls off
Sponge bath only

Front 161

How long does it take the cord to fall off?

Back 161

7-14 days

Front 162

What should nurse and parents assess for with cord?

Back 162

Check cord daily for odor, oozing, and reddened areas

Front 163

What special considerations should be made in relation to diapers and the cord?

Back 163

Fold down the diaper so that it is not irritating or rubbing on the cord.

Front 164

What are the 2 newborn medication protocols?

Back 164

Eyes- erythromycin, sliver nitrate, tetracycline and ophthalmic solution of povidone-iodine

Front 165

How much Vit K is given to a newborn?

Back 165

0.5 to 1mg is given IM within 1 hr of birth

Front 166

What is the rationale for giving Vit K to the newborn?

Back 166

sterile gut, no bacteria to synthesize Vit K.

A prophylactic injection of vit K is given to prevent hemorrhage, which can occur because of low prothrombin levels in the first few days of life.

Front 167

How and where is the Vit K given to newborns?

Back 167

Given IM in lateral aspects of the thigh- vastus lateralis

Front 168

Why do we give newborns Erythromycin antibacterial eye ointment?

Back 168

Prophylactic eye treatment for Neisseria gonorrhoeae is legally required on all newborns

effective against gonorrhea and chlamydia which can both lead to blindness

Front 169

What will the eye ointment do to the newborns eyes?

Back 169

May cause eyes to appear swollen and slightly reddened with with disappear in a day or two.

Front 170

How is the penis circumcised?

Back 170

The prepuce is slit
Prepuce drawn over a metal cone
Clamp is applied for 3-5 minutes
then excess prepuce is cut away

Front 171

What position should be avoided for a baby recently circumcised?

Back 171

Avoid positioning baby on his stomach

Front 172

What to assess for in circumcised newborns?

Back 172

Check for any foul-smelling drainage or bleeding at least once a day – light, sticky, yellow drainage part of healing process

Front 173

What is the newborn screening so important?

Back 173

Screens for more than 20 disorders. Including PKU(phenylketonuria) and hypothyriodism.

Front 174

When is the first Heb-B immunization given?

Back 174

1st dose at birth to 2 months old.

Front 175

What temperatures are signs of illness in a newborn?

Back 175

Temp > 38°C (100.4°F)
Temo < 36.6°C (97.8°F)

CALL MD

Front 176

What does it mean if the newborn refuses two feedings in a row?

Back 176

Can be a sign of illness- Call MD

Front 177

If newborn has more than one episode of forceful or frequent vomiting over six hours...

Back 177

coud be a sign of illness, call MD

Front 178

Newborn Lethargy (listlessness)....

Back 178

Is a sign of illness, Call MD

Front 179

Inconsolable infant....

Back 179

Is a sign of illness, Call MD

Front 180

Discharge/bleeding from umbilical cord, circumcision, or any opening....

Back 180

Is a sign of illness, Call MD

Front 181

Two consecutive green, watery stools....

Back 181

Is a sign of illness, Call MD

Front 182

Newborn- No wet diapers for 18 to 24 hours – fewer than 6 to 8 wet diapers a day....

Back 182

Is a sign of illness, Call MD

Front 183

Eye Drainage in the newborn...

Back 183

Is a sign of illness, Call MD

Front 184

Why are relaxation techniques important for the mother during labor?

Back 184

Tense muscles increase resistance to the descent of the fetus and contribute to maternal fatigue

Front 185

What is the advantage to using Patterned-paced breathing?

Back 185

Used correctly, patterned-paced breathing increases the woman’s pain threshold, encourages relaxation, enhances the ability to cope with uterine contractions, and allows the uterus to function more efficiently

Front 186

Why does hyperventilation happen during labor?

Back 186

The woman is breathing very heavily over a prolonged period of time.

Front 187

What is the result of hyperventilation?

Back 187

an imbalance of oxygen and carbon dioxide (that is, too much carbon dioxide is exhaled, and too much oxygen remains in the body).

Front 188

What are the s/s of hyperventilation?

Back 188

are tingling or numbness in the tip of nose, lips, fingers, or toes; dizziness; spots before the eyes; or spasms of the hands or feet (carpal-pedal spasms)

Front 189

During the 1st stage- active phase of labor, how often should the nurse palpate contractions?

Back 189

Every 15-30 minutes

Front 190

During the second stage of labor, how often are the maternal pulse, BP, and FHR assessed?

Back 190

Every 5-15 minutes

Front 191

Who determines the birthing position?

Back 191

Not only the woman, but also by the CNM/physician

Front 192

birthing position- Decrease in BP in some women, some difficulty breathing d/t pressure of uterus on diaphragm, aspiration of vomitus more likely, and some women feel that this is am embarrassing position

Back 192

Recumbent Birthing Position

Front 193

Position favored by some women primarily for the positive use it makes of gravity. Size of pelvic outlet is increased. Second stage may be shortened. May be hard to maintain balance

Back 193

Squatting Position

Front 194

What situation is squatting position best for?

Back 194

Large baby

Front 195

Birthing position that does not compromise venous return, increases perineal relaxation, decreases need for episiotomy, appears to prevent rapid descent. It is difficult for mother to view birth however.

Back 195

Left Lateral Sims’ Position side lying

Front 196

What situation is Left Lateral Sims’ Position side lying position best for?

Back 196

If the baby is descending too rapidly

Front 197

Birthing position where gravity aids, there is no compromised venous return, and the woman can view the birth. However, it is difficult to support the womans back.

Back 197

sitting on birthing stool

Front 198

What situation is sitting on a birthing stool best for?

Back 198

If mom has decreased peripheral pulses

Front 199

Birthing position that does not compromise venous return and the mom can view the birth. However, if legs are wide apart, relaxation of perineal tissue is decreased

Back 199

semi-fowler’s

Front 200

What situation is semi-fowler’s position best for?

Back 200

mom wants to see birth of baby

Front 201

Birthing position where gravity aids, does not compromise venous return, woman can view birth, legs can be repositioned at will. No disadvantages.

Back 201

Sitting in a birthing bed

Front 202

What situation is sitting in a birthing bed best for?

Back 202

mom requires frequent repositioning of legs for comfort

Front 203

Birthing position that increases perineal relaxation, decreases need for episiotomy, increases placental and umbilical blood flow, decreases fetal distress, improves fetal rotation, better access to perineum, better access to fetal nose and mouth for suction at birth, facilitates birth of infant with shoulder dystocia

Back 203

Birthing on hands and knees

Front 204

What is the disadvantage to birthing on hands and knees?

Back 204

woman cannot view birth, , decreased contact with birth attendant, caregivers cannot use instruments, may be increased maternal fatigue

Front 205

What situation is birthing on hands and knees best for?

Back 205

baby is in distress d/t moms decreased blood flow to placenta and more comfortable for a mom experiencing back labor