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;
48 Cards in this Set
- Front
- Back
Lochia
|
-Rubra: First 3 days after child birth, blood
-Serosa: Fourth day lochia changes to pink or brown-tinged -Alba: white or cream colored by the 11th day may persist to the 6th week after childbirth |
|
Lochia Amount
|
-Scant: les than 1 inch stain on pad
-Light: 1 - 4 inch stain -Moderate: 4 - 6 inch stain -Large: Saturated peripad in 1 hour -Excessive: saturated pad in 15 minutes -A constant trickle of lochia indicates excessive bleeding and requires immediate attention -Foul odor can suggest endometrial infection |
|
Perineal Assessment
|
-REEDA
-R: redness -E: edema -E: ecchymosis (bruising) -D: discharge -A: approximation (should be closed as if they were stuck or glued together) |
|
Fundal Height
|
-Immediately following delivery the fundus can be found midway between the symphysis pubis and the umbilicus
-Then the fundus rises to the level of the umbilicus and remains at this level for 24 hours -After 24 hours the fundus begins to desend by approximately 1cm, or 1 fingerbreadth oer day -By 10th day it is back in the pelvic cavity |
|
Postpartum Vital Signs
|
-HR: 50-60 is normal as large amounts of blood return to the maternal circulation after the placenta is born
-B/P: hypotension may indicate a hemorrhage -Resp: 16-20 -Temp: 100.4 is common during the first 24 hours after birth |
|
Newborn Vital Signs
|
-Temp:
*Axillary: 97.7 - 99.5 *Rectal: 97.7 - 99.7 -HR: 120-160 -Resp: 30-60 -BG: 40-45 |
|
Newborn Measurments
|
-Weight: 2500-4000g
-Length: 48-53cm -Head Cir: 33-35.5cm -Chest Cir: 30.5-33cm |
|
Signs of Delayed Bonding
|
-Using negative terms to describe infant
-Discussing infant in impersonal or technical ways -Failing to give the infant a name or to use name -Visiting or calling infrequently or not at all -Decreasing number & length of visits -Showing interest in other infants -Refusing offers to hold and learn to care for infant -Showing decrease in or lack of eye contact |
|
Mastitis
|
-A painful infection of the breast usually caused by the entry of germs, often from the baby's mouth, into a milk duct through a crack or fissure in the nipple.
-Symptoms include fever, soreness, and swelling. It occurs in about one in 20 breastfeeding mothers at some time during lactation, most commonly between the tenth and 28th days postnatally. |
|
Breast Feeding
|
-Latch within the first 2hrs of birth
-Offer breast every 2-3hrs -Feed 20min or longer ea side -Position: football, cross, cradle, side lying -Stimulate baby's lower lip -Support baby's head -Listen for swallows -Avoid artificial nipples -Avoid formula or glucose H2O -Offer encouragement -Est. care plan if problems *begin pumping as soon as problem arises -Not wanting to breast feed: *do not take hot showers *No stimulation of breasts -Tight fitting bras |
|
S/S Mastitis
|
-Temp up to 40c
-Hard irregular warm red spot on breasts -Pain in breasts -Feel like flu-like symptoms |
|
Avoiding Mastitis
|
-Alternating breasts
-Allow breasts to air dry -Avoid soap or alcohol -Proper positioning of baby -Avoid stasis with warm soaks, freq feedings |
|
Rh problems
|
-Only an issue for Rh "-" the mom gets RhoGam at 28wks and again at discharge
|
|
Nutritional Needs of Lactating Mother
|
-Calories: 2700 (500 more calories than were being consumed before pregnancy)
|
|
Blood Loss
|
-Vaginal Birth: 500-700cc
-C-section: 1000cc |
|
Twins
|
-Increase risk for post partum hemorrhage
|
|
Subinvolution
|
-The failure of the uterus to shrink according to normal progressio
-Caused by retained fragments or infection -S/S: *fundus that does not shrink 1cm per day *Lochia that deviates from rubia-serosa-alba, varies in amount *Uterine ternderness, heaviness, backache |
|
Involution
|
-Retrogressive changes that return the reproductive organs, particularly the uterus to their pre-pregnancy
size and condition |
|
Hematoma
|
-Assess for hematoma if pt is complaining of pain in the perineal area
|
|
Baby not breathing
|
-Turning blue
-Lower head and stimulate baby to cry |
|
Meconium Aspiration
|
-May be caused by:
*hypoxia creating a relaxation of the anal sphincter *Vagal stimulation possible from cord compression *GI motility, normal for the term or post term infant *>38wks, decreased amniotic fluid, increased cord compression -Can cause pneumonia, asphyxia, pneumothorax, distress |
|
Vernix
|
Thick white protectant over skin
|
|
Lanugo
|
-Fine hair
|
|
Cephalhematoma
|
-Does not cross suture line
-Check for jaundice -Does not appear until 24 - 48 hours after birth -Gone within a few weeks |
|
Caput Succedaneum
|
-Edema that does cross the suture line
-Swelling due to labor process |
|
Mongolian Spots
|
-On butt, looks like bruises
|
|
Thermoregulation
|
-If baby's temp goes below 97F put under warmer
-Top priority for cold stress |
|
Bilirubin
|
-With the breakdown of RBCs, bilirubin is an usuable byproduct that needs to be excreted
-It can be toxic at high levels -It is fat soluble so it can be absorbed by the subcut fat -Causing yellowish discoloration |
|
Physiologic Jaundice
|
-Occurs when bilirubin reaches 5-7
-Never present during the first 24 hours of life -Appears on the second or third day -Nomral in newborns -Levels begin to fall about a week after birth -Photo therapy may be used |
|
Pathologic Jaundice
|
-Occurs during the first 24 hours of life
-a bilirubin level above 1 or a total bilirubin concentration that increases by more than 5 per day or is higher than 12 or persists after the second week -Due to abnormalities causing excessive destruction of RBCs -Can be due to incompatible blood (mother's/infant's), infection, metabolic disorders |
|
Downs Syndrome
|
Trisomial 21
|
|
Addicted Newborn
|
-Will have trouble feeding
|
|
Stool
|
-The breast fed infant usually has more frequent stools than the formula feed baby
|
|
Tetralogy of Fallot
|
-Large ventricular septal defect (VSD - hole in the wall separating the right and left ventricles)
-Pulmonary stenosis (obstructed blood flow to the lungs). |
|
Postpartum Assessment
|
-BUBBLE HE
-B: breasts -U: uterus -B: bladder -B: bowel -L: lochia -E: episiotomy -H: homan's Sign -E: emotional support |
|
Reflexes
|
-Moro: allow the head and trunk of newborn to fall backward (arms and legs should extend and abduct
-Palmer grasp: when infant's hand is touched at the base of the fingers the hand should close into a tight fist -Plantar grasp: same as above except on the feet -Babinski: stroking the sole of the infant's foot causing the toes to flare -Rooting: when infant's check is touched near the mouth the head turns toward that side -Sucking: when the mouth or palate is touched the infant should begin to suck -Tonic neck: arm and leg should extend on the side of the body in which the head is turned (fencing reflex) -Stepping: when infant is held upright w/their feet touching a hard surface they should lift one foot then the other as if they were walking |
|
Umbilical Cord Care
|
-Cord should be checked for bleeding or oozing
-Cord clamp should be securely fastened -Parents should clean the cord with alcohol at least 3 times daily -Fold the diaper below the cord -Clamp can be removed 24hrs after birth if cord is dry |
|
Umbilical Cord Process
|
-It becomes brownish black within 2-3 days
-Falls off within app. 10-14 days after birth |
|
Signs of neonatal hypoglycemia
|
-Jitteriness
-Poor muscle tone -Diaphoresis -Poor suck -Tachypnea -Dyspnea -Cyanosis -Apnea -Low temp -High-pitched cry -Irritability -Lethargy -Seizures, coma -Some infants may be asymptomatic |
|
Respiratory Distress Syndrome
|
-Increases w/decreased gestational age, multiple gestation and uncontrolled DM
-A deficiency of surfactant production -Surfactant keeps the aveoli surface tension down to prevent aveoli from collapsing at the end of expiration |
|
-Signs of Respiratory Distress
|
-Tachypnea > 60
-Retractions: *sternal *substernal *suprasternal *intercostal -Flaring of the nares -Cyanosis: generalized -Grunting: end expiratory pressure against a closed glottis -Seesaw respiration -Decreased breath sounds -Crackles |
|
Acrocyanosis
|
-Bluish discoloration of the hands and feet due to reduced peripheral circulation
-Normal in the newly born infant -Should go away after the first couple of hours of life to 1-2 days after birth |
|
Erythromycin Eye Ointment
|
-Prophylaxis against gonorrhoeae and chlamydia
|
|
Teratogenic
|
-Any substance or agent that is capable of interfering with normal embryonic development and can produce non-heritable birth defects. Tetragenic substances are most often radiation or chemicals
-drugs given to the mother that can cross the placental barrier to the unborn child. They are caplable of interfering with the development of the fetus, causing birth defects. |
|
Newborn Test
|
-Heel stick for:
*B/G *PKU (phenal ketone uria) *bilirubin test *Coomb's test -Auditory test |
|
Breast Fed Infant's Stool
|
-Yellow, gold, soft and mushy
|
|
Formula Fed Infant's Stool
|
-Pale yellow, formed, pasty
|
|
Alveolar Development
|
-Occurs 24-28wks
-Betamethasone can help to mature lungs prior to delivery |