Part III Flashcards
(25 cards)
Explain Postpartum Psychosis?
· Postpartum Psychosis
- Incidence is one in 1000 live births.
- Usually happens within 3 months.
- Onset abrupt-Considered an emergency!
- Depersonalization, confusion, hallucinations, psychomotor disturbances
- Significant risk factors include history of bipolar disorder or postpartum psychosis
Treatments-lithium, antipsychotics, psychotherapy, removal of baby, social support
Explain Posttraumatic Stress Disorder.
Posttraumatic Stress Disorder
- Labor reality fails to meet expectations-usually experienced complications.
- Intrusive flashback thoughts, difficulty thinking/sleeping, irritability, avoidance of others.
- Significant risk factors include prior trauma, psychiatric history, and women who have emergency cesareans.
Explain APGAR scoring
APGAR SCORING
· Completed at 1 & 5 minutes of age
· Assesses: heart rate, respiratory effort, muscle tone, reflex irritability, and color
· Highest score is 10 points
o 8-10 points considered normal
o 4-7 points equals moderate difficulty
o Continue to score if 5-minute score is 6 or less
· Purpose: To assess the transition to extrauterine life and help determine interventions
When is APGAR scored?
Completed at 1 & 5 minutes of age
What is the purpose of APGAR?
Purpose: To assess the transition to extrauterine life and help determine interventions
What is scored with APGAR?
Assesses: heart rate (not rhythm), respiratory effort, muscle tone, reflex irritability, and color
What are the Newborn Vital Signs?
NEWBORN VITAL SIGNS
· RR: 30-60 (irregular is normal; count a full minute)
· HR: 110-160 (normal rhythm expected; count a full minute)
· BP: 75-50/45-30 mm Hg at birth
Axillary Temperature: 97.7-99.5 F
o Murmurs not uncommon
o Assess distal pulses
Are murmurs and crackles okay to hear in Newborns?
yes! Murmurs are not uncommon (blood flow changes direction after cord is cut)
*Crackles are also normal to hear!
Ex:
What is the APGAR of the following 1-minute old baby?
- HR: 155
- semi-flaccid
- Acrocyanosis
- crying vigorously with stimulation
APGAR 8 (10 minus 2)
HR: full pts
Tone (semi-flaccid): -1
Color (Acrocyanosis): -1
Ex:
What is the APGAR of the following 1-minute old baby?
- HR 185
- weak respiratory effort
- grimaced with stimulation
- blue all over
- semi-flaccid
APGAR 5 (10 minus 5)
weak respiratory effort: -1
Grimace with stem: -1
tone: - 1
color: -2
*HR is high but with APGAR it just needs to be above 100! Full points given
What are ways to prevent Newborn Hypothermia?
Keep hat on, swaddle, skin to skin, dry baby off
Low temperature leads to ___________.
hypoglycemia
What is a way to help keep a baby from losing heat through evaporation?
keep the baby dry
What is a way to help keep a baby from losing heat through conduction?
Keep a cold object/surface from touching the baby
What is a way to help keep a baby from losing heat through radiation?
don’t place the baby by cold objects
What is a way to help keep a baby from losing heat through convection?
don’t place the baby where there is a cold draft
What are s/s or hypothermia in infants?
Signs/Symptoms of hypothermia:
o Poor feeding, hypoglycemia
o Lethargy, irritability
o Low temp, cool, mottled skin
o Poor muscle tone
o Tachypnea (rate > 60)
What is a bishop score?
Measures the readiness of the cervix and how likely an induction will be successful
What is a Ballard score?
BALLARD SCORING TOOL
· Gestational Age Assessment-Does the physical appearance match the assumed age of the baby?
· Typically done within 2 hours of birth
How would a term vs preterm baby look different?
Preterm Baby: More lanugo (hair on body); more vernix (white coating); soft; more flexible; smooth, non-creased
Term Baby: less lanugo (hair on body); dry, cracked (esp. postterm); less flexible; deep creases on bottom of feet
What is SGA, LGA, and AGA?
· SGA: Small for Gestational age (Birth weight is < 10th percentile)
· LGA: Large for Gestational age (Birth weight is > 90th percentile)
· AGA: Average for Gestational age (Birth weight is between 10th and 90th percentiles)
How many weeks along is a premature and post-term baby?
· Prematurity: < 37 weeks’ gestation
· Post-term: > 42 weeks’ gestation
What is important to remember to remember about newborn safety and security?
· Locked Maternity Units
· ID bands & security monitors placed on baby in delivery room
· Digital footprints or cord blood for DNA
· Teach family about process, safety, and staff ID
o All staff should have proper ID-Alert staff immediately if uneasy
o Keep infant on the side of the bed furthest from the door
o All staff will transport the baby in a crib
· Code “Adam”
What are the 3 newborn medications given?
NEWBORN MEDICATIONS
· Vitamin K (AquaMEPHYTON) - IM injection
o Treatment of Vitamin K deficiency bleeding
o Promotes liver formation of clotting factors
· Erythromycin 0.5% - eye ointment
o Prophylactic treatment of Ophthalmia neonatorum
o Required by law, but parents can refuse
o Gonorrhea & Chlamydia
· Hepatitis B- IM vaccine offered
