Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
79 Cards in this Set
- Front
- Back
|
The placental site heals by the process of
|
exfoliation
|
|
|
Immediatly after birth the nurse can expect the fundus to be located
|
The uterus is the size of a large grapefruit after birth, and the fundus can be palpitated midway btw the symphysis pubis and the umbilicus. Within 12 hours it rises to the level of the umbilicus. By the 2nd day it starts to descend 1 cm a day
|
|
|
When reading the postpartum chart the nurse notices that the client's fundus is recorded as "u+1" The nurse understands that this means?
|
1 cm above the umbilicus. Positive are above, negative are below
|
|
|
During the 2nd postpartum day , a woman asks the nurse "Why are my afterpains so much worse this time then after the birth of my 1st child?" The best ans the nurse can give is?
|
afterpains are much more acute for multiparas because of the repeated streching of muscle fibers leads to low muscle tone that results in repeated contraction and relaxation of the uterus. Breastfeeding increases the severity of the afterpains. Afterpains are self limiting and will decrease rapidly after 48 hrs
|
|
|
The nurse is assessing the client's vaginal discharge. It is red and has about a 2-inch stain on the peripad. The nurse will record this finding as?
|
a light amt of locia rubra. occurs 3-4 days after birth. A light amt is classified as a 1-4 inch stain on the pad
|
|
|
The new mother is complaining of pain at the episiotomy site; however because she is breastfeeding she does not want any medication. What other alternatives can the nurse offer this mother to help relieve the pain
|
Topical anesthetics can be applied directly to the site to numb the area. or ice
|
|
|
A mother that is 3 days postpartum calls the clinic and complains of "night sweats". She is afraid that she is going into early menopause. The nurse should base her answ on the fact that?
|
Diaphorisis and diuresis rid the body of excess fluids that accumulate during the pregnancy. comfort measures include showers and dry clothes
|
|
|
On the first day postpartum the client's white bl cell count is 25,000/mm3. The nurse's next action should be?
|
marked leucocytosis occurs during the postpartum period. The WBC count increases to as high as 30,000/mm3. It should fall to normal by day 7 so chart the count.
|
|
|
Reasons for constipation during this time are?
|
diminished bowel tones,
fear of the pain from the episiotomy iron supplementation some pain meds |
|
|
One nursing measure that can help prevent postpartum hemorrhage and UTI's is?
|
encourage voiding every 2-3 hrs
|
|
|
While doing client teaching the woman tells the nurse, "I don't have to worry about contraception because I am breastfeeding". The nurse should base her answ on the fact that?
|
Menses in a breastfeeding mother may resume btw 12 wks and 18 mths. Normally the 1st few cycles are without ovulation; however ovulation could occur before the 1st mensus. so other contracptive measures should be taken
|
|
|
A women was admitted to the ED with her newborn baby. The baby was born 4 days ago at home. The women had no prenatal care. Assessing the lab work it is noted that the mother is O neg. and the baby is O positive and the Coombs test shows that the mother is not sensitized to the positive bl. The nurses next action should be
|
While the mother should have been given Rh(D) immune globin, it should have been given within 72 hrs.
|
|
|
When assessing a women that gave birth 2 hrs ago. the nurse notices a constant trickle of lochia. The uterus is well contracted. The next nursing action should be?
|
excessive lochia in the presence of a contracted uterus suggest lacerations of the birth canal. Notify the MD
|
|
|
An important nursing consideration for a woman who had a ceasereon is?
|
turn cough deep breathe
|
|
|
What is the taking-in phase?
|
mother is primarily focused on her own need for food, fluid, and sleep. She may be passive and dependent. normally lasts 2 days
|
|
|
The maternal adaption phase in which a mother gives up her old role as being childless and her old lifestyle is called?
|
letting-go
|
|
|
when does postpartum blues start and end
|
by 1 wk post and end 2-3 wks later
|
|
|
When the father develops a bond with the new infant and has an intense interest in how it looks and responds is called?
|
engrossment
|
|
|
A newborn is rooming in with his teenage mother who is watching TV. The nurse notes that the baby is awake and quiet. The best nursing action is to?
|
pick the baby up and point out his alert behaviors to the mother
|
|
|
When making a visit to the home of a postpartum women 1 wk after the birth, the nurse recognizes that the women characteristically?
|
attempt to meet the needs of the infant and is eager to learn about infant care
|
|
|
a primiparous women is in the taking-in stage of psychosocial recovery and adjustment following birth. The nurse, recognizing women's needs during this stage should?
|
provide time for the mother to reflect on the birth
|
|
|
The reason a premature infant is at risk for hypothermia is because?
|
there are no stores of brown fat. Brown fat is the major heat producer in an infant
|
|
|
Signs of cold stress are?
|
increased respiratory rate, increased activity level, crying, BMR, and heat production. Newborns cannot shiver they increase activity instead.
|
|
|
The hemacrit for a newborn is 72%. The nurse knows that the newborn is at risk for?
|
Jaundice, normal is 48% - 69%. a level greater than 69% indicates polycythemia which increase the risk for jaundice and damage to the brain
|
|
|
Vitamin K is given to a newborn to?
|
increase the ability of the blood to clot
|
|
|
A newborn does not drink much and the mother is worried. The nurse tells her
|
at birth the stomach capacity is about 6 ml, but will expand to about 90ml within the 1st week
|
|
|
all types of baby, such as pre-term, larger than avg etc are susceptable to hypoglycemia except?
|
avg-for-gestional age
|
|
|
the liver changes bilirubin to a water soluable form in a process called
|
conjugation
|
|
|
If enough unconjugated biliruben accumulates in the blood, it may cause staining of the tissues in the brain resulting in?
|
kernicterus or bilirubin encephalopathy
|
|
|
The factors that lead to the production of excessive amts of biliruben during the 1st wk of life are?
|
liver immunity
a sterile intestine trauma during birh |
|
|
When doing a newborn assessment on a 2 day old infant, the nurse notices facial jaundice. The biliruben level was assessed and found to be 6mg/dl. The nurse understands that this jaundice will be classified as?
|
physiologic jaundice, in which jaundice is not present during the 1st 24 hrs of life, it is normal - when seen in just the face the level is usually btw 5-7 mg/dl
|
|
|
The best time for the parents to spend time with the infant is when the infant is going through what stage?
|
second period of reactivity-when the infant is alert and ready to feed
|
|
|
The normal respiratory rate of a newborn is?
|
30 to 60
|
|
|
Can infants have periods of apnea and be normal
|
yes, periods can last up to 15 sec. however if other signs then notify MD
|
|
|
During an infants 1st assessment a few min after birth the nurse notes moisture in the left lung. the infant is having no resp. difficulity. the nurse's next action would be to
|
doc and continue to monitor this is normal
|
|
|
what are the signs of respiratory distress?
|
susternal retractions
grunting seesaw respirations |
|
|
the ruddy, redish color of the newborns skin caused by polycythemia is called?
|
plethora
|
|
|
a newborn's HR is assessed at 105 the nurse should?
|
doc as normal when sleeping their HR goes down
|
|
|
What is the best way to take a newborn's temp?
|
axillary
|
|
|
What is the correct method of assessing the fontanels of a newborn?
|
head elevated and baby calm. crying will cause it to protrude
|
|
|
the nurse notices a soft swollen area over the 1 day old newborn's skull. It is approx. 3 by 2 cm and has clear edges that stop at the suture line. The nurse may doc as being?
|
cephalhematoma -does not cross the suture line, caput succedaneum does
|
|
|
During an initial assessment crepitus is noted on the right clavicle. the nurse should?
|
notify the MD-
|
|
|
the nurse notices one artery and one vein in the initial assessment of a newborn. what should the nurse do?
|
assess for other abnormalities. this is associated with chromosal, renal, GI defects.
|
|
|
When the fingers and toes are more then 5 each this is called
|
polydactyly
|
|
|
What test are used to assess for hip dysplasia and instability?
|
Barlow's, Ortolani's, bending the knees and comparing hgt, comparing gluteal creases, comparing leg lengths
|
|
|
How much can a newborn lose of its body wgt in the 1st 24 hrs and still consider normal
|
10%
|
|
|
When doing the intial measurments of a newborn, the nurse records the head diameter as 34 cm and the chest as 32cm. the nurse is aware that
|
normal - head should be 33-35.5 cm and chest 30.5 to 33 cm. the chest is usually 2-3 cm smaller then head
|
|
|
The nurse notices a 4-hr old newborn has developed jitterness. the next action should be?
|
assess the blood glucose level
|
|
|
A shrill, highpitched cry by a new born may indicate?
|
neurologic disorders or other problems
|
|
|
A newborn's bl. glucose reading is 38mg/dl. the nurse should?
|
if the glucose reading is around 40-45, the infant is usually fed then reassessed in 30 min
|
|
|
a 2 day old infant passes a greenish brown stool. this stool can be called
|
transitional
|
|
|
A new mother asks about the red stains in her baby's boys's wet diapers. The nurse explains this as?
|
Urate crystals "brick dust staining"
|
|
|
if the meatus is located on the underside of the penis it is called
|
hypospadias
|
|
|
The thick white substance that resembles cream cheese and provides a protective coating for the fetal skin in utero is called?
|
vernix caseosa
|
|
|
On which infant would the nurse notice large amts of lanugo?
|
a preterm dark skinned infant. fine hair
|
|
|
How do you perform a Scarf's sign for gestional age?
|
Bring the arm across the body to the opposite side and note the position of the elbow in relation to the midline
|
|
|
When the infant turns toward the side of the mouth stroked it is called
|
rooting
|
|
|
a newborns' pulse should be assessed using which pulse point
|
apical
|
|
|
By which route should Vit. K be given to a newborn?
|
Intramuscular
|
|
|
What does the nurse tell a mother concerned about edema in both her 8 hr old newborn's eyes?
|
The eye meds may cause this
chpt 21 |
|
|
The normal respiratory rate for a newborn is?
|
30-60
|
|
|
The ruddy, redish color of the newborn skin caused by polycythemia is called?
|
plethora
|
|
|
When the fingers or toes of a newborn have more than 5 digits, it is called?
|
polydactyl
|
|
|
A newborn has been assessed as high risk for hypoglycemia. The nurses assesses the newborn's bl. glucose at 38 mg/dl.What should be the nurse's next action?
|
`feed the newborn a small amt of glucose then follow with breastmilk for formula -
|
|
|
The nurse should assess all newborns for jaundice daily. This is done by?
|
blanching the infant's skin on the nose or sternum
|
|
|
A newborn's mother has tested postive for Hep B. When should the newborn receive the Hep B vaccine?
|
by 2 mths
|
|
|
The majority of infant abductions occur in a hospital setting where?
|
mother's room
|
|
|
screening blood test on a newborn are best performed after howmany hours?
|
24
|
|
|
A pregnant women complains of inverted nipples. She is planning to breastfeed and feel that the nipples may be a problem. The nurse should teach her to?
|
wear a breast cup in her bra
worn in the last couple of weeks of pregnancy, it will exert slight pressure against the areola and help the nipple protrude. |
|
|
a newborn that weighs 6.8lbs. to meet the energy needs the newborn will need btw ? and ? kilocalaries per day?
|
325-357.5
|
|
|
In order to obtain the proper kcal, a 6.8 lbs newborn would need to drink btw ? and ? ounces of breast milk or formula a day?
|
16-18
|
|
|
The newborn that was 6.8lbs at birth may lose up to ? ozs within the 1st 7 to 10 days of birth
|
10.4
|
|
|
The newborn that weighs 6.8lbs at birth will need ? to ? ml of fluid during the 1st 2 days of life
|
117-175.5
|
|
|
The hormone that causes the breasts to produce milk is?
|
prolactin
|
|
|
The hormones that inhibit breast response to prolactin and prevent milk production are?
|
estrogen, progesterone, human placental lactogen
|
|
|
Breast milk is produced in the ? of the breasts
|
aveoli
|
|
|
Diarrhea stools can be id by a ?? in the diaper around the stool?
|
water ring
|
|
|
Prickly heat develops in infants who are dressed to warmly in any weather. This is called?
|
miliara
|
|
|
Chronic inflammation of the scalp and other areas of the skin characterized by yellow,oily lesions is called?
|
seborrheic dermatitis
|
