Pregnancy
You see the following on Cindy's chart 91435.
How many preterm births has Cindy had?
How many living children does Cindy have?
Preterm births: 4
Living children: 5
What is the best way to help a healthy, term newborn thermoregulate?
Skin to skin
A postpartum woman with diabetes asks if it is safe for her to breastfeed. Can she breastfeed? What are the benefits (or risks if she should not)?
YES! Breastfeeding has been associated with reduced risk of childhood obesity and development of diabetes in the child
Explain one difference between placental abruption and placenta previa.
1. Previa = usually painless bright red bleeding; Abruption = usually painful - may or may not have bleeding
2. Previa = most require cesarean delivery; Abruption = may be able to attempt vaginal birth
Name 2 situations where a pregnant woman who is A- would receive Rhophylac?
1. Routine at 28 weeks
2. Trauma during pregnancy (MVA, DV, etc.)
3. Postpartum if newborn is Rh+
Name 3 pain interventions for a newborn.
1. Skin to skin
2. Pacifier (if appropriate)
3. Positioning
4. Holding
5. Motion
6. SweetEase (sucrose water)
You are assessing a breastfeeding session with your patient. What is the number one way to tell if the baby is breastfeeding effectively?
Listening for audible swallows during breastfeeding
Which of the "4 T's" is missing:
Tone
Trauma
Tissue
?
Thrombin
What does the acronym B.U.B.B.L.E.R.S. stand for?
Breasts
Uterus
Bowel
Bladder
Episiotomy/Incision
Emotional ReSponse
How many arteries & veins is normal to find in a newborn's umbilical cord?
2 arteries, 1 vein (AVA)
What should your patient do if she has a "yellow" sign or symptom from the "Know Your Zone" patient teaching once she is at home?
Yellow = call her healthcare provider as soon as possible
Name the 4 types of hypertensive disorders of pregnancy.
1. Gestational hypertension
2. Preeclampsia
3. Chronic hypertension
4. Superimposed preeclampsia
Explain the difference between postpartum blues, postpartum depression, and postpartum psychosis.
Blues: transient and resolves by 2 weeks postpartum
Depression: lasts beyond 2 weeks and may need pharmaceutical and/or therapy
Psychosis: Rare with sudden onset within first 2 weeks postpartum; characterized by delusions/hallucinations, paranoia.
According to NRP, this intervention is the MOST IMPORTANT to assist a newborn who is not breathing and/or has a low heart rate at birth.
PPV - positive pressure ventilation
What is the best way to decrease bilirubin levels in a term, healthy jaundiced newborn?
Frequent protein feedings. Frequent feedings lead to urination and defecation which both expel bilirubin from the newborn's body.
Name the 3 things that are different with CPR on a pregnant woman.
1. Remove EFM
2. Displace uterus to the left
3. Perimortem cesarean after 4 minutes with no ROSC
Where do you find the definition of Within Defined Limited "WDL"?
Under reference text in your Epic charting.
Where is jaundice first noticed on a newborn?
Head & face
Name 3 symptoms of hypoglycemia in a newborn.
hypotonia (floppy/limp)
lethargy
poor feeding
temperature instability
weak or high pitched cry
Mrs. Jones is a gestational diabetic on insulin. She is being admitted for labor & her OB ordered the OB Intrapartum IV Insulin Infusion Panel. What are the 4 times/instances you are going to take her blood sugars?
1. On admission
2. PRN signs & symptoms of hypoglycemia
3. Every hour on insulin drip
4. Every 2 hours while not on insulin drip