Assessment
This medication is used to cause uterine contractions to induce labor.
What is oxytocin (Pitocin)?
This will cause the uterus to be boggy, displaced, and increases the risk of postpartum hemorrhage.
What is uterine atony?
Immediate intervention for a postpartum mom with shaking/chills following birth?
What is a warm blanket?
Continue prenatal vitamins until they run out
Avoid gas-producing and spicy foods
Consume an extra 300-500 calories a day
Drink between 2 and 3 liters of fluid a day
What are nutritional requirements for breastfeeding moms?
Two days postpartum, the peri pad has 10 cm bright red lochia with small clots.
What is moderate lochia rubra?
This medication is utilized to manage postpartum hemorrhage - use sparingly in patients with HTN.
What is methylergonovine (Methergine)?
Elevated temp
Painful breasts
Erythema to breasts
What is mastitis?
These often occur following birth and are made more intense during breastfeeding or with oxytocin or other medications that cause uterine contractions.
What are afterpains?
This intervention will aid in prevention of complications such as uterine atony, DVT, constipation, and urinary retention.
What is early ambulation?
Must use a small syringe to rinse mouth/palate after feeding
May use a dropper or larger nipple to avoid friction at affected site during feeding
Hold upright for feedings to avoid aspiration
What is cleft lip/palate?
The postpartum client is independent with caring for her baby.
What is the taking-hold phase?
This is a topical anesthetic often used for perineal injuries.
What is benzocaine (or dibucaine)?
Pain with hyperflexion of foot/calf
Swelling of one lower extremity
What are signs of a DVT?
The postpartum patient has soaked a peri pad in 15 minutes and has become pale and confused.
What is postpartum hemorrhage?
What is fundal massage?
6-8 wet diapers a day
Brisk skin turgor
Moist mucous membranes
Flat fontanelles
What are signs of hydration in the newborn?
The infant is not gaining weight, lethargic, irritable, with weak physical/motor responses (reflexes). These are often signs that appear in infants of mothers with postpartum depression.
What is failure to thrive?
What is erythromycin?
A 6-week postpartum mom comes to the OB clinic for a follow up visit and states that she has "never felt sadder" and expresses guilt because she should be so happy right now with the new baby.
What is postpartum depression?
Normal postpartum vaginal discharge that will begin as rubra, then serosa, then diminish to alba.
What is lochia?
Massage fundus
Increase IV fluids
Apply oxygen
Administer methylergonovine
What are emergency interventions for postpartum hemorrhage?
Offer sucrose feeding, followed by regular feeding for glucose levels of 30 mg/dL or less.
What are interventions for hypoglycemia?
This assessment will be done at 1 and 5 minutes following birth. It is an indicator of healthy respiratory function.
What is the APGAR score?
This medication should be administered to postpartum moms within 72 hours of birth to prevent maternal antibody formation from Rh incompatibility between mother/baby.
What is Rhogam?
Expiratory grunting
Cyanosis
Substernal retractions
Apnea
Increased respiratory rate
Decreased oxygen saturation
What is respiratory distress syndrome?
This surgical incision allows for easier vaginal birth and prevents lacerations. The wound is stitched with absorbable sutures that will heal in about three weeks.
What is an episiotomy?
This item should be used after every voiding or bowel movement and should be applied front to back.
Urine output less than 1 ml/kg/hr
Weight loss
Dry mucous membranes
Depressed fontanelles
What are signs of dehydration (fluid volume deficit)?
This is a result of molding in the birth canal that crosses the suture line on the skull and will resolve on its own.
What is caput succedaneum?
This medication should be administered via nebulizer or endotracheal tube to pre-term newborns who are having symptoms of respiratory distress to help with ventilation.
What is surfactant?
In assessing the newborn, one leg appears shorter than the other.
What is hip dysplasia?
What are perineal lacerations?
Wear supportive bra
Inspect breasts daily for cracks/erythema
Pump or manual expression for engorgement
What are interventions for breastfeeding moms?
Urine output greater than 3 mL/kg/hr
Edema
Crackles in lungs
Intake greater than output
Weight gain
What are signs of overhydration (fluid volume excess)?
The newborn has pearly, raised nodules on the roof of the mouth.
What are Epstein's pearls?
This medication can help relieve gas pressure/bloating in postpartum mothers.
In assessing the newborn, the nurse notes a small, dimpled area with a tuft of hair on the lower back.
What are signs of spina bifida (spinal cord malformation)?
First type of breast milk that is excreted and contains protein and maternal antibodies. Not as high in calories or fat.
What is colostrum?
Continue breastfeeding to prevent engorgement
Complete all antibiotics
Keep breasts clean
Practice good hand hygiene
Apply cool or warm compresses to ease discomfort
What are interventions for mastitis?
Hydrocele
Hypospadias
Epispadias
Family history of hemophilia
What are contraindications for circumcision?
Ears lower than pinna of ear
Single crease in palm of hand
Floppy muscle tone
Varying degrees of developmental delay
What is Down Syndrome?
This medication must be administered IM to newborns within 24 hours of birth to help with clotting - important to do this before circumcisions are performed.
What is vitamin K (phytonadione)?
The newborn's head circumference is 3 cm greater than the chest circumference
The baby's eyes are bulging
The baby's fontanelles are bulging
The baby has a high-pitched cry
What are signs of hydrocephalus?
Separation of abdominal muscles
What is diastasis recti?
Elevate affected extremity
IV heparin
Activity restriction
What are nursing interventions for someone with a DVT?
Hold baby while feeding
Make eye contact/baby talk
Early skin to skin contact
Baby's toes fan out when the pads of the feet are stroked.
What is the Babinski reflex?
This supplement may be ordered for postpartum clients who had hemorrhage or history of anemia. It is best absorbed on an empty stomach and with fluids that contain vitamin C. It can cause stools to be dark and causes constipation or upset stomach in some clients.
What is iron?
Yellowing of skin and mucous membranes
Bilirubin level increased (usually 12 mg/dL or greater)
Treated with phototherapy, increased feedings, or IV immunoglobulin/blood transfusions
What is jaundice (hyperbilirubinemia)?
A syndrome of four congenital heart defects resulting in need for surgical intervention. Includes "tet" spells where the child will need to be placed in knee-chest position and given rest/supplemental oxygen.
What is tetralogy of Fallot?
Avoid submersion baths until stump falls off
Use alcohol swabs to help dry stump
Fold diaper down to prevent tissue trauma
Report bleeding or purulent drainage to provider
What is umbilical cord care?
Keep head covered
Swaddle baby during first few days of life
Keep baby warm and dry
Avoid windy, cold, drafty areas
Skin to skin contact
What are ways to promote thermoregulation in the newborn?
Congenital defects (heart, cleft lip/palate)
Cognitive delay
Microcephaly
Poor bonding/attachment
Wide-set eyes
Small facial features
What are signs of fetal alcohol syndrome?
This medication may be given to infants who have substance withdrawal syndrome.
What is: phenobarbital/morphine?
High-pitched cry
Irritable, difficult to soothe
Jittery/tremors/hyperreflexia
Nasal congestion
Poor suck/swallow reflexes
Small for gestational age
What are signs of substance withdrawal?
These babies are born after 42 weeks and are at risk for hypoxia, meconium aspiration and birth injuries including shoulder dystocia, clavicle fractures, and hip dysplasia. They are also likely to have cold stress because they don't have as much subcutaneous fat.
What are post-term newborns?
Keep cord at bottom of bed
Reposition infant frequently
Encourage frequent feedings to excrete bilirubin
Keep eyes covered during therapy
What are interventions for phototherapy?
Assess hydration status
Avoid oil-based lotions
Check temp every hour
Keep eyes covered when under light
What are safety interventions for phototherapy?