Chapter 14/15
huge red flag when seen during Lochia Alba
presence of clotting or change of color other than white
give 2 positive and negative indicators of attachment
varies
at the first breath, what fetal shunt closes first?
foramen ovale
fetal heart rate normal range
110-160 BPM
which antibody crosses the placenta in the last trimester
IgG
name 3 interventions for engorgement
If breastfeeding
warm before feeding, then cold packs after
Feed often (every 2 – 3 hours with deep latch)
Don’t overpump
If not breastfeeding
Cold packs
Tight bra (compression)
No stimulation
No hand expression
describe placenta previa
Placenta implants over or near the cervical opening, and the lower uterine segment does not contract as well → when the placenta detaches, the exposed vessels bleed heavier due to poor contraction.
babies guts are sterile and need a certain bacteria present in the gut to absorb this; after birth, an injection of this is given
vitamin K
what is a huge difference between neonates and adults when currently experiencing sepsis/infection?
fever typically does not present in neonates, but rather hypothermia
bypasses the liver; connects umbilical vein to the inferior vena cava
ductus venosus
highest risk factor in postpartum hemorrhage
uterine atony
postpartum psychosis
decreases surface tension to prevent alveolar collapse
surfactant
a sunken fontanelle may indicate
dehydrated baby
excretion of this indicates GI patency when baby swallows amniotic fluid to kickstart their GI
meconium
Name the 3 phases of Reva Rubin's Maternal Role Attainment
Taking-in phase
Taking-hold phase
Letting-go phase
physical test to test for DVT, positive sign is a pain when a quick and forceful dorsiflexion of the foot
Homan's sign
Evaporation: loss of heat from the neonate’s wet skin to the surrounding air as the liquid converts to vapor
Implication? Dry baby with towel and replace wet linens
Conduction: loss of heat when in direct contact with cooler surface
Implication? Avoid placing baby in cold surfaces for long periods of time such as scale, mattress
Convection: loss of heat from the warm skin of the neonate to the cooler surrounding air
Implication? Avoid placing baby near open windows, drafts, air conditioning, fans
Radiation: loss of heat from the neonate’s warm skin through indirect contact with cooler nearby surfaces and objects
Implication? Avoid placing baby in a cold environment, or near cold windows or walls; keep temperature of room around 72 – 78 degrees Fahrenheit (22 – 26 degrees Celsius)
a very high-pitched cry may be a sign of ...
possible neurological injury
describe the parts of Leopolds maneuvers
Fetal position (two hands to palpate the top of the uterus for the fetal part)
Head feels round (breech), and buttocks feel soft (head down)
Presentation (palpate both sides of the abdomen for fetal back versus limbs)
Back is smooth (place external fetal here) and legs are nodular
Lie (grasp above pubic symphysis)
Tells head engagement or if ballotable (floating)
Attitude (move hands down the uterus to the pelvis)
Determine how engaged (how deeply) the presenting part is
Name all steps of interventions for late decelerations
L-lateral side
IV fluids
O2 saturation
Notify provider STAT
Stop pitocin
methadone
differentiate breast milk vs formula-fed stools
Yellow, seedy and loose; stringy; mild sour smell; several stools each day
Yellow, brown, pale; formed, pasty, thicker; stronger odor; fewer stools each day
best breastfeeding hold for c-section moms, large breasts, small/preterm infants, multiples
football hold
neonates have limited heat production due to... (a lot of answers)
they cannot shiver or have enough muscle fibers to generate heat
lack of brown fat
big head