Newborn interventions
To prevent cold stress and reduce metabolic and glucose demands in a SGA, or preterm infant, the nurse should prioritize this simple intervention.
What is maintain warmth? (or keep baby warm)
To ensure a patient can receive immediate blood transfusions or aggressive fluid volume replacement for an active postpartum hemorrhage, the nurse must establish and maintain this specific clinical setup.
What is maintain primary IV line and prep another IV at a different site. ?
This is the most common PP infection.
What is mastitis?
When screening a patient for postpartum depression before discharge, the nurse should utilize this 10 item questionnaire.
What is the Edinburgh Postpartum Depression Scale (EPDS)?
The nurse administers an intramuscular injection of this within one hour of birth.
What is vitamin K. ?
When a newborn's glucose cannot be regulated by feedings, this is administered to oral mucosa.
What is 40% dextrose gel?
Beyond uterine atony, a nurse assessing a patient for a tissue-related cause of secondary PPH should look for a history or evidence of these specific retained structures.
What are retained placental fragments?
When a postpartum patient presents with lower abdominal tenderness, a temperature elevation above 100.4 degrees F, and malodorous or foul smelling lochia, the nurse recognizes these as classic signs of this specific uterine infection.
What is endometritis (not to be confused with endometriosis)?
Nursing interventions for a patient with PPD or PPP.
What are: Enforce safety, encourage nutrition and exercise and sleep, administer medications, therapeutic communication, provide educational material, teach how and when to ask for help, refer to psychotherapy and support groups. ?
When assessing lochia volume, the nurse defines heavy bleeding if a sanitary pad becomes completely saturated within this maximum time standard.
What is one hour (or less)?
This is often the intervention for a newborn with RDS.
What is CPAP/mechanical ventilation?
When a patient experiences a massive obstetric hemorrhage with estimated blood loss exceeding 2,000 mL, the nurse knows that this critical collaborative intervention must be instituted without hesitation.
What is a blood transfusion?
They present with erythema, purulent drainage, warmth, and pain at the surgical site.
What are surgical site infections (incision site infections)?
The reasons that postpartum psychosis is considered an emergency psychiatric condition.
What are risk of suicide, child abuse and infanticide. ?
During a postpartum fundal assessment, if the nurse notes the fundus is firm but there is still a continuous, steady trickle of bright red blood, they should immediately suspect this specific source of bleeding.
What is perineal, cervical or vaginal laceration. ?
When evaluating the safety and readiness of a late preterm infant before confirming they can be safely discharged home, the nurse must verify the newborn can successfully pass this specific positional challenge.
What is a car seat test?
To direct rapid clinical treatment and estimate the severity of active blood loss during an obstetric hemorrhage, the nurse must continually monitor these five specific patient parameters.
What are: blood pressure, pulse, capillary refill, LOC (mental status) and urinary output.
The nurse knows that the C-section patient must receive broad spectrum antibiotics during this time frame to minimize infection risks.
What is 1 hour before surgery ?
The three types of mood disorders and what differentiates them from the others.
What are: 1- PP blues (baby blues). Usually resolved within 1-2 weeks. Mild mood symptoms that do not impact parent's ability to function or care for infant.
2- PPD. Can start any time within the first year after birth, but usually in the first month (must be after 2 weeks). More sever symptoms, which interfere with daily function, care and attachment.
3- PPP. Usually begins within days to weeks after childbirth. Presents with delusions, hallucinations, disorganized thoughts, etc, and may include suicidal or infanticidal ideation. Patients may lose touch with reality.
When a postpartum patient with an active hemorrhage has a documented history of chronic hypertension or preeclampsia, the nurse knows that this specific uterotonic medication is strictly contraindicated.
What is Methergine?
Name three ways a nurse can help an infant with withdrawal syndrome.
What are: Pacifier, skin to skin, non stimulating environment, cluster care, holding infant, swaddle.?
These are the five causes of PPH (not risk factors, causes.)
What are: uterine atony, retained placental tissue, lacerations or hematomas, bleeding disorders, and uterine inversion.
Bonus: what are the interventions for these findings?
These are 5 of the many risk factors for PPI.
According to research, these are factors that can contribute to PPD.
What are: sharp decrease in estrogen and progesterone, history of depression, volatile emotions, fatigue and stressful life events.
A dropping fibrinogen level and prolonged PT/PTT during an active PPH provide early warning signs for this life threatening coagulopathy.
What is Disseminated Intravascular Coagulation (DIC)?