MATERNAL PHYSIOLOGICAL CHANGES
Within 12 hrs following birth, where would the nurse expect to locate the client's fundus?
What is 1cm above the umbilicus (belly button); it should be firm and midline.
This is the first priority nursing action when a RN assesses the fundus and it's "boggy."
What is massage the fundus.
This is the term for greater than 500 ml blood loss after vaginal delivery and greater than 1000 ml after cesarean birth
What is postpartum hemorrhage (PPH)
This the first stage of the transition period & lasts up to 30 minutes after birth in a newborn.
What is first period of reactivity
This the most common cause of pathologic hyperbilirubinemia (Jaundice)
What is hemolytic disorders in the newborn
This is uncomfortable postpartum uterine cramping caused by periodic relaxation and vigorous contractions.
These are more common in subsequent pregnancies (and for breastfeeding moms).
What are afterpains
When engorgement occurs, these are some of the recommendations for discomfort:
Name at least two.
What is:
Cabbage leaves, Benadryl
Motrin
Good supportive bra
Encourage breastfeeding (if breastfeeding with proper latch of the newborn.
Warm compresses for breastfeeding moms, ice packs for bottle feeding moms.
This is the transient, self-limiting mood disorder that affects new mothers after childbirth due to hormonal changes.
What is postpartum blues
This is the appearance of slightly cyanotic hands and feet, is caused by vasomotor instability, capillary stasis, and a high hemoglobin level.
This is considered normal in a newborn.
What is acrocyanosis
In this syndrome, the infant is noted to be small for gestational age (SGA) with small eyes and a thin upper lip. This syndrome is multi-systemic causing physical, cognitive and behavioral long-term complications.
What is Fetal Alcohol Syndrome (FAS)
This is what rubra looks like, consists of, and when it occurs.
Lochia Rubra is bright red blood within the first few days postpartum. Rubra consists of blood and decidual debris. It is a fleshy odor; it's not a foul-smelling odor.
During this phase the mother assumes responsibility for her own care and shifts her attention to the infant
What is the Taking-hold phase.
This is considered one of the most common postpartum infections. Signs include fever, increased pulse, chills, anorexia, nausea, fatigue, lethargy, pelvic pain, uterine tenderness, and foul smelling profuse lochia.
What is endometritis
This is used to prevent gonorrheal and chlamydial infections of the infant’s eyes potentially acquired from the birth canal following birth.
What is Erythromycin ophthalmic ointment
This complication is thought to be a result of high arterial blood oxygen levels; (during ventilation) and blindness may be the ultimate poor outcome mostly affecting a premature baby.
What is Retinopathy of Prematurity (ROP)
This is the most serious condition that causes bladder distention and uterine atony.
What is excessive uterine bleeding (PPH).
On assessment a nurse assesses a postpartum client who is complaining of increased uterine tenderness & has a fever.
This may be occurring...
What is retained placenta fragments.
This is the delayed (abnormal) return of the uterus to normal size and function, resulting in late postpartum bleeding.
What is subinvolution
There are several normal newborn skin assessment items in a newborn assessment.
Name at least three of these and describe:
What are:
Newborn rash
Milia
Stork-bites
Mongolian spots
Vernix and Lanugo
This newborn has clinical manifestations: LGA, plump, listless and lethargic...(Macrosomic baby). This newborn also tends to have issues with hypoglcemia.
What is infant of diabetic mother
These are pelvic floor exercises that will help to strengthen the perineal muscles and encourage healing.
What are Kegel exercises
There are several non-pharmacological treatments that can be used and encouraged for a postpartum client who has had an episiotomy and/or laceration.
Name at least two:
What are:
Applying ice packs for comfort.
Warm water in the peri bottle
Tucks pads
Dermoplast spray
Lying on the client's side
On assessment, the nurse finds pain and tenderness in the patient's lower left extremity, along with warmth, redness and tenderness.
This may be occurring..
What is thrombophlebitis (DVT)
This reflex occurs when rubbing the side of the foot, the toes fan out on a newborn.
What is the Babinski reflex.
This is one of the first steps in providing care to an infant whose mother abused substances during pregnancy (first part of the question)
Second part: What meds are given for withdrawals? (Name at least one)
Third part: Name at least one of the side effects seen in a newborn going through withdrawals.
What is Neonatal Abstinence Scoring (the higher the score, the more issues trying to console the newborn)
Methadone, Phenobarbital
High-pitched cry, non-consolable, poor feeding.