POST PARTUM
What hormones prepare the breasts for lactation?
a. Estrogen and Progesterone
b. Estrogen and Prolactin
c. Prolactin and Oxytocin
d. Progesterone and Prolactin
Correct: Estrogen and Progesterone
Prolactin also rises during pregnancy
Oxytocin is necessary for letdown (milk ejection)
The 3 greatest risks in the post-Partum period?
Hemorrhage, infection and shock
Movement of heat away from the body occurs when the newborns have direct contact with objects that are cooler.
a. Evaporation
b. Convection
c. Conduction
d. Radiation
Correct is conduction
Evaporation: airdrying of the skin
Convection: Transfer of heat from the infant to surrounding areas.
Radiation: transfer of heat to cooler areas.
A full-term newborn was just born. Which nursing intervention is important for the nurse to perform first?
a. Assess Apgar score.
b. Remove wet blankets.
c. Insert eye prophylaxis.
d. Elicit the Moro reflex.
B. remove wet blankets. (*Conduction)
Which of the following is not a major risk factors for the post-partum patient.
A. Hemorrhage
B. Aneurysm
C. Infection
D. Eclampsia
E. Thrombophlebitis
Hemorrhage
Thrombophlebitis
Infection
When is the need for Rhogam?
a. Mother is Rh + and infant RH-
b. Mother is Rh - and infant RH+
c. Mother is Rh- and the infant is RH-
d. Mother is Rh+ and the infant is RH+
Moms who are Rh negative get a RhoGAM shot to prevent Rh isoimmunization. About 15% of people are Rh-negative. If the infant is also Rh - this is not necessary. This needs to be given in the 28th week.
What is the role of oxytocin?
coordinate and generate uterine contractions
Facilitates the letdown reflex. (More readily available than prolactin).
In the first 24 hours in a term infant blood sugar should be:
a. 70-100 mg/dl
b. 50-70 mg/dl
c. 40-60 mg/dl
d. 50-90 mg/dl
40-60mg/dl the first 24hrs
50-90 mg/dl thereafter
A nursing student is preparing to administer an injection of vitamin K, 1 mg IM, to a newborn. The student asks a nurse, “Where should I give the injection?” Which is the most accurate response by the nurse?
a. Gluteus maximus.
b. Vastus medialis.
c. Gluteus minimus.
d. Vastus lateralis.
Correct: D Vastus Lateralis
What does BUBBLEHE Stand for?
Breasts
Uterus
Bowels
Bladder
Lochia
Episiotomy
Homan’s Signs
Emotions
A breastfeeding mother is 10 days post-partum. Her breasts are hard and firm. The RN instructs the mother
a. To apply an ice pack to the breasts
b. To apply hot pack
c. To breast feed more frequently
d. To take a warm shower
Take a warm shower which will assist in let down and soften the breast making it easier to breast feed.
What is the fundus location at birth? and at 24 hrs.?
After birth: midway between umbilicus and symphysis pubis
24 hours: 1 cm below umbilicus and is firm and midline
A nursing student is performing an initial newborn assessment. The newborn is observed to have a caput succedaneum. What are likely causes of this condition? Select all that apply.
a. Scheduled cesarean delivery.
b. Prolonged second stage of labor.
c. Breech presentation.
d. Vacuum-assisted vaginal delivery.
e. Prolonged active phase of labor.
Correct: B, D, E
True/false: Acrocyanosis within the first 24 hours of birth indicates a serious cardiac anomaly.
False: This is a normal manifestation and occurs when the infant is cold. Due to poor perfusion of blood to the periphery of the extremities.
Which of the following is NOT included in the Apgar testing:
A. Grimace
B. Respirations
C. Reflexes
D. Pulse
E. Activity
Appearance
Pulse
Grimace
Activity
Respirations
What is an Edinburgh Screening?
Edinburgh Postnatal Depression Screen
Maximum score: 30 Possible Depression: 10 or greater Always look at item 10 (suicidal thoughts)
The nurse knows that this mechanism of birth blood away from lungs by connecting pulmonary artery to descending aorta.
A. Ductus Arteriosis
B. Foramen Ovale
C. Ductus Venosus
D. Ductus Septus
A. DA
The first stool a neonate passes is known as_________. Its appearance is______________. It is passed usually within ________timeframe.
Meconium-first stool
Greenish-black, sticky, thick, tarlike
Usually within 12 hours
Consists of particles of amniotic fluid
Transitional stoo
Dark green-yellow
Combination of meconium and milk stools
Normal Deviations of the newborn skin include. Select all that apply:
A. Desquamation
B. Telangiectatic nevi
C. Dermal melanocytosis
D. Lanugo
E. polydactyly
Normal:
Lanugo (fine soft hair. More present in premature infants)
Erythema toxicum (newborn rash)
Mongolian Spots (Dermal melanocytosis)
Telangiectatic nevi (Stork bites)
Cold stress can cause which of the following. Select the correct options.
1. Increased oxygen need or Decreased oxygen need
2. Increase surfactant production or Decreased surfactant production
3. Decrease glucose need or Increased glucose need
4. Metabolic acidosis or Metabolic Alkalosis.
Cold stress:
Increased oxygen need
Decreased Surfactant production
Increased glucose need
Metabolic acidosis
FYI: Glucose metabolism in the absence of enough oxygen increases acid production.
Physiological jaundice presents with the following. Select all that apply.
A. Considered transient
B. occurs within two to three days
C. Rises higher
D. Visible in levels >5.
E. 12 is an acceptable level in 24 hours
Physiologic jaundice
Transient hyperbilirubinemia
Never present in first 24 hours, usually 2-3 days
Usually visible when levels greater than 5 mg/dL
Rate of rise and fall of bili levels important
Age of infant dictates acceptable level (8 or less at 24 hours)
Pathologic jaundice
May occur in first 24 hours
May rise higher and last longer
Something abnormal
excessive rbc destruction
problem with conjugation of bili
When checking the umbilical cord on the newly born infant the nurse contacts the provider when the following is observed:
A. Two veins and one artery
B. Two arteries and one vein
One artery-- Renal or heart anomalies