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LCON OB > Final Exam Blueprint > Flashcards

Final Exam Blueprint Flashcards

1
Q

Initial newborn

A

➤ Airway maintenance (Suction mouth 1st then nose)
➤ Maintaining Adequate O2 supply
➤ Maintaining body temperature
➤ Eye prophylaxis
➤ Vitamin K prophylaxis
➤ Promoting parent-infant interaction
➤ Skin-to-skin contact

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2
Q

Deceleration causes

A
  • These are periodic changes in FHR.

🔸 Early Decels
- Responses to the fetal (HEAD COMPRESSIONS)
- These are OK

🔸 Late Decels
- Caused by Uteroplacental (PLACENTA) insufficiency
- These are NOT Ok

🔸 Variable Decels
- These are caused by (CORD COMPRESSION)
- Abrupt/sudden drop that lasts more than 15 secs
- Periodic changes (with contractions)
- Episodic changes (w/out contractions)

🔸 Prolonged Decels
- Interruption to the fetal oxygen supply

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3
Q

Newborn Nutrition

A

🔸 Fluids
- 60-80 mL/kg per day for first 2 days of life (no water)

🔸 Energy
- Human milk and most formulas are 20 kcal/oz.

🔸 Carbohydrate
- 60 g/day for first 6 months of life

🔸 Fat
- 31 g/day for first 6 months of life

🔸 Protein
- 9.1 g/day for first 6 months of life

🔸 Vitamins
- Provided by breast milk or formula. AAP recommends Vitamin D supplementation for breastfeeding infants.

🔸 Minerals
- Calcium, phosphorus, iron, fluoride all provided by both types of milk

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4
Q

Formula Feeding

A

➤ Teach parents about how to prepare & store
- 15-30mL each feed for first 48 hrs

➤ Feed on demand 6-8 feeds per 24 hrs

➤ Hold bottle semi-upright while supporting head
- NEVER prop a bottle bc baby can choke
- Burp baby several times to avoid spitting up

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5
Q

A breastfeeding mom develops engorged breasts 3 days after birth. What action would help this woman achieve her goal of reducing the engorgement?

A

Breastfeeds infant every 2 hrs

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6
Q

Premenstrual Syndrom (PMS)

A
  • It states 2-3 days before periods start

🔸 S/S of PMS
* Fluid retention
* Pelvic fullness
* Edema of lower extremities
* Bloating
* Weight gain
* Breast tenderness
* Panic attacks
* Increased appetite
* Headaches
* Fatigue
* Backaches
* Premenstrual cravings (sweets, food bings, salts, increases appetite)
* Emotional/behavioral change (Depressions, crying spells, irritability)

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7
Q

Antepartum testing

A

🔸 1st Visit (within 12wks)
- HCG
- RPR
- HIV
- A1C
- UA
- CBC w/diff
- Blood Type & Rh
- Cervical exam and pap smear
- Hemoglobin Electrophoresis (check anemias)

🔸 Once a month (wk 12-28)
- UA at every visit
- TB skin test
- Rubella titer
- Hep B test
- Triple Screen
- Ultrasound 18-20 weeks
- 1hr glucose tolerance test @ (24-28 weeks)

🔸 Every 2 wks (Starts wk 29-36)
- UA at every visit
- Ultrasound if not done before
- Blood Type & Rh

🔸 Weekly (wks 36 - delivery) - Important
- GBS
- HIV
- Cervical exams
- POSSIBLE U/S for presentation

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8
Q

Intrapartum

A

During delivery

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9
Q

Breastfeeding hormones

A

🔸 Prolactin
- Milk production

🔸 Oxytocin
- Milk ejection reflex (Let down)

🔸➤ Prolactin & Oxytocin are called MOTHERING HORMONE

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10
Q

Induction of labor

A

➤ Its the use of medications or other methods to bring on (induce) labor

➤ Its the stimulation of contractions that have not begun naturally

➤ Occurs 39 wks or Greater

➤ It could be Elective induction

➤ Cervical ripening methods
- Promote cervical softening, dilation, & effacement

➤ Chemical agents like prostaglandins can soften & thin the cervix

➤ Mechanical & physical methods help stimulate release of prostaglandins
- Inserting a balloon catheter can thin out the cervix
- Physical methods like sex becoz semen has prostaglandins, nipple stimulation causes oxytocin release, & walking

➤ Amniotomy which is artificial rupture of membranes, make sure fetus is at 0 station

➤ Oxytocin (low dose)

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11
Q

Major factors that affect the
labor process.

A

🔸 Passanger.
- Size of fetal head
- Fetal presentation
- Fetal lie
- Fetal attitude
- Fetal position

🔸 Passageway
- Also known as the Birth canal.
- is composed of :-
* Boney pelvis
* Soft tissues

🔸 Powers
- Primary powers (Involuntary contractions)
- Secondary powers

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12
Q

What are the 5 p’s

A

🔸 Passenger
(Fetus & Placenta)

🔸 Passageway
(Birth canal)

🔸 Powers
(Contractions & maternal pushing efforts)

🔸 Psychologic Response
(Emotional response)

🔸 Position of Mother

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13
Q

Antepartum

A

Before delivery

🔸 1st Trimester
- ( 0 - 13 wks)

🔸 2nd Trimester
- (14 - 26 wks)

🔸 3rd Trimester
- (27 - 40 wks)

🔸 4th Trimester
- (After delivery - 6wks)

➤ Gestation is 40 wks (10 months)

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14
Q

Signs and symptoms of
pregnancy: presumptive,
probable, and positive.

A

🔸Presumptive signs (Subjective Signs)
- Breast changes
- Amenorrhea
- Nausea & Vomiting
- Urinary frequency
- Fatigue
- Quickening= 1st recognition of fetal movement

🔸Probable signs (Objective)
- Goodell sign (softening of cervical tip)
- Chadwick signs (bluish color of cervix)
- Hegar sign (softening and thinning of the uterus)
- Positive result of pregnancy test (serum)
- Positive result of pregnancy test (urine)
- Braxton hicks contraction (false contractions)
- Ballottment

🔸Positive signs (Diagnostic Signs)
- Visualization of fetus by real-time ultrasound
- FHTs detected by ultrasound
- Visualization of fetus by radiographic study
- FHTs detected by Doppler ultrasound stethoscope
- FHTs detected by fetal stethoscope
- Fetal movement palpated
- Fetal movement visible

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15
Q

Naegele’s Rule; EDD (estimate
date of Delivery

A
  • To determine the Expected Date of
    Delivery (EDD), take the Last Menstrual
    Period (LMP) date, add 7 days, and count
    back 3 months.

➤ LMP + 7 days - 3 months = EDD

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16
Q

GPTAL

A

🔸 Gravida
- Number of times the patient is pregnant,
including a current pregnancy

🔸 Preterm
- Number of deliveries that were 20.0 to 36.6
weeks gestation

🔸 Term
- Number of deliveries that were 37 or more
weeks gestation

🔸 Abortions
- Number of times uterus was emptied prior to
20 weeks (Are not viable)

🔸 Living
- Number of children that are alive

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17
Q

Endocrine system (Pregnancy Hormones)

A

🔸 Human Chorionic Gonadotropin (hCG)
- Maintains corpus luteum production of Estrogen & Progesterone until placenta takes over

🔸 Human Chorionic Somatomammotropin (hCS)
- Also known as Human Placental Lactogen (hPL)
- Acts as growth hormone
- Contributes to breast development
- ↓ Metabolic of glucose
- ↑ fatty acids for metabolic needs

🔸 Progesterone
- ↓ secretion of FSH/LH
- ↓ Uterine contractility
- ↓ Ability to use insulin
- Maintains pregnancy by relaxing smooth muscles
- ↑ Fat deposits in SubQ tissue over the abdomen, back & upper thigh

🔸 Estrogen
- ↓ secretion of FSH/LH
- ↓ maternal use of insulin
- Relaxes pelvic ligaments & joints
- Interferes with folic acid
- ↑ Fat deposits in SubQ tissue over the abdomen, back & upper thigh-
- ↑ Size of the genitals, uterus & breasts
- ↑ Vascularity
- ↑Total body proteins
- ↑ Retention of Na+ & H2O

🔸Insulin
- ↑ production of insulin to compensate for insulin antagonist caused by placental hormones (insulin antagonists decrease tissue sensitivity to insulin/ability to use it)

🔸 Oxytocin
- Stimulates uterine contractions
- Stimulates milk ejection from the breasts

🔸 Cortisol
- ↑ production of insulin
- ↑ peripheral resistance to insulin

🔸 Prolactin
- Prepare breasts for lactation

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18
Q

Roles for Nurses in Genetics

A

➤ They identify families in need genetic Counseling

➤ They collaborate with other interprofessional teams to make referrals to specialists in genetics

➤ They provide emotional support during all aspects of the counseling process 🔸🔸🔸

➤ They are needed to provide individuals & families maximize the benefits of genetic revolution…but first nurses need :-
* Working knowledge
* Awareness of recent advances
* Understanding of possible effects on families

🔸 The best time to ask about genetic counseling is :-
* Before pregnancy
* During pregnancy
* After delivery

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19
Q

Neonatal Care
Management/interventions

A

➤ Airway maintenance (Suction mouth 1st then nose)
➤ Maintaining Adequate O2 supply
➤ Maintaining body temperature
➤ Eye prophylaxis
➤ Vitamin K prophylaxis
➤ Promoting parent-infant interaction
➤ Skin-to-skin contact

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20
Q

Newborn vital signs

A

🔸 HR
- Normal (120 -160 bpm)
- Sleeping (80 -100 bpm)
- Crying (180 bpm or greater)

🔸 BP
- At birth (75-95/37-55 mmHg)
- 12 hrs (50-70/25-45)
- 96 hrs (60-90/20-60)

🔸 RR
- (30 – 60 bpm)

🔸 Blood volume
- (80 -100 mL/kg)

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21
Q

APGAR Score

A

🔸 Apgar
- Appearance
- Pulse
- Grimace
- Activity
- Respiration

🔸 Score 2
- A (Pink)
- P (>100 bpm)
- G (Cries & Pulls away)
- A (Active movements)
- R (Strong Cry)

🔸 Score 1
- A (Extremities Blue)
- P (<100 bpm)
- G (Grimaces/ Weak cry)
- A (Arm, leg flexed)
- R (Slow, irregular)

🔸 Score 0
- A (Pale/ Blue)
- P (No pulse)
- G (No response to stimulation)
- A (No movements)
- R (No breathing)

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22
Q

Signs of Prolapsed Umbilical Cord

A
  • Women feels cord after membrane rupture
  • Rupture of membranes can lead to infection & prolapsed cord!!!

🔸 This can lead to chorioamnionitis so limit vaginal exams

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23
Q

Cold Stress in newborns

A
  • It occurs when hypothermia in newborns is not corrected.
  • ↑ O2 demand
  • ↑ RR
  • ↓ O2 levels causing respiratory destress
  • ↓ PO2
  • ↓ Blood pH
  • ↓ Blood glucose

➤ Skin-to-skin is the ideal way to maintain warmth

🔸 Don’t bath the Newborn right after they are born

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24
Q

What are the Nursing interventions of Cold stress in Newborns?

A

➤ Check the Temperature
➤ Encourage the mother to breastfeed to prevent hypogycemia
➤ Assess the Respiration for Respiratory destress
➤ Newborns temperature should remain 97.7°F to 99.5°F
➤ Skin-to-skin contact promotes temperature regulation
➤ Baby’s do not shiver; they may cry, not feed, or become pale
➤ Dress the baby in warmer clothes
➤ Move the baby to a warmer environment or away from any cold areas
➤ Use breast milk or formula feeding to help warm up the baby

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25
Q

Signs and symptoms of Mastitis

A

➤ Sudden onset of influenza-like symptoms:-
* Chills
* Headaches
* Malaise
* Body aches
* High fever
* Nausea & Vomiting
➤ Localized breast pain & tenderness
➤ Hot & red area on the breast

🔸 Most common in the Upper Outer quadrant of the breast

🔸Pts will need antibiotics & NSAIDs

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26
Q

Normal vital signs for newborn

A
  • Temp (98.6-100.0 (rectal))
  • HR (120-160)
  • RR (30-60)
  • BP: systolic 60-80; diastolic 40-50
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27
Q

Why is Erythromycin Eye Ointment used?

A

To prevention of Ophthalmia Neonatorum cause by Gonococcal or Chlamydia

28
Q

Uniqueness of human milk

A

➤ Its the Gold standard for infant nutrition
➤ Its easy to digest
➤ It meets the nutritional needs for growing infants
➤ It improves the infants response to infection
➤ Its important in the regulation of inflammatory responses
➤ It contains immunologically active components that provide some protection against :-
* Broad spectrum bacteria
* Viral & protozoal infections

➤ Its highly complex with:-
* Ant-infective
* Nutritional components combined with growth factors, enzymes that aid in digestion & absorption of nutrients
* Fatty acids that promote brain growth & development

29
Q

Why do breastfeeding babies need (Vitamin D)

A
  • It’s the only thing missing from human breast milk

Vitamin D is essential for :-
* Facilitating intestinal absorption of Calcium & Phosphorus
* Bone mineralization
* Calcium reabsorption from the bones

30
Q

Why are Newborns given Vitamin K prophylaxis?

A
  • Vitamin K is required for Blood coagulation
  • Newborns don’t have the intestinal flora to produce Vitamin K
  • So Vitamin K injection is given to every newborn at birth to prevent hemorrhagic complications in newborns
31
Q

Teaching on Morning sickness during pregnancy

A

➤ Eat dry, starchy foods like toast or crackers on awakening in the morning
➤ Avoid drinking too much fluids in the morning or when nauseated
➤ Eat small amounts frequently like every 2-3 hours
➤ Avoid skipping meals
➤ Get out of bed SLOWLY
➤ Decrease intake of fried foods & other fatty foods
➤ Avoid brushing teeth immediately after eating

32
Q

Ortolani Maneuver

A
  • Its used to confirm the hip dysplasia/ dislocation.
  • Hip integrity is assessed by using Ortolani Maneuver; only doctors or NP’s can do this!

🔸 Flex the infant’s hips & knees to 90 degrees & apply pressure over the leg & gently adduct the leg with your thumbs. If the hip was dislocated a clunk will be felt as the hip relocates. This would be considered a positive ortolani test.

33
Q

Newborns feeding Cues (early signs of hunger)

A
  • Sucking /mouthing motions
  • Hand-to-mouth/hand-to-hand movements
  • Rooting reflex (infant moves towards whatever touches the area around the mouth & attempts to suck
34
Q

Breastfeeding positions

A

🔸 Cradle position
- Most common position for infants who learned to latch

🔸 Cross-cradle/Modified cradle positions
- Across the lap
- Works for smaller babies

🔸 Football/ clutch hold
- Under the arm

🔸 Side lying
- Allows the mother to rest while breastfeeding

🔸 Laid back position

35
Q

National recommendations for breastfeeding for the USA

A

➤ Infants should be exclusively breastfed for 6 months

➤ Breastfeeding should continue for 1 year & thereafter as desired by mother and infant

➤ Receive safe & nutritionally adequate complementary foods beginning at 6 months

36
Q

Newborn senses

A

🔸 Vision
- Pupils react to light & they have the blink reflex.
- They can see objects as far as 2.5ft
- Clear visual distance is 8 -12 inches; this is kind of the distance between mom’s & infant’s faces during breastfeeding. (they can have blurry vision
until a foot away)
- Newborn’s prefer their mom’s face

🔸 Hearing
- Prefer hearing their mother’s voice & rhythmic sounds
- They recognize sounds & attempt to locate a source.
- They are used to hearing a regular rhythm of mom’s heartbeat so this
sound is very soothing to them.
- You can even place a regular heartbeat stimulator nearby to help a
fussy baby

🔸 Smell
- Highly developed sense of smell & can react to odors.
- Can smell their own mom’s milk

🔸 Taste & touch
- Prefer sweet stuff & they respond to touch
- Early skin-to-skin contact promotes tactile interaction & stimulation.

37
Q

Newborn skin normal findings

A

🔸 Skin is very thin at birth
🔸 Desquamation
- skin peeling at few days old; happens more w post-term babies

🔸 Vernix caseosa
- Its the cheesy white substance covering the body
- It serves as a protective covering.

➤ Removal of this is followed by desquamation

🔸 Milia
- Tiny white bumps usually on nose & forehead; these are sweat glands.

🔸 Congenital dermal melanocytosis
- Also know as Mongolian spots
- Its the blue/black areas of hyperpigmentation

🔸 Nevi
- Also known as Stork bites
- Are very common pink areas & require no treatment.

🔸 Erythema toxicum
- Also known as Newborn rash
- It looks alarming but doesn’t require treatment.

➤ Signs at risk for integumentary probs:-
* Jaundice
* Pallor
* Lesions
* Petechiae

38
Q

Prolapsed umbilical cord

A
  • When the umbilical cord exits the cervical or before/below the fetal presenting part
39
Q

Factors contribution to Prolapsed umbilical cord

A
  • Long cord (longer than 100 cm)
  • Malpresentation (breech)
  • Transverse lie
  • Unengaged presenting part
40
Q

Nursing interventions of Prolapsed Umbilical Cord

A

➤ Put sterile gloves on and insert two fingers into vagina into the cervix. Push head back to relieve pressure

➤ Do not remove or move your hand bcoz you need to relieve cord compression! Have someone else put a towel under the woman’s hip.

➤ Place women to extreme modified sims position or knee position (looks like doggy style)

➤ If cord is protruding from vagina, wrap it loosely in a sterile towel with saline.
➤ Administer oxygen with non-rebreather mask at 10L

➤ Start IV fluids

➤ Monitor FHR

41
Q

VEAL, CHOP, MINE

A

🔸 VEAL
* Variable decelarations (Cord Compression)
* Early decelarations (Head Compression)
* Accelarations
* Late decelarations (Placenta insufficiency)

🔸 CHOP
* Cord compression
* Head compression
* Ok
* Placenta insufficiency

🔸 MINE
* Move the mother (Change the position)
* Intervention is not necessary
* No intervention needed
* Evaluate for why
- Stop Pitocin
- Give O2
- Give fluids
- Reposition mother
- possible c-section if persists

42
Q

A woman is pregnant for the second time. With her first pregnancy, she gave birth at 35 weeks; the child is currently 3 years old. what she GTPAL?

A

G2, T0, P1,A0, L1

43
Q

Variability and the types of Variability.

A

🔸 Variability - is the fluctuation in the baseline FHR.

➤ Absent
- 0 bpm
- Undetectable or abnormal
- Fetal hypoxemia or metabolic acidosis

➤ Minimal
- < 5 bpm

➤ Moderate
- 6 to 25 bpm
- Normal

➤ Marked
- > 25 bpm
- Unclear significance

➤ Sinusoidal Pattern
- Wavy line
- Its a fatal sign (NOT A GOOD SIGN)

44
Q

Umbilical cord care

A

➤ Cord care is done to prevent or decrease risk of hemorrhage or infection becoz the stump is at risk for bacterial growth.

➤ Clean cord with water (Don’t use an antiseptic)

➤ The plastic cord clamp that was applied at birth is removed once the stump has dried typically in 24-48 hrs.
- Stump should be assessed for edema, redness, & drainage.
- Area should be kept clean, dry, open to air, & loosely covered

45
Q

Newborn screening including (Labs & diagnostic tests)

A

🔸 Venipuncture & urine specimen & Newborn screening:-

➤ Screening for Genetic, Endocrine & Metabolic disorders
- Screening is important for early detection of genetic diseases that result in severe health problems.
- Blood samples are used to screen for those disorders; capillary heelstick!

➤ Newborn hearing screening
- Rubber earpiece is placed in babies ear & in a healthy ear you can hear an “echo”

➤ Screening for critical congenital heart disease
- Pulse ox is used to detect hypoxemia; if its at 90% you need to assess the baby

46
Q

Circumcision care

A

➤ Circumcision is removal of the foreskin (prepuce) of the penis
➤ Baby can be fussy, have disturbed sleep-wake states & disorganized feeding behaviors after the procedure.
➤ If bleeding occurs on an incision site nurse should apply gentle pressure with a gauze pad.
➤ Infant should have a wet diaper 2-6x every 24 hrs
➤ Keep the area clean & cleanse penis w water only; DO NOT USE BABY WIPES
➤ Apply diaper loosely to prevent pressure
➤ The glans of penis is dark red after circumcision & then becomes covered in yellow exudate (this is normal, DO NOT remove the exudate becoz its granulation tissue)
➤ Redness, swelling, discharge & odor indicates infection
➤ Nurse provides education to parents; discomfort for the baby will subside

47
Q

Hyperbilirubinemia therapy for jaundice

A

➤ Hyperbilirubinemia is associated with high levels of bilirubin
➤ Physiologic jaundice requires no treatment; its caused by high levels of unconjugated bilirubin; it appears after 24 hrs & resolves in 1-2 weeks.
➤ Pathologic jaundice requires phototherapy to help treat becoz these are even higher levels of unconjugated bilirubin
➤ Phototherapy converts bilirubin to a form that can be excreted via urine & poop. Baby should only wear diaper!
➤ Exchange transfusion: when phototherapy is not effective this may be needed. A portion of the infant’s blood is replaced with donor blood.

🔸 Screening process:
- Measure total serum bilirubin by getting blood from babies heel (heel stick)

48
Q

Hypoglycemia

A

➤ Early & regular feedings can help prevent this.

🔸 Symptoms of Hypogycemia
* Jittery
* Apnea
* Seizures
* Lethargy
* Poor feeding
* Abnormal cry
* Hypotonia
* Hypothermia,
* Respiratory distress

49
Q

Neonatal pain

A

🔸 Pain can cause:-
* ↑ HR
* ↑ or ↓ BP
* Rapid, shallow respirations
* Baby has high pitched & shill cry

🔸 Facial expressions include:-
* Grimacing
* Eye squeeze
* Open mouth
* Quivering tongue

50
Q

Non-pharmacological & Pharmacological interventions of Neonatal pain

A

🔸 Non-Pharmacological Interventions
- Swaddling
- Breastfeeding
- Skin-to-skin contact
- Tucking
- Pacifier use
- Oral sucrose

🔸 Pharmacological interventions
- Non-opioid analgesia eg. (tylenol can be used for mild to moderate pain)

51
Q

A nurse administers vitamin K to the newborn for which reason?

A

Bacteria that synthesize vitamin K are not present in the newborn’s intestinal tract/ help with the clotting factors

52
Q

Diabetes mellitus

A
  • Most common endocrine disorder associated with pregnancy!!!!!
    • High risk
    • Key to an optimal outcome is strict maternal glucose control of HbA1c optimal between 5-6%
53
Q

Gestational diabetes mellitus (GDM)

A

➤ If you had diabetes before getting pregnant, its not gestational!

➤ Any degree of glucose intolerance with onset or recognition during pregnancy

➤ Glycosylated hemoglobin A1c
* 5-6% optimal level to avoid babies that are too large (macrosomia)

➤Screen at 24 to 28 weeks with glucola drink
* If blood sugar is too high, you have to do a 3 hour test and get blood drawn once every hour

🔸 Antepartum care
* Diet & exercise
* Insulin therapy
* Monitor blood glucose levels
* Fetal surveillance!

🔸 Intrapartum
* Avoid dextrose solutions
* Monitor glucose hourly🔸🔸🔸

🔸 After birth care
* Encourage breastfeeding to decrease risk of getting type 2 diabetes after GDM

🔸➤ After birth reassess at 6-12 weeks because gestational is supposed to go away!

54
Q

Pregestational diabetes mellitus

A

➤ 6 - 6.5 A1c before pregnancy may be an indicator

55
Q

Preeclampsia

A

➤ Its HTN in pregnancy

➤ Most common medical complication reported during pregnancy

➤ Pregnancy specific condition in which hypertension and proteinuria develop after 20 wks gestation in previously normotensive women:-
* HTN & protein in urine
* Reflexes increased (+3 or +4)
* Seizures (eclampsia)

➤ Resolves after placenta is expelled (usually)

🔸 Care management of Preeclampsia
* Magnesium sulfate

(always have calcium carbonate at bedside)

56
Q

HELLP syndrome

A

➤ Its a lab diagnosis for preeclampsia that involves hepatic dysfunction
➤ Can develop in women who do not have HTN & proteinuria
➤ Most common in White women
* Hemolysis, Elevated Liver enzymes, Low Platelets
* Diagnosed by labs
* Increased risk of maternal death
* Super sick

➤ HELLP Syndrome can cause
* Pulmonary Edema
* Acute renal failure
* Placental abruption
* Liver hemorrhage/failure
* Acute respiratory distress syndrome
* Disseminated intravascular coagulation (DIC)

57
Q

Bulb syringe suctioning

A

🔸 Keep the bulb syringe easily accessible and visible
- Its used only when there is a concern that the airway is obstructed.
- This suctioning can cause trauma to the nasal mucosa

🔸 Suction Mouth before the nose
- This prevents the infant from inhaling the pharyngeal secretions by gasping as the nares as touched

🔸 Compress the bulb and insert the tip into one side of the mouth.
- Avoid the center of the infant’s mouth becoz the gag reflex can be stimulated

🔸 Gently suction one nasal passages at a time

🔸 Stop suctioning when the airway is no longer obstructed

🔸 Clean the bulb with warm soapy water & rinse thoroughly after each use

58
Q

Protective Environment

A
  • Focuses on the non-separation of mothers & babies (rooming in) to reduce the need for a separate nursery
59
Q

What should be avoided in male infants until after Vitamin K injection?

A

Circumcision

60
Q

Acrocyanosis is an expected (Normal) finding for?

A

The first 24 hrs

61
Q

True/false Murmurs are common in Newborns?

A

True

62
Q

Signs & symptoms of Respiratory Distress

A
  • Cyanosis
  • Stridor
  • Gasping
  • Wheezing
  • Nasal flaring
  • RR < 30 or >60 bmp
  • Retraction btw the ribs
63
Q

Neonate

A
  • Its the period btw Birth & day 28 of life
  • Major adaptations occur the First 6-8 hours
64
Q

First Period of reactivity

A
  • It lasts for 30 mins
  • HR ↑ btw 160-180 bmp (1st 30 mins)
  • HR ↓ after 30 mins to baseline (120 -160 bmp)
  • Infant alert & has spontaneous startles, Crying & head movements
65
Q

Period of decreased responsiveness
(Follows 1st period of reactivity)

A
  • Lasts from 60 - 100 mins (1-2 hrs)
  • Infant is pink
  • RR are rapid & shallow up to 60 bmp
  • Baby is asleep or contented (has a marked decrease in motor activity)
66
Q

Second period of reactivity
(Follows the period of decreased responsiveness)

A
  • Lasts from 10 min - several hrs
  • Infant is wide awake, alert
  • Occurs btw 2 - 8 hrs after birth
  • Tachycardia & tachypnea occurs intermittently
  • Meconium may be passed
  • Increased muscle tone, Change in skin color (skin pinks -up) & mucus production
67
Q

The nurse knows that thermoregulation presents a problem for newborns becoz?

A

The thin layer of SubQ fat provides poor insulation

LCON OB (5 decks)

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