PRENATAL
The prevention of unwanted pregnancy:
What is family planning?
The process of the mother establishing a relationship with the fetus
What is: “I am pregnant,” “I am going to have a baby,” and “I am going to be a mother”
Nonpharmacologic pain management therapies utilized in labor
What are:
Aromatherapy
Acupressure
Counterpressure can help the woman cope with lower back pain.
Supplements
TENS
Music
Bath
Puerperal infection signs and symptoms and common treatment
Postpartum or puerperal infection is any clinical infection of the genital canal that occurs within 28 days after miscarriage, induced abortion, or childbirth. The definition used in the United States continues to be the presence of a fever of 38° C (100.4° F) or higher on 2 successive days of the first 10 postpartum days, starting 24 hours after birth. Antibiotic administration
Universal Newborn screenings: Critical congenital heart disease (CCHD): Timing and process
Screening is performed when the infant is between 24 and 48 hours of age. The test is performed using pulse oximetry technology. O2 is measured in the right hand and one foot. A passing result is an O2 saturation of ≥95% with a ≤3% absolute difference between upper and lower extremity readings.
Common process used to calculate the expected delivery date
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What is Nägele’s rule, the EDB is calculated by subtracting 3 months from the month of the LMP and adding 7 days + 1 year to the day of the LMP
Labor positions and nursing implications
The woman should maintain a side-lying position.
Signs and symptoms of hemorrhagic (hypovolemic) shock:
Respirations, pulse, skin condition, urinary output, and level of consciousness are more sensitive means of identifying hypovolemic shock. Blood pressure is not a reliable indicator; several more sensitive signs are available. Blood pressure does not drop until 30% to 40% of blood volume is lost.
Nursing responsibilities with phototherapy:
The infant’s eyes must be protected by an opaque mask to prevent overexposure to the light. Eye shields should completely cover the eyes but not occlude the nares.
Signs of potential complications in the second and third trimesters of pregnancy
What is:
An alteration in the pattern or amount of fetal movement may indicate fetal jeopardy.
Pharmacological labor pain relief option considerations
Determined by stage of labor and the anticipated method of birth
Postpartum hemorrhage assessment and nursing interventions
The nurse should first assess the uterus for atony by massaging the woman’s fundus. Uterine tone must be established to prevent excessive blood loss. The nurse may begin an IV infusion to restore circulatory volume, but this would not be the first action. Blood pressure is not a reliable indicator of impending shock from impending hemorrhage; assessing vital signs should not be the nurse’s first action. The healthcare provider would be notified after the nurse completes the intervention if the discharge is still excessive.
Types of heat loss that impact thermoregulation of the newborn
Convection-flow of heat from the body to cooler ambient air
Radiation-loss of heat from the body surface to a cooler solid surface, not in direct contact
Evaporation-loss of heat that occurs when a liquid is converted to a vapor.
Conduction- loss of heat from the body surface to cooler surfaces in direct contact
Physiologic effects of labor pain:
Predominant pain comes from cervical changes, the distention of the lower uterine segment, and uterine ischemia. Referred pain occurs when the pain that originates in the uterus radiates to the abdominal wall, lumbosacral area of the back, iliac crests, and gluteal area.
Second-stage labor pain is intense, sharp, burning, and localized.
Third-stage labor pain is like that of the first stage
Describe Rh isoimmunization prevention:
An Rh– mother delivering an Rh+ baby may develop antibodies to fetal cells that entered her bloodstream when the placenta separated. The Rho immune globulin works to destroy the fetal cells in the maternal circulation before sensitization occurs.
Indications for routine newborn vitamin K medication
Vitamin K is provided because the newborn does not have the intestinal flora to produce this vitamin for the first week. The maternal diet has no bearing on the amount of vitamin K found in the newborn. Vitamin K promotes the formation of clotting factors in the liver and is used for the prevention and treatment of hemorrhagic disease in the newborn. Vitamin K is not produced in the intestinal tract of the newborn until after microorganisms are introduced. By day 8, normal newborns are able to produce their own vitamin K.
Causes of fetal tachycardia
What is fetal hypoxemia
Fetal tachycardia can be considered an early sign of and may also result from maternal or fetal infection
Episiotomy care
Perineal ice packs, use of a sitz bath 3X per day and a stool softener
Recommendations for follow up with provider post discharge for the newborn
Breastfeeding infants are routinely seen by the pediatric health care provider clinic within 3 to 5 days after birth or 48 to 72 hours after hospital discharge and again at 2 weeks of age. Formula-feeding infants may be seen for the first time at 2 weeks of age.