Mood Disorders/Grief
This is a validated tool for identifying women who might be experiencing postpartum depression.
A condition resulting at home during the postpartum period in which the client reports her breasts feel warm, firm, and tender. The skin is shiny and taut.
What is: Engorgement - it is characterized by increased circulation in the breasts and increasing milk production. It commonly occurs at about the third day after birth.
These interventions prevent heat loss in the newborn
What are:
Covered in warm blankets
Radiant warmer
Skin to Skin
Placing a cap on the newborn
Avoiding drafts
These are characteristics of a newborn born with Down Syndrome
What are:
Hypotonia- less control of head
Epicanthal eye folds
Single Transverse Palmar Crease (Simean crease)
Nuchal fold at the neck
Large tongue
Which hypothalamic hormone would the nurse identify as helping treat postpartum uterine atony and hemorrhage?
What is: Oxytocin
Which assessment findings are suggestive of postpartum depression?
What is: Lethargy, Ambivalence, Emotional Lability, Anorexia, Insomnia
What are teaching points for the breastfeeding client - promoting lactation
What is: The client should empty the breasts at each feeding to keep milk flowing. Alternating between breasts to start feedings is a permissible and often-used technique of breast-feeding. Gently stroking the baby’s cheek elicits the rooting reflex; the infant’s head turns toward and touches the mother’s breast.
Breast massage/hand expression prior to feeding
What is: The most important intervention immediately after the newborn is delivered is to maintain an open airway. The nurse must first remove the nasopharyngeal and oropharyngeal secretions with a suction or a bulb syringe to ensure airway patency.
What are:
Keep infant calm and comfortable to reduce overreaction to stimuli- kangaroo care for fussiness
Administering neonatal doses of the dependent substance
Monitoring the neonate closely- observe for worsening signs of withdrawal/seizures
Educating the mother about the risks to the neonate
Breastfeeding may be recommended if mother on treatment program
The most common medications used after initiation of an opioid for NAS are clonidine and phenobarbital.
Naloxone should never be administered to an infant with NAS because it will exacerbate the underlying withdrawal syndrome.
How should the nurse interpret a laboratory report of a postpartum client being prepared for discharge that has a white blood cell (WBC) count of 16,000/mm 3 (16 × 10 9/L)?
This is an expected postpartum finding
(20,000–25,000/mm 3 WBC) is common during the first 4 to 7 days of the postpartum period. There is no need for further intervention because the client is exhibiting an expected postpartum leukocytosis.
PP Blues are transient symptoms that a client may experience after childbirth. About 85% of women experience postpartum blues, with symptoms of mild irritability, tearfulness, rapid mood fluctuations, and anxiety.
The nurse is aware that the client has type AB Rh-negative blood. Her newborn’s blood type is B positive. This intervention should be included in the plan of care.
Rho(D) immune globulin will prevent sensitization resulting from Rh incompatibility that may arise between an Rh-negative mother and an Rh-positive newborn. Should be administered within 72 hours postpartum
What are:
Rooting
Grasp
Plantar
Moro
Babinski
Stepping
These are complications of the newborn from a mother with an active Chlamydial infection
What are: Pneumonia, Preterm birth, conjunctivitis (Ophthalmia neonatorum)
Other infections: Microcephaly is more likely to occur in newborns with severe infections of toxoplasmosis or cytomegalovirus. Cataracts may occur in a newborn whose birth parent had rubella during pregnancy.
Hearing Loss
These are signs and symptoms of Mastitis
What is: Temperature greater than 100.4 F, chills, malaise, red streaks or painful reddened area on one breast
During this maternal adjustment phase a woman is primarily concerned with self-care needs and being cared for.
What is: Taking-in Phase
The taking-in phase generally occurs during the first 24 hours after delivery and may last up to 2 days
This is the rationale for administering Vitamin K (phytonadione) to the newborn
What is: Because the infant’s intestine is sterile at birth, it lacks the flora to synthesize vitamin K, which activates coagulation factors and prevents hemorrhage in the newborn.
What are:The vernix on the skin of a newborn provides protection and should not be removed. A newborn’s skin can be cleansed using mild soap with a neutral pH if needed or plain warm water without bubble baths. A newborn is at increased risk for aspirating talcum powder and cornstarch products if used too close to the face; therefore, parents should be instructed to avoid these products.
Problems to the newborn when mother contracted Rubella during the first trimester of pregnancy
What is: Deafness, Cardiac Anomalies; miscarriage
The following items should be addressed in discharge teaching with the postpartum client to aid in preventing infection.
What is: Excellent nutrition and rest improve the immune system and help to prevent infection. Tub baths are permitted. Handwashing
Avoid Douching, Tampons. Avoid until the cervix has closed completely; they may promote infection when used too early.
These are side effects to educate the postpartum mother who is prescribed Setraline for PPD.
What is: Sertraline, a selective serotonin reuptake inhibitor (SSRI), inhibits neuronal uptake of serotonin in the central nervous system, thus potentiating the activity of serotonin. Central nervous system side effects of this medication include agitation, anxiety, confusion, dizziness, drowsiness, and headache.
The health care provider has prescribed 500 mg of cephalexin by mouth every 6 hours for 10 days for a client with mastitis. The primary health care provider has given the client 24 sample tablets of 250 mg apiece. How many days should this supply last? Use a whole number __ days
What is: 3 days
The prescribed medication is 500 mg. The available medication is 250 mg per tablet. First, the number of tablets needed for each dose should be determined. The number of doses per day in a q6h (every 6 hours) dosing schedule is 4. This information can be used to determine how many days the samples will last.
These interventions should be included in the care plan for an infant that is FTT?
What is:
Following a structured routine throughout the day
The nurse should talk to the infant during feeding time; this indicates that the nurse cares and demonstrates the social aspects of eating.
The infant should be fed in the same manner at each meal.
Hold the infant while being fed
No other distractions during feeding
At 20 hours of age, a newborn is found to have a bilirubin concentration of 13 mg/dL (274 mcmol/L). These are possible clinical findings most likely contributed to this bilirubin level
Traumatic birth
Cephalhematoma
Petechiae scattered on the body
ABO/RH incompatibility
This complication is a factor in increasing the risk for postpartum (puerperal) infection
What is: PP Hemorrhage. Hemorrhage depletes the cellular response to infection; trauma provides an excellent avenue for bacteria to enter.