postpartum
postpartal period vaginal vs c/s
vaginal:6 wks
c/s: 8-10 wks
what are the methods of heatloss
conduction: cold metal scale
convection: cold air over baby
evaporation: wet baby
radiation: cold window near
what is the baby acne
milia
when is a preterm delivery
before 37 weeks
uterine involution decreases how much a day? why might there be no involution
↓ by 1cm each day
reasons for no involution: hemorrhage, bladder distention, big/small baby, multiples
normal VS for a newborn
HR: 110-160
RR: 30-60
T: 97-99
excess blood, this increase risk of jaundice
does not cross suture line
1 sided cone head
a patient at 38 weeks has painless bright red blood, quit smoking when she found out she was pregnant and underwent infertility treatment.
what could be the cause of the bleeding
placenta previa
reuben phases: done by the parent
taking in: 24-72hr, accepting the birth
taking hold: 2-6wks, gaining confidence
letting go: time varies, letting others care for the baby
newborn reflexes
palmar grasp, plantar grasp, rooting, sucking, stepping, tonic neck
what are the causes of hyperbilirubinemia
1. normal jaundice @ 2-3days due to excess RBC breakdown
2. pathological jaundice: this is from incompatible blood types between mom and baby.
baby will be jaundice within 24 hours
what is the management for a patient at 18 weeks who during her prenatal appointment was 1 cm dilated
this is cervical insufficiency
mx:
Cerclage
progesterone
bed rest
pelvic rest
describe BUBBLLEHHE
breasts, uterus, bowels, bladder, lochia, laceration episiotomy, edema, hemorrhoids, homens sign, emotional status
due to a weak immune system at birth, what is given to the newborn through breastfeeding to increase antibodies
IgA
only helps for 6 months
calculate this APGAR score
limp/ absent muscle tone
HR is 60
minimal response to stimulation
pink body
slow and irregular breathing
5
patient at 37 weeks presents with:
BP reading at 140/98 then 158/110
severe headache that does not relive with medication
bilateral bitting edema on lower extremities
pain in her upper right abdomen
what are the nurses next steps
MX: labetalol and Magnesium Sulfate
since the patient is at 37 weeks c/s delivery is likely
progressive changes
lactation: ↑ oxytocin → ↑ prolactin → milk
menstrual flow: returns at 6-10 months (depends of breath feeding) or 10 weeks if formula feeding
parental role
what are the three different explanations for the first breath
1. mechanical pressure change in lunges from CTX
2. ↑ CO2 & ↓ O2, which leads to ↑ acidosis and baby becoming hypocapnia
3. stimulation of cold receptors
what is the cause of Transient Tachypnea of Newborn (TTN)
slow or incomplete removal of fluid in lungs
can be due to c/s, quick delivery, late cry
34 week patient who has preeclampsia is experiencing "knife-like" pain, painful dark red bleeding, and states she hasn't been feeling the babies movements as much.
what is she experiencing and what are the nurse's next steps
placental abruption
mx: IVF, O2, delivery