Exam Flashcards

Question

transitional milk

Answer 1

-Produced at 1-2 weeks postpartum -High in proteins and also lactose, fat, vitamins and calories

Answer 2

-Produced by 2 weeks postpartum -Foremilk is the initial release and is high in lactose, protein and water soluble vitamins -Hindmilk occurs from “let down” – about 10 minutes into feeding and is high in fat

Answer 3

-Dilute urine -Hearing swallowing -Breasts feel softer after feedings -6-8 wet diapers by day 5 or 6 -3-5 stool diapers -Feeling a strong, deep pulling during feeding -Seeing milk in your baby’s mouth -Leaking from your breast or the feeling of “let down” 15-20 minutes of vigorous suckling on each breast or 20 to 30 minutes on one breast -At least 8 feeds per day - Poop changes color from black or dark green to yellow by day 5 -Should be back to birth weight 2 weeks postpartum

Answer 4

Tummy to tummy Bring baby to breast Skin to skin

Answer 5

The average time for early feedings is 30 to 40 minutes Don’t go longer than 5 hours between feedings No pacifiers for 6-8 weeks (decreases nipple confusion)

Answer 6

-The CPS recommends that, unless a medical indication exists, supplements should not be given to breastfeeding newborns -Possible indications for supplementary feeding include hypoglycemia, ineffective feeding, dehydration, weight loss of more than 10% associated with delayed lactogenesis, or delayed passage of bowel movements or meconium stool continued to day 5.

Answer 7

L-Latch A-Audible Swallowing T- type of nipple C- comfort (breast and nipple) H-Hold (positioning)

Answer 8

Drowsiness, sleepiness, difficulty arousing the baby Baby release from your breast spontaneously Relaxed appearance Limp arms and hands

Answer 9

Nipple confusion Engorgement (short term) Reduced milk supply (long term) Sore nipples Shortened duration of breastfeeding Incorrect sucking patterns and ineffective sucking Exposure to potential allergens from formula

Answer 10

-The baby loses more than 10% of the BW -Baby has not begun to regain weight by his 5th day after birth -Baby has not regained his birth weight by 2 weeks -Baby is not urinating at least 6 to 8 times per day at 5 to 6 days old -Baby is not having several stools per day after the 3-4th day of breastfeeding -Cracked nipples -Poor latch -Not enough milk

Answer 11

Weaning is initiated when infants are introduced to foods other than breast milk and concludes with the last breastfeeding. Gradual weaning is easier than abrupt

Answer 12

Fresh milk -deep freeze 6 months+ -fridge freezer 3-4 months -fridge 8 days -room temp; colostrum 24 hours; mature milk 10-12 hours Thawed breast milk - do not refreeze -can last in the fridge up to 24 hours -room temp 1 hour

Answer 13

-breasts become enlarged, reddened, painful, shiny, and edematous. -Nipples may become effaced, milk flow decreases, and the newborn can have difficulties latching on. -Factors that contribute to engorgement include delayed initiation of breastfeeding, infrequent or time-restricted feedings, feeding supplementation, inefficient infant latch, breast surgery, or any situation where milk stasis occurs -Apply warmth to breast before, gentle massage, cold compress after feeding to help with pain

Answer 14

-Infection/inflammation of breast -Causes - Inadequate emptying of the breasts is common, related to engorgement, plugged ducts, a sudden decrease in the number of feedings, abrupt weaning, or wearing underwire bras. Sore, cracked nipples

Answer 15

Small white pearl visible on tip of nipple

Answer 16

-no water needed. -Expensive -sterile until the can is opened. -Babies who have the greatest chance of infections should have sterile formulas. (premature, low birth weight, under two months of age, weakened immune system)

Answer 17

-needs to be mixed with sterilized water. -sterile until the can is opened

Answer 18

-needs to be mixed with sterilized water. -Cheapest -Not for premature babies -Powdered formula is not sterile and may carry harmful bacteria that can make your baby sick if not prepared safely

Answer 19

The bottle of formula can be put back in a fridge for up to 24 hours from the time it was prepared as long as you can answer “yes” to each of these statements: 1. The bottle of formula has been kept cold while travelling. 2. The bottle of formula has been out of the fridge for less than 2 hours. 3. The baby has not taken any formula from the bottle, even only a few mouthfuls.

Answer 20

-Remove the formula from the fridge just before you need to feed your baby. body temperature (warm) cool. -Either way is fine. -Warm the bottle of formula in a container of warm water, or a bottle warmer. Keep the nipple area out of the water. -Do not heat any bottles in the microwave. -Warm the bottle for no more than 15 minutes. Shake the bottle a few times during warming. -Check to make sure the formula is not too hot before the feeding. -Do not reheat formula during a feed or refrigerate a partly used bottle -A bottle should be used within two hours of heating,

Answer 21

-Foods or liquids given to the infant in addition to breast milk or formula -After 6 months of age -Iron-fortified cereal, meat, or meat alternatives are recommended to be the first solid foods introduced. -Fruits and vegetables daily starting at 8 months

Answer 22

1-2.25 kg during the first trimester then 500g each week until birth

Answer 23

-The life or health of the mother or fetus is jeopardized. -For the mother, high-risk status arbitrarily extends through puerperium (approximately 6 weeks after childbirth). -Maternal complications usually are resolved within 1 month of birth.

Answer 24

-What decides the level of the hospital and what hospitals can take which patients -Quality care to all pregnant women and newborns according to their need -Utilization of highly skilled personnel, intensive care facilities

Answer 25

all mothers and babies care referred to a central hospital for care no matter what their care needs are

Answer 26

Level I: -low risk pregnancies, deliveries and newborns Level II 2A, 2B, 2C: -low to moderate risk pregnancies & neonatology Level III 3A and 3B: -high to ultra high risk pregnancies, deliveries and newborns

Answer 27

Hypertensive disorders** Infection Hemorrhage Complications from birth Unsafe abortion

Answer 28

Hypertensive disorders Pulmonary and amniotic embolism Hemorrhage Mental illness

Answer 29

Age (<20, >35 years), lack of prenatal care, low education level

Answer 30

-Preterm and multiple birth rates are leading causes of neonatal morbidity and mortality. Other causes of neonatal death: -Low birth weight -Respiratory distress syndrome -Sudden infant death -Effects of maternal complications

Answer 31

-Aneuploidy - having one or more extra or missing chromosome (eg, downs syndrome) -ultrasound examination for nuchal translucency (measures fluid in nape of neck) >3mm highly indicative of genetic disorder or physical anomalies >3.5 mm increased risk of CHD -Amniocentesis to confirm or echo

Answer 32

MSAFP levels are used as screening tool for open neural tube defects and abdominal wall defects

Answer 33

-Blood test -Screens for aneuploidy -done at 10-12 weeks -Uses a sample of maternal blood which has broken down components of fetal cells Measures amount of cfDNA circulating in maternal blood and compares it to known standards -Ex: if more than the expected amount of chromosome 21 DNA is detected, it can then be assumed that the fetus is contributing the extra amount and therefore has trisomy 21 Only free if >40 when delivering or already have a baby with trisomy

Answer 34

-Fetal activity, gestational age, fetal growth, fetal anatomy, placental position and function -Done around 6 weeks -Provides visual assistance for invasive procedures -Full bladder helps push uterus up and get a better picture

Answer 35

-Performed to obtain amniotic fluid which contains fetal cells to test for chromosomal problems -Under ultrasound, a needle is inserted trans abdominally into the uterus and amniotic fluid is withdrawn -Possible after 14 weeks -Can assess fetal lung maturity late in pregnancy

Answer 36

Leakage of amniotic fluid through puncture hole Maternal hemorrhage Infection Accidentally puncture bladder or intestine Amniotic fluid embolism Labour, miscarriage

Answer 37

-Technique for genetic studies -Earlier diagnosis and rapid results -Performed between 10 and 13 weeks of gestation -Equal to amniocentesis in accuracy and risk -Indications similar to amniocentesis -Removal of small tissue specimen from fetal portion of placenta -Chorionic villi originate in zygote. -Tissue reflects genetic makeup of fetus.

Answer 38

-Insertion of needle directly into fetal umbilical vessel under ultrasound guidance -Direct access to fetal circulation -Used for fetal blood sampling and transfusion -Second and third trimester

Answer 39

-used as screening tool for neural tube defects -Detects 80% to 85% of all open NTDs and open abdominal wall defects early in pregnancy -Screening recommended for all pregnant women at 15-20 weeks -Triple- and quad-screening to detect autosomal trisomies (21 Downs and 18 at 16-18 weeks) -Not diagnostic just indicates a possibility

Answer 40

-Test for Rh incompatibility -Detects other antibodies that may place fetus at risk for incompatibility with maternal antigens -If above 1:8 amnio required for severity of bilirubin

Answer 41

Fetal movement counting Electronic fetal monitoring Nonstress test (NST) Contraction stress test (CST) Biophysical profile (BPP) Amniotic fluid volume (AFV)

Answer 42

-Fetal movement is a reassuring sign -Decreased fetal movement → decreased placental perfusion, fetal acidemia -In a reclined position should feel 6 movements within 2 hours

Answer 43

-Most common method of fetal assessment -Hypoxia or asphyxia -redistribution of blood flow to vital organs -Decreased total oxygen consumption -Switch to anaerobic glycolysis

Answer 44

-a normal fetus produces characteristic heart rate -patterns in response to fetal movement. -FHR should accelerate with movement -can be performed easily and quickly in an outpatient setting -It is noninvasive and has no known contraindications. -Disadvantages → high rate of false-positive results for atypical or abnormal tracings

Answer 45

-Empty bladder, sit semi fowlers with slight left tilt -FHR is recorded with doppler, tocodyna, ometer detects uterine contractions or fetal movements -Abnormal tracing persistently lacks accelerations after 80 minutes or contains significant abnormality of baseline heart rate or variability or shows evidence of significant decelerations -Normal NST is predictive of good perinatal outcome for 1 week

Answer 46

-Evaluest response of fetus to induced contractions to identify poor placental perfusion -The goal of a CST is to induce three contractions, each lasting 1 minute within a 10-minute period so that the fetal heart response to the contractions can be evaluated Nipple-stimulated contraction test -Massage nipple for 2 minutes, rest for 5, repeat Oxytocin-stimulated contraction test -Iv infusion of oxytocin -Negative result = no late decelerations -Positive result = repetitive late decelerations -Provides a warning of fetal compromise earlier than NST

Answer 47

preterm labour, placenta previa, vasa previa, cervical insufficiency, multiple gestation, previous classical uterine incision for c section

Answer 48

-Non invasive -used to assess current fetal well-being by observing fetal breathing movements, fetal movements, fetal tone, and amniotic fluid volume Score interpretation -Score of 8-10 is healthy -Score of 6 means we need to retest in 24 hrs -Score of 6 with abnormal fluid means delivery must happen now -less than 6 means delivery

Answer 49

1) breathing movements -at least one episode continuing more than 30 seconds 2) movements -at least 3 body or limb movements 3) tone -an episode of active extension with return to flexion, or opening and closing of the hand 4) amniotic fluid volume -at least one cord and limb free pocket which is 2cmx2cm

Answer 50

-Abnormalities in AFV are frequently associated with fetal disorders. -depths (in centimeters) of amniotic fluid in all four quadrants surrounding the maternal umbilicus are totalled, resulting in an amniotic fluid index (AFI) -AFI less than 5 cm = oligohydramnios -AFI more than 25 = polyhydramnios

Answer 51

-systolic/diastolic flow ratios and resistance indices to estimate blood flow in various arteries. -17-22 weeks -Vessels studied Fetal umbilical and middle cerebral arteries; maternal uterine arteries -it is a helpful tool in the management of high-risk pregnancies due to intrauterine growth restriction (IUGR), diabetes mellitus, multiple fetuses, or preterm labour

Answer 52

Systolic blood pressure (BP) >140 mm Hg diastolic BP > 90 mm Hg

Answer 53

systolic BP >160 mm Hg diastolic BP >110 mm Hg *emergency*

Answer 54

-hemolysis -elevated liver enzymes -low platelets -Cerebral edema and seizures, acute renal failure, pulmonary edema -Death of pregnant patients associated with placental abruption, hepatic rupture, eclampsia -Increased risk of preterm birth, IUGR, acute hypoxia -Mortality 25%

Answer 55

Pre-existing hypertension with evidence of pre-eclampsia (before 20 weeks of gestation)

Answer 56

-Gestational hypertension with pre-eclampsia (after 20 weeks of gestation) -Gestational hypertension with comorbid conditions

Answer 57

Hypertensive disorder (>140) accompanied by new onset proteinuria and possibly other end organ dysfunction (caused by reduced organ perfusion)

Answer 58

-Proteinuria -Systolic BP >160 mm hg -Diastolic BP >110 mm hg -Mean arterial pressure (MAP) >105 mm Hg -Cerebral disturbances (seeing spots, headaches, blurred vision, decreased LOC, etc) -Epigastric pain

Answer 59

-Seizure activity or coma in women diagnosed with preeclampsia -Can happen before birth, during birth, 6 weeks after birth

Answer 60

>40 age nulliparity IVF interpregnancy interval >7 years family history obesity/GDM multifetal gestation pre existing medical condition chronic hypertension renal disease type 1 DM

Answer 61

-blood pressure -elevated DTR (clonus) -fetal health surveillance (NST, CST, BPP, ultrasound) -Assess uterine tone and tenderness → uterine tenderness with increasing tone can indicate abruption

Answer 62

Fetal health surveillance Activity restriction Diet 2-4L of fluid/day

Answer 63

-Hospital care -Magnesium sulphate (prevents seizures) -Control of BP (labetalol)

Answer 64

-lethargic, feel hot, headache, nausea, vomiting, poor reflexes, respiratory depression -Antidote calcium gluconate (10mL over 3min)

Answer 65

-persistent headache, blurred vision, photophobia, epigastric or right upper quadrant pain, altered mental status , hyperreflexive Treatment -Airway first (turn head to one side, place pillow under one shoulder or back) -call for help -protect patient from injury (padded side rails raised) -observe and record convulsion activity -monitor uterine activity

Answer 66

-Twice the risk of developing hypertensive disorders and pre eclampsia -Large for gestational age baby, c section higher risk

Answer 67

Fetal macrosomia, shoulder dystocia, hypoglycemia at birth, IUGR

Answer 68

-Screen for GDM from 24-28 weeks -High risk screen at 16 weeks Risk factors ->35 years of age, corticosteroids, obesity, pre gestational diabetes, previous gestational diabetes, giving birth to a baby >4 kg, parent brother or sister with type 2 diabetes, PCOS, high risk group (african, arab, asian, latin american, indigenous, south asian) Identify hyperglycemia early

Answer 69

Diet Exercise Monitoring blood glucose levels Insulin therapy Fetal surveillance

Answer 70

-Induction offered for GDM between 38-40 weeks -Check blood sugar q1h during labour -Keep glucose under 8

Answer 71

-Most GDM return to normal -More likely to reoccur in future pregnancies -More likely to develop type 2 diabetes later in life

Answer 72

-Nausea and vomiting during pregnancy is the most common medical condition, affecting 50 to 90% of women. -Protracted vomiting, retching, severe dehydration, and weight loss requiring hospitalization -Usually begins during the first 10 weeks of pregnancy (most common during 4-8 wks)

Answer 73

-Hemorrhagic disorders in pregnancy are medical emergencies. -50% of bleeding in the third trimester is placenta previa or placental abruption. -Maternal blood loss decreases oxygen-carrying capacity. -Increased risk for hypovolemia, anemia, infection, preterm labor, and preterm birth -Fetal risks include anemia, hypoxemia, hypoxia, anoxia, stillbirth

Answer 74

-miscarriage spontaneous abortion): pregnancy ends prior to 20 weeks gestation -10-15% of all confirmed pregnancies end in miscarriage -Early (0-11 weeks) and late (12-20 weeks) -S/S → Bleeding, cramping, low back pain, decreasing HCG

Answer 75

-Threatened → bleeding, baby is alive -Inevitable → heavy bleeding, cervical os is open -Missed losses → baby died inside, cervix is closed

Answer 76

-Cause of late miscarriage -Incompetent cervix, cervical insufficiency -Passive and painless dilation of the cervix without contractions or labour -Can be caused by short cervix (<2.5cm)

Answer 77

-Cervical cerclage - a suture is placed around the cervix beneath the mucosa to constrict the internal os of the cervix -Conservative management of restricted activity and increase hydration -Shirodkar or McDonald procedure

Answer 78

-Fertilized ovum implanted outside uterine cavity -95% occur in uterine (fallopian) tube Symptoms -Abdominal pain -Delayed menses -Abnormal vaginal bleeding -Methotrexate can dissolve the pregnancy -`Can be caused by pelvic inflammatory disease, tubal ligation

Answer 79

-benign, proliferative growth of the placental trophoblast in which the chorionic villi develop into edematous, cystic, avascular transparent vesicles that hang in a grapelike cluster Two distinct types of hydatidiform mole: -Complete mole: results from fertilization of egg with lost or inactivated nucleus -Partial mole: result of two sperm fertilizing a normal ovum

Answer 80

caused by: -placenta previa -placental abruption -Placenta accreta, increta, percreta -Vasa previa -Velamentous insertion of cord -Battledore (marginal) insertion of cord

Answer 81

-Placenta implanted in lower uterine segment near or over internal cervical os → causes bleeding when the cervix dilates -Painless vaginal bleeding -At risk for hemorrhage, placental attachment problems, C/S, anemia, infection, preterm birth, stillbirth, malpresentation, fetal anemia, IUGR, fetal anomalies

Answer 82

covers the internal os totally

Answer 83

when cannot measure the exact location

Answer 84

placenta 2.5cm or closer to cervical os

Answer 85

-Reduce activity and close observation -Ultrasound every 2 weeks -Fetal surveillance (NST, BPP) once or twice weekly -Corticosteroids to increase lung maturity -Must be delivered C section

Answer 86

-premature separation of placenta -1 (mild): 10-20% separated, <500ml blood loss -2 (moderate),: 20-50% separated, 1000-1500mL blood loss -3 (severe): >50% separated, >1500 mL blood loss, DIC, shock -Painful vaginal bleeding Outcomes -Maternal death, hemorrhage, hypovolemic shock, hypofibrinogenemia, DIC, infection, renal failure IUGR, pre term birth, fetal death, cerebral palsy, SIDs -Most common cause is hypertension and cocaine use -Can be caused by trauma (MVA), clotting problems

Answer 87

trophoblastic invasion extends beyond the normal endometrial barrier

Answer 88

beyond myometrium

Answer 89

beyond uterine serosa

Answer 90

When fetal vessels lie over the cervical os and are implanted in fetal membranes rather than the placenta

Answer 91

-the umbilical cord inserts into the amniotic sac instead of the placenta -When blood vessels run through the amniotic sac, they don't have that protection. -If the blood vessels in the amniotic sac are above the cervix, it causes vasa previa. -Higher incidence in multiple gestations and pregnancies from assisted reproductive technology -Rupture of membranes or traction on cord may tear one or more fetal vessels -Fetus may rapidly bleed to death as a result

Answer 92

-Cord isn't inserted properly into baby or placenta -cord inserted into side of placenta instead of centre -Increases risk of fetal hemorrhage, especially after marginal separation of placenta

Answer 93

-Tachycardia, diaphoresis, bleeding from many areas, bruising, petechiae -Pathological form of diffuse clotting causing widespread external and internal bleeding -It is always the result of another condition (eg placental abruption) -Management → fix causative condition, volume expansion, oxygen, clotting factors, vitamin K

Answer 94

-Type of hemophilia that can affect women -Clotting factor VIII deficiency and platelet dysfunction -Management → DDVAP

Answer 95

-Persistent presence of bacteria in the urinary tract with NO symptoms -Causes increased risk for preterm labor and low birth weight infants

Answer 96

Dysuria, urgency frequency lowe abd or suprapubic pain

Answer 97

-Can cause sepsis, ARDS, preterm labour -Fever, shaking, chills, lumbar aching, anorexia, nausea, vomiting

Answer 98

Miscarriage, preterm labour, placental abruption and stillbirth

Answer 99

-Uterus and bladder positioning -Elevated levels of progesterone -Decreased tolerance for hypoxia and apnea -Acidosis develops more quickly in the pregnant woman. -Cardiac output -Circulating blood volume

Answer 100

-Careful monitoring of fetal status assists greatly in maternal assessment. -Fetal monitor tracing works as an “oximeter” of internal maternal well-being. -Fetal non stress test

Answer 101

Immediate stabilization -Stabilize the mother before you check fetus Primary survey: CABDs -Compressions, airway, breathing, defibrillation Secondary survey -Maternal health -Fetal health surveillance

Answer 102

-Fetal survival is unlikely if Caesarean birth is accomplished more than 20 minutes after maternal death. -Consider Caesarean birth after 4 minutes of resuscitative efforts that produce no response in the mother. -Rarely successful

Answer 103

Trauma from accidents

Answer 104

Hypertensive disorders

Answer 105

eat small, frequent meals low-fat, high-protein foods dry, bland foods; and cold foods avoid greasy and highly seasoned foods A snack before bedtime is also advised. increase dietary intake of potassium and magnesium fluids between meals rather than with them sometimes helps lessen nausea drinking liquids from a cup with a lid and drinking tea or water with lemon slices

Answer 106

-Insulin needs decrease in first trimester and then increase in second trimester Maternal risks and complications -Preterm labour and birth -Infections -Polyhydramnios -Ketoacidosis -Hypoglycemia Fetal and newborn risks -Large-for-gestational-age infants, Macrosomia (>4kg) → shoulder dystocia -Sudden stillbirth -Congenital anomalies -Birth injuries -Hypoglycemia at birth

Answer 107

-Prenatal visits 1-2 weeks and q1week during last trimester -Diet and exercise -Monitoring blood glucose levels -Insulin therapy -Complications requiring hospitalization (DKA) -Determination of birth date and mode of delivery -Induction between 38-40 weeks -NSTs twice a week

Answer 108

-Insulin requirements decrease substantially in the immediate postpartum period. -Breastfeeding issues -Anticipate PPH -Increased risk of mastitis and yeast infections

Answer 109

-Graves' disease or human chorionic gonadotropin (hCG)–mediated hyperthyroidism responsible for 90 to 95% of cases -4-8 weeks → severe nausea, vomiting, fatigue, heat intolerance, warm skin, weight loss -High risk for preeclampsia, abruption

Answer 110

Cool dry skin, weight gain, coarse hair, muscle weakness, constipation

Answer 111

-Increased intravascular volume -Decreased systemic vascular resistance -Increased heart rate and stroke volume -Intravascular volume changes after birth

Answer 112

-Class I: asymptomatic without limitation to physical activity -Class II: symptomatic with slight limitation of activity -Class III: symptomatic with marked limitation of activity -Class IV: symptomatic with inability to carry any physical activity Determined at 3 months and again at 7 or 8 months of gestation, as progression may occur

Answer 113

-Therapy focused on minimizing stress on heart -Greatest stress 28-32 weeks -Signs and symptoms of cardiac decompensation --> Edema, tachycardia, cough, dyspnea, fatigue, palpitations, weak pulses, cyanosis, tachypnea -Nutrition and activity counselling -Cardiac medications, as needed -Anticoagulant therapy -Heparin

Answer 114

Telemetry Fluid management Keep head and shoulders elevated epidural/vaginal delivery

Answer 115

Antepartum risks -Infertility -Attempt weight loss (5-10% of weight loss can help fertility) -Higher risk for GDM and HTN -May need repeat ultrasounds for anatomy scan Intrapartum and postpartum risks -Increased risk of shoulder dystocia, Caesarean birth, induction -Difficulty with EFM -Difficulty with breastfeeding -Risk for postpartum hemorrhage, wound dehiscence, DVT

Answer 116

Hgb <110 Most common Prenatal vitamins and iron supplements can prevent 60-120 mg/day

Answer 117

More common with multiple pregnancies and on anticonvulsants

Answer 118

-Prevent hypoxic episodes in the mother and fetus -Avoid triggers, inhaled corticosteroids first line in pregnancy

Answer 119

-Infants of mothers with cystic fibrosis will be carriers of the gene. -Exocrine glands produce excessive viscous secretions. -With severe disease, pregnancy is often complicated by chronic hypoxia and frequent pulmonary infections. -Problems with respiratory and digestive systems -Higher risk for GDM

Answer 120

-Mid to late third trimester -Purple lesions (itchy hives) -Treat with steroid cream -More common with male babies and multiples

Answer 121

-Pruritus in palms and soles of feet -Usually worse at night -Elevated bile acids caused by disruption of hepatic bile flow +/- jaundice -Treatment → ursodeoxycholic acid, antihistamines -Itch relief → cool baths, oatmeal products added to a bath, oatmeal cream or lotion, baking soda baths, or an aqueous cream containing 2% menthol

Answer 122

-Changes to medications may have to be made. -Lowest effective dose and monotherapy if possible -Risks to infant with anticonvulsant therapy include congenital malformations, cognitive impairments, intrauterine growth restriction (IUGR), NTD

Answer 123

-Remissions during pregnancy are common -Bedrest, steroids, and immunosuppressive agents are used to treat acute exacerbations. -Higher risk of UTIs and operative vaginal birth

Answer 124

Risk peaks in third trimester , no risk to fetus Steroids help

Answer 125

-Autoimmune antibody production affects skin, joints, kidneys, lungs, serous membranes, central nervous system, liver, and other body organs. -Be in remission (no symptoms for 6 months) before you get pregnant -Triggers are stressful events -Symptoms → muscle pain, fatigue, weight change, fevers -Immunosuppressive medications and NSAIDs are not recommended during pregnancy. -Occasional doses of NSAIDs can be given -Low dose aspirin recommended starting before 16 weeks to reduce risk of pre eclampsia -Prednisone often used -Efforts are aimed at reducing the risk of infection.

Answer 126

-Autoimmune motor (muscle) end-plate disorder -Muscle weakness in the eyes, face, tongue, neck, limbs, and respiratory muscles -Women with MG usually tolerate labour well. -Pregnancy does not appear to affect the overall course of MG, but as the uterus enlarges respirations may be compromised -May require forceps or vacuum delivery cause of weak muscles

Answer 127

-Chronic effects of SCI may include autonomic dysrreflexia (AD), impaired pulmonary function, chronic pulmonary or genitourinary infections, anemia, osteoporosis, and decubitus ulcers. -Risk of deep vein thrombosis (DVT), pulmonary embolism, ulcers, UTIs -May need induction if cannot feel uterine activity or contractions -Anaesthetic consultation is suggested because of the risk of AD during labour and the potential for impaired pulmonary function. -Must ensure bladder emptying -Vaginal birth preferred

Answer 128

-Strict adherence to antiretroviral medication is needed. -Opportunistic infections should be treated with medications specific for that infection. -Every effort should be made to decrease the newborn's exposure to blood and secretions. -membranes should be left intact until the birth. -If rupture of membranes occurs before labour, induction of uterine contractions with oxytocin may be appropriate. -Immediately after birth, infants should be wiped free of all body fluids. -Breastfeeding is not recommended

Answer 129

-depression, anxiety, obsessive-compulsive disorder, and trauma and stressor-related illnesses.

Answer 130

-symptoms of common mental health concerns in the context of the transition to parenthood that do not result in substantial impairment. -Such symptoms often resolve with support and resolution of initial stressors (e.g., sleep deprivation, difficulty breastfeeding). -These are known as adjustment disorders which are defined as emotional or behavioural symptoms (such as low mood or anxiety) in response to a specific stressor or another event that exceeds what would normally be expected. -These disorders typically occur within three months from the time of the stressor, resolve within six months, and may require supportive care but not formal therapies or medication

Answer 131

ask advise assess assist arrange

Answer 132

SSRI, SNRI

Answer 133

-occurs in one-third of newborns exposed to SSRIs or SNRIs in utero and is generally mild and self-limiting -similar to NAS

Answer 134

Bleeding complications Miscarriage Stillbirth Prematurity Low birth weight Sudden infant death syndrome

Answer 135

Hypoglycemia, poor sleeping and eating, tremors, lethargic

Answer 136

-Buprenorphine or Suboxone which is an opioid replacement may cause withdrawal symptoms 30-60 hours after birth and last up to 28 days -Methadone is standard care for opioid replacement in pregnancy -Leads to improved prenatal care, higher birth weight and increased rates of baby being discharged home with mother -Infants show withdrawal symptoms within 48-72 hours after birth until 30 days post birth -Narcotic antagonists (e.g. Naloxone, Nubain) should not be used as they are contraindicated for women with opioid use disorder or infants of known or suspected opioid dependent women due to the risk of precipitating acute withdrawal.

Answer 137

shrill cry, jerkiness, diaphoresis and sneezing

Answer 138

-decrease substance use. -Consequences of drug use should be clearly communicated and abstinence recommended. -Women are more receptive to making lifestyle changes during pregnancy than at any other time. -Methadone treatment for pregnant women -Promote: Maternal–infant attachment Breastfeeding

Answer 139

cervical changes and uterine contractions occurring between 20 and 37 weeks of pregnancy

Answer 140

-any birth that occurs before completion of 37 weeks of pregnancy -Late preterm: between 34-37 weeks gestation -#1 risk factor → previous preterm labour - at risk: Multiple gestation, GDM, hypertension, placental disorders

Answer 141

-helps predict preterm labour -swabbed from the vagina, detects inflammation in the placenta which is associated with preterm labour, especially if seen in second trimester

Answer 142

-Patients whose cervical length is greater than 30 mm are unlikely to give birth prematurely -<25mm likely preterm birth

Answer 143

-smoking cessation -Reduced activity and sexual activity -Progesterone vaginal supplements -Educate about early symptoms of preterm labour. -Teach what to do if symptoms occur.

Answer 144

-Gestational age between 20 and 37 weeks -Uterine activity (contractions) -Progressive cervical change -Effacement of 80% -Cervical dilation of 2 cm or greater

Answer 145

-suppress uterine activity and slow down labour -Afford opportunity to begin administering antenatal glucocorticoids -Accelerate fetal lung maturity -Reduce severity of sequelae in preterm births -Nifedipine, indomethacin, magnesium sulfate, nitroglycerin

Answer 146

-Antenatal glucocorticoids (dexamethasone) -Considered one of the most effective and cost-efficient interventions for preventing morbidity and mortality associated with preterm labour -Given between 24-34+6 weeks of gestation when preterm birth is threatened -Can cause hypoglycemia in mom

Answer 147

-Labour that progresses to cervical dilation of 4 cm is likely to lead to preterm birth. -Preterm births in tertiary care centres lead to better neonatal and maternal outcomes. -Women at risk should be transferred quickly to ensure the best possible outcome. -The first dose of antenatal glucocorticoids should be given before transfer. -Give magnesium sulphate for neuroprotection

Answer 148

-uterine contractions more frequent than every 10 minutes (persisting for more than 1 hour) -lower abd cramping -dull intermittent low back pain -painful menstrual like cramps -suprapubic pain -pelvic pressure -urinary frequency -changes in amount and character of discharge -rupture of amniotic membranes

Answer 149

-stop what you're doing -empty your bladder -drink 2-3 glasses of water -lie down on side for 1 hour -palpate for contractions -call HCP if symptoms continue -if symptoms go away, resume light activity

Answer 150

-Membranes rupture before 37 weeks of gestation -Often preceded by infection -#1 risk factor is previous PPROM -Pathological weakening of amniotic membrane caused by inflammation or factors that increase uterine pressure -Chorioamnionitis is the most common complication -Diagnosed after woman complains of sudden gush or slow leak of vaginal fluid -Between 34-36 weeks - Active pursuit of labour and birth -Before 32 weeks - conservative management -Transfer to a level 3 hospital -NST, BPP, fetal movement counting, corticosteroids, antibiotics, magnesium

Answer 151

-Pregnancy extends beyond the end of week 42 of gestation. Clinical manifestations include: -maternal weight loss, -decreased uterine size, -meconium in the amniotic fluid, -advanced bone maturation of the fetal skeleton. -Dry cracked skin, long finger and toenails, skin stained meconium, skinny, low AFV Risks -Dystocia -severe perineal injuries -Chorioamnionitis -Endomyometritis -postpartum hemorrhage -Caesarean birth

Answer 152

-Defined as abnormally slow progress of labour -Affected by powers, passenger and passageway -Greater than 4 hours of less than 0.5 cm per hour of cervical dilation in active labour or greater than 1 hour of active pushing with no descent -Dysfunctional labour from abnormal uterine contractions preventing normal progress of: Cervical dilation Effacement (primary powers) Descent (secondary powers)

Answer 153

-Frequent painful contractions that are ineffective -Felt more in midsection not fundus -Uterus not resting between contractions -Usually occur in latent stage (less than 4cm)

Answer 154

-Inadequate uterine activity -Patient makes into active stage of labour but then contractions become weak and inefficient

Answer 155

-Bearing down efforts may be compromised when large amounts of analgesics or anesthesia are given -Exhaustion from lack of sleep or long labour

Answer 156

Anomalies Cephalopelvic Disproportion Malposition (feel back labour) Malpresentation (breech) Multifetal pregnancy

Answer 157

Turning of fetus from one non-cephalic to a cephalic presentation by manipulation of the maternal abdomen External cephalic version Internal version

Answer 158

-Labour that lasts less than 3 hours from onset of contractions to the time of birth -Results from hypertonic contractions -Maybe from cocaine use, to much oxytocin, placental abruption -Can result in lacerations, PPH, uterine rupture

Answer 159

-indicates how successful induction will be -score of 7 or more, induction of labour is usually successful dilation effacement station cervical consistency cervix position

Answer 160

Chemical agents -Prostaglandins -Oxytocin Mechanical and physical methods -Dilators → balloon catheters, hydroscopic dilators (substances that absorb fluid from surrounding tissues and enlarge), lamineria tents -Less adverse effects than chemical agents Alternative methods -Blue cohosh and castor oil: labour stimulating -Black cohosh and evening primrose oil: ripen cervix -Acupuncture: stimulate contractions

Answer 161

-Artificial rupture of membranes (AROM) -Performed by primary health care provider -Often used in combination with oxytocin

Answer 162

-Hormone normally produced by posterior pituitary gland -Stimulates uterine contractions and milk let down -Used to induce labour or augment a labour progressing slowly because of inadequate uterine contractions -Hazards in the labouring patient include placental abruption, uterine rupture, unnecessary Caesarean birth because of abnormal fetal heart rate and patterns, postpartum hemorrhage, and infection.

Answer 163

-Stimulation of uterine contractions after labour has started spontaneously but progress is unsatisfactory. -Implemented for management of hypotonic uterine dysfunction -Common augmentation methods -Oxytocin infusion -Amniotomy -Noninvasive methods -Emptying bladder, ambulation, position changes, relaxation, nourishment, hydration, hydrotherapy -Nipple stimulation

Answer 164

Maternal indications -Shorten second stage in event of dystocia Fetal indications -Abnormal FHR tracing, abnormal presentation -Arrest of rotation -Delivery of head in a breech presentation -Patient must be fully dilated and engaged, with empty bladder -Outlet forceps - crowning, head is visible, least difficulty -risks --> Bruising on infants head, bell's palsy

Answer 165

-Attachment of vacuum cup to fetal head, using negative pressure to assist birth of head -Not used on babies <34 weeks -Patient must be fully dilated and engaged -Nurse document how many pulls it took -Risk to newborn of cephalhematoma, scalp lacerations, subdural hematoma

Answer 166

-Transabdominal incision of uterus -classic (vertical) - Vaginal birth is contraindicated in subsequent pregnancies due to high chance of uterine rupture -Lower segment (low transverse, low vertical) -Preoperative care -NPO 8 hours before Post-op -Vital signs q15min for 1-2 hours -Pain relief

Answer 167

-patient who has had a Caesarean birth with a low transverse uterine incision and subsequently becomes pregnant may not have any contraindications to labour and vaginal birth in that pregnancy and may be offered a TOLAC -Observance of a woman and her fetus for a reasonable period of spontaneous active labour to assess the safety of vaginal birth for both -Evaluated for the occurrence of active labour, including adequate contractions, engagement and descent of the presenting part, and effacement and dilation of the cervix

Answer 168

-Indications for primary Caesarean birth such as dystocia, breech presentation, or abnormal FHR pattern often are nonrecurring. -Success rate is 60-80% -Strong predictors of successful VBAC are prior vaginal birth and spontaneous labour

Answer 169

-Meconium-stained amniotic fluid -Shoulder dystocia -Prolapsed umbilical cord -Rupture of the uterus -Amniotic fluid embolism

Answer 170

-Indicates the fetus has passed meconium (first stool) before birth -The fluid is green in colour -Described as thin (light coloured) or thick (heavy coloured) -Meconium aspiration syndrome (MAS) -Severe aspiration pneumonia occurs most often in term or post term infant who passed meconium in utero -Collaborative care -Newborn resuscitation -Clear the airway

Answer 171

-Head is born, but the anterior shoulder cannot pass under the pubic arch. -The newborn is more likely to experience birth injuries. -Maternal complications are postpartum hemorrhage and rectal injuries. -Suprapubic pressure and maternal position changes free the anterior shoulder -Mazzanti and Rubin technique -McRoberts maneuver - patients legs are hyperflexed on abdomen -Squatting

Answer 172

-When cord lies below presenting part of fetus -Contributing factors include the following: -Long cord (>100 cm) -Malpresentation (breech or transverse lie) -Unengaged presenting part -Rupture of Membranes -Oligohydramnios

Answer 173

-Fetal hypoxemia can happen quickly -examiner putting a sterile gloved hand into the vagina and holding the presenting part off of the umbilical cord -position such as lateral recumbent, Trendelenburg, or knee–chest → gravity keeps the presenting part off the cord. -Fully dilated you can do forceps or vacuum assisted -Emergency c section

Answer 174

-Very serious obstetrical injury -Most often occurs with a previous classic incision -Uterine dehiscence - separation of a prior scar -can result in the ejection of fetal parts or the entire fetus into the peritoneal cavity -Prevention is best treatment

Answer 175

-Amniotic fluid containing particles of debris -Foreign substance enters maternal circulation -Risk factors are rapid labour and meconium staining -Triggers a rapid, complex series of pathophysiological events -Results in disseminated intravascular coagulation, hypotension, and hypoxia

Answer 176

-Oxygen (10L/min) -Prepare for intubation -CPR -IV fluids and place patient on side -Give blood

Answer 177

-reduced in the first trimester -increased during second and third trimester -episodes of hypoglycaemia more likely to appear in first trimester -insulin needs should return to normal within 7-10 days after birth if bottle feeding

Answer 178

crackles, irregular weak rapid pulse, edema, frequent cough, difficulty breathing, tachypnea

Answer 179

Positioning -modified Sims position -Trendelenburg position -knee–chest position

Answer 180

-Meconium-stained amniotic fluid -Fetal heart tones heard at or above the maternal umbilicus -Preterm labour and birth -Polyhydramnios

Answer 181

-hypotonic, uncoordinated, or infrequent uterine contractions -ineffective maternal bearing-down efforts -alterations in the pelvic structure -large fetus -short stature -Uterine overstimulation with oxytocin

Answer 182

-a prolonged latent phase (<20 hours) -protracted active phase dilation of less than 1.2 cm/hr -protracted descent of less than 1 cm/hr -no change in greater than or equal to 2 hours (secondary arrest)

Answer 183

-significant but stable antepartum hemorrhage -chorioamnionitis

Answer 184

-leading cause of maternal mortality worldwide -Any blood loss that has the potential to cause hemodynamic instability -Life-threatening, with little warning -Early/primary (within 24 hours of birth) or late/secondary (more than 24 hours after birth up to 6 weeks) -Loss of >500 mL of blood after vaginal birth -Loss of >1000 mL after Caesarean birth

Answer 185

Tone (uterine atony) Trauma (lacerations, episiotomy, uterine inversion) Tissue (retained placental fragments) Thrombin (coagulopathy)

Answer 186

-Early recognition is critical. -The first step is evaluation of contractility of uterus and amount of bleeding -Firm massage of fundus -Administer intravenous fluids and medication to manage bleeding (oxytocin) -Oxygen -Empty bladder

Answer 187

-Prevent by restoring circulatory blood volume and eliminating cause of the hemorrhage Treatment -Fluid resuscitation (3:1 ratio) -Improve or monitor tissue perfusion (Hemabate) -Transfusion -Oxygen Mild - diaphoresis, decreased cap refill, cool extremities, anxious Moderate - above + tachypnea, hypotension, oliguria Severe - above + severely hypotensive, decreased LOC (agitation, confusion)

Answer 188

Pregnant women at higher risk: -Venous stasis -Hypercoagulation Collaborative care -Superficial → analgesics NSAIDs, rest, elevation of limb, elastic compression stockings, and heat -DVT → anticoagulants, bed rest, elevation of limb, analgesia -PE → anticoagulants

Answer 189

-Most common streptococcal -Puerperal infection: any clinical infection within 42 days after abortion or birth -S/S → pyrexia (fever >38), tachycardia, localized pain -endometritis -wound infections -UTI -mastitis

Answer 190

-Infection of lining of uterus -Fever, increased pulse, chills, anorexia, nausea, fatigue and lethargy, pelvic pain, uterine tenderness, and foul-smelling, profuse lochia. -Give antibiotics

Answer 191

-C section, episiotomy -fever, erythema, edema, warmth, tenderness, pain, seropurulent drainage, and wound separation

Answer 192

dysuria, frequency and urgency, low-grade fever, urinary retention, hematuria, and pyuria

Answer 193

-Breast infection -Chills, fever, malaise, and local breast tenderness are noted first. -Localized breast tenderness, pain, swelling, redness, and axillary adenopathy may also occur

Answer 194

-Posterior displacement, or retroversion -Retroflexion and anteflexion -Uterine prolapse is a more serious displacement. -S/S → Low back pain, painful intercourse, exaggerated menstrual symptoms -Tx → Estrogen, kegel exercises

Answer 195

protrusion of bladder downward into vagina when support structures in vesicovaginal septum are injured

Answer 196

herniation of the anterior rectal wall through relaxed or ruptured vaginal fascia and rectovaginal septum.

Answer 197

-Up to 80% of women experience a mild depression or “baby blues.” -Lasts less than 2 weeks -10 to 15% of women have more serious depression. -Can eventually incapacitate women to point of being unable to care for themselves and their babies

Answer 198

-Predictor is having a partner with PMD -Anger, frustration, tired

Answer 199

1/5 Generalized anxiety disorder Obsessive-compulsive disorder Panic disorder and panic attacks Specific phobias Social anxiety disorder Post-traumatic stress disorder CBT, exposure therapy, SSRIs

Answer 200

-Characterized by low mood and lack of interest in activities, can be mild to severe -intense and pervasive sadness with severe and labile mood swings. It is more serious and persistent than postpartum blues, lasting more than 2 weeks -Can improve by 6 months postpartum naturally -Treatment options -Antidepressants, antianxiety medications, and electroconvulsive therapy -Psychotherapy focuses on fears and concerns of new responsibilities and roles; monitoring for suicidal or homicidal thoughts

Answer 201

-Syndrome characterized by depression, hallucinations, delusions, and thoughts of harming either infant or self -Onset within 2 weeks postpartum -Pre existing bipolar is a risk factor -Psychiatric emergency; may require psychiatric hospitalization -Antipsychotics and mood stabilizers such as lithium are treatments of choice

Answer 202

-Approximately 8 babies are stillborn every day -Approximately 5 babies die within the first year after birth every day -As many as 1 in 4 pregnancies end in miscarriage

Answer 203

1) Shock and numbness → first 2 weeks 2) Searching and yearning → intense grief, up to month 4 3) Disorientation → month 5-9, deep sadness and depression, disorganization 4) Recognition and resolution → 10-24 months and beyond, return to “normal” functioning

Answer 204

Help mother, father/partner, and siblings actualize their loss Help parents with decision making Help bereaved to acknowledge and express their feelings Normalize the grief process and facilitate positive coping Meeting the physical needs of the bereaved postpartum patient Creating memories for families to take home Documentation Providing sensitive care at and after discharge Grandparents and siblings

Answer 205

-Rare for woman to die in childbirth -caused by a variety of complications, including embolism, hypertension, hemorrhage, infection, and cardiomyopathy -Families are at risk for developing complicated bereavement and altered parenting of surviving baby and other children in the family. -The emotional toll on nursing and health care professionals must be addressed. -Attending the memorial or funeral service may benefit staff and family. -Debriefing

Answer 206

They promote blood flow allowing for healing and strengthening of musculature

Answer 207

sudden dyspnea and chest pain

Answer 208

-Born before completion of 37 weeks of gestation -Organ systems are immature and lack adequate physiological reserves to function in the extrauterine environment. -The lower the birth weight and the gestational age, the lower the chances of survival. -Leading cause of newborn deaths in canada High risk for problems related too: Thermoregulation Hypoglycemia Hyperbilirubinemia Respiratory distress (decreased surfactant, alveoli, muscle tone, small airways, apneic breathing patterns) Poor feeding and discharge delays Infection

Answer 209

poverty, multifetal gestation, smoking, use of IVF, low pre pregnancy weight, high stress, maternal infections, hypertension, placental conditions

Answer 210

Born between 34 and 36 6/7 weeks of gestation

Answer 211

-Oxygen therapy -Start with room air 21% (warm and humidified) -Nasal cannula Continuous distending pressure -Infants unable to maintain adequate oxygenation despite nasal cannula can use CPAP -Increases residual capacity and prevents alveolar collapse -Orogastric tube to suction to decompress stomach from the oxygen Mechanical ventilation -Indicated for apnea, meconium aspiration, RDS, congenital malformations -Bronchopulmonary dysplasia (adverse effect)

Answer 212

Tachypnea, nasal flaring, expiratory grunting

Answer 213

Hypovolemia → prolonged cap refill, pallor, poor muscle tone, lethargy, tachycardia then bradycardia, respiratory distress HR below 60 → compressions

Answer 214

Neutral thermal environment Care of hypothermic infant - Gradual rewarming, skin to skin

Answer 215

-Optimal nutrition is critical. (may need NG tube) -Sucking, swallowing, gag reflex -Can’t coordinate sucking and swallowing until 32-36 weeks -No gag reflex until 36 weeks -Necrotizing enterocolitis -Breastmilk only, formula is too hard to digest -Gavage feeding -Proves breast milk through NG or orogastric tube -Check stomach for residuals -Higher chance of rhinitis -Flush line with sterile water before and after feeds -Gastrostomy feeding -Done slowly, skin care around insertion site -Non-nutritive sucking -non-nutritive sucking on a pacifier during the procedure may improve oxygenation and facilitate earlier transition to nipple feeding

Answer 216

Become hypothermic, lethargy, poor feeding, pallor, mottling, hypotensive, tachy or brady, retractions, vomiting, diarrhea, decreased urine output

Answer 217

-Stable temp for 2-4 hours before first bath -Skin very fragile (neutral ph soaps) -Do not remove vernix

Answer 218

C section babies

Answer 219

Respiratory distress syndrome (RDS) Patent ductus arteriosus Periventricular-intraventricular hemorrhage Necrotizing enterocolitis

Answer 220

-Gestation beyond 42 weeks, regardless of birth weight Meconium aspiration syndrome (MAS) -Risk for chemical pneumonitis -Gentle oropharyngeal suctioning Persistent pulmonary hypertension of the newborn (PPHN) -Pulmonary hypertension, right-to-left shunting, and normal heart -Maybe be single entity or with MAS, RDS or others -Tx → pulmonary vasodilators

Answer 221

Perinatal asphyxia Immunodeficiency MAS Hypoglycemia → oral feedings or IV dextrose Hyperglycemia Heat loss → external heat source (radiant warmer or isolette) Polycythemia

Answer 222

-Greater risk for morbidity -Higher incidence of birth injuries -Asphyxia -Congenital anomalies

Answer 223

Macrosomia Hypoglycemia shortly after birth Hypocalcemia and hypomagnesemia Cardiomyopathy Hyperbilirubinemia and polycythemia RDS Congenital hyperinsulinemia → can lead to reduced surfactant → RDS

Answer 224

-Physical injury sustained during labour and birth -Elective Caesarean birth is chosen for some pregnancies to prevent significant birth injury.

Answer 225

-Linear fracture -Depressed fractures (ping pong ball indents) -Clavicle most commonly fractured

Answer 226

Erb palsy → arm just hanging there, not flexed Brachial palsy Facial nerve paralysis Phrenic nerve paralysis → paralyzes the diaphragm (cyanosis and resp distress)

Answer 227

Intracranial hemorrhage Cerebral palsy Seizures Hydrocephalus Spinal cord injury Hypoxic ischemic encephalopathy

Answer 228

Reduction in oxygen delivery to the fetus (caused by placental insufficiency, umbilical cord accidents, abnormal fetal presentation, prolonged late stages of labour)

Answer 229

-GBS leading cause of sepsis -Early onset (congenital) within 24-48 hours after birth -Late onset (occuring after 72 hours of age) -Acquired through the infant's environment (hospital-acquired) -Apnea, tachypnea, grunting, nasal flaring, hypotension, tachycardia, lethargy, hypotonic, seizures, vomiting, pallor, petechiae -50% mortality rate

Answer 230

group of infectious diseases that may contribute to newborn illness Toxoplasmosis Other (HBV, parvovirus, HIV, West Nile virus) Rubella Cytomegalovirus (CMV) Herpes simplex virus (HSV)

Answer 231

Neonatal Cytomegalovirus Infection

Answer 232

-changes the placental structure which may damage the placental bloodflow to baby, negatively effecting fetal growth -no convincing evidence of in-utero transmission of COVID-19 to the fetus -The rate of neonatal infection is very low -Severity of infection in infants is less then in adults

Answer 233

-breastfeeding is not contraindicated for mothers who are suspect or COVID-19 positive -just use precautions (hand washing, masks, coughing away fro infant)

Answer 234

Hand hygiene most important to reduce spread Goal is to identify causative organism Routine precautions Pregnant health care provider precautions Specimen collection Assist family with coping

Answer 235

-Hemolytic disease occurs when blood groups of the mother and newborn are different. -Rh incompatibility: -ABO incompatibility -Occur when maternal antibodies are present naturally or form in response to antigen from fetal blood crossing placenta and entering maternal circulation -High risk of jaundice

Answer 236

Congenital heart disease Abdominal wall defects Imperforate anus Neural tube defects Cleft lip or palate Clubfoot Developmental dysplasia of the hip

Answer 237

-deficiency in or absence of the enzyme needed to metabolize the essential amino acid phenylalanine into tyrosine → hyperphenylalaninemia -failure to thrive, frequent vomiting, irritability, hyperactivity, cognitive impairment. -Needs low diet in phenylalanine and medications

Answer 238

-three enzyme deficiencies → galactose accumulates in blood -Hepatic dysfunction → cirrhosis & jaundice, enlarged spleen -Vomiting, diarrhea, therapy, weight loss. -Eliminate all lactose including breastmilk

Answer 239

-poor feeding, lethargy, prolonged jaundice, bradycardia, cyanosis. -large fontanels, hoarse cry, constipation -Needs medications, lifelong thyroid hormone replacement

Answer 240

-set of behaviours exhibited by newborns exposed primarily to opioids -Intrauterine exposure to drugs may lead to neonatal intoxication or withdrawal -Is not always illicit drug use. -The presentation of NAS can be similar to, and must be distinguished from: neonatal sepsis -Hypoglycemia, -hypocalcemia -intracranial hemorrhage. -If NAS is left untreated, seizures from withdrawal and intracranial hemorrhage may occur

Answer 241

Neurological -Irritability, high-pitched cry -Seizures, hyperactivity, tremors, hypertonic muscles Autonomic -Sweating, hyperthermia, mottled skin, nasal stuffiness, tachypnea Gastrointestinal -Poor feeding, uncoordinated or ineffective suck -Vomiting, loose stools, dehydration, weight loss Miscellaneous -Disrupted sleep patterns, excoriation, temp instability

Answer 242

-eat, sleep, console Reduce environmental stimuli Rooming In Caregiver presence Skin-to-skin contact Baby held by caregiver Safe swaddling Optimal feeding at early feeding cues Quiet, low light environment Non-nutritive sucking/pacifier Rhythmic movement Additional help/support in room Cue-based responsive care Limiting visitors Caregiver self-care/rest pharmacological --> morphine

Answer 243

used for uterine prolapse A fitted pessary may be inserted into the vagina to support the uterus and hold it in the correct position

Answer 244

-overdistended uterus (twins) -magnesium sulphate during labour -forceps assisted birth -oxytocin induced labour -high parity

Answer 245

headache, nausea, vomiting, diarrhea, fever, chills, tachycardia, hypertension

Answer 246

copper coloured maculopapular rash on the palms, and around the mouth and anus

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