Quiz #5 Labour & the Birthing Process, Postpartum, and Newborn Flashcards

Question

what are 3 main presentations of baby at birth?

Answer 1

1. Cephalic presentation (head first) 2. Breech presentation (legs or butt first) 3. Shoulder presentation

Answer 2

-presentation is determined by what the examiner feels first up there on check-up

Answer 3

* Maternal age * Pre-existing medical conditions: diabetes, hypertension, cardiac disease, anemia, thyroid disorder, renal disease, obesity * Genetic factors: family history * Obstetrical history: gravidity, parity, number of living children and their ages, history of stillborn, previous infant with congenital anomalies, recurrent abortions, use of assisted-reproductive technology, interpregnancy spacing

Answer 4

• Prenatal care: when started • Nutrition: weight gain, diet, obesity, eating disorders • Health compromising behaviours: smoking, alcohol or substance use • Blood group or Rh sensitization • Medications: prescription, over-the-counter, and complimentary/alternative medications -History of infection: STI's, TORCH infections, group B streptococci status

Answer 5

• Length of gestation: preterm, late preterm, term, or post term • First stage of labour: length, electronic fetal monitoring-internal or external, rupture of membranes (time, presence of meconium), signs of fetal distress, labour complications (bleeding [placental abruption or placenta prevail]), maternal analgesia or anesthesia • Group B streptococci status: treatment during labour Second stage of labour: length, vaginal or c section, instrument assisted-forceps, vacuum extractor, complications (eg. Shoulder dystocia, cord prolapse)

Answer 6

-enables rapid assessment of newborn's transition to extrauterine existence on basis of five signs indicating physiological state. The higher the number (out of 10), the better the newborn

Answer 7

1. Heart rate, based on auscultation or palpation of umbilical chord 2. Respiratory rate based on observed movement or auscultation of respiratory efforts 3. Muscle tone based on degree of flexion and movement of extremities 4. Reflex irritability based on response to stimulation 5. Generalized skin colour, described as pallid, cyanotic, or pink

Answer 8

1 and 5 min after birth

Answer 9

if score is less than 7 at 5 min, reassess Apgar 10-20 min

Answer 10

side lying position to clear secretions

Answer 11

Obligatory nose breathers

Answer 12

1. A clear airway 2. Effective establishment of respirations 3. Adequate circulation, adequate perfusion, and 4. effective cardiac function Adequate thermoregulation (exposure to cold stress increases oxygen and glucose needs). Signs of potential complications related to abnormal newborn breathing are listed in box 26-3

Answer 13

• Bradypnea- respirations less than 30BPM • Tachypnea- respirations greater than 60BPM • Abnormal breath sounds- crackles (fine crackles may be heard in first few hrs after birth) • Respiratory distress- nasal flaring, retractions, gasping -O2 sats less than 95%

Answer 14

inflammation of eyes from gonorrheal or chlamydial infection, contracted by newborn during passage through mother's birth canal

Answer 15

12-18hrs after birth 1. Perform all procedures that require quiet first (observing position, skin colour, tone, condition) 2. Next auscultate the lungs, heart and abdomen 3. Perform more disturbing procedures (temp., testing reflexes, last) 4. Measure head circumference and length as a baseline for further comparison

Answer 16

1. Lasts up to 30-60 min after birth and is called the first period of reactivity (this is where crackles may be heard through auscultation, high HR and RR until it levels out. Second period of reactivity occurs 2-8hrs after birth 2. Newborn either sleeps or has decrease in motor activity called the period of decreased responsiveness that lasts from 60-100 min 3. Second period of reactivity occurs roughly between 2 and 8hrs after birth and lasts from 10 min to several hours. Brief moments of tachypnea/tachycardia occur

Answer 17

1. Convection is the flow of heat from body surface to cooler ambient air (room @ 24deg. And cap to keep head warm) 2. Radiation is the loss of heat from the body surface to a cooler solid surface not in direct contact but in relative proximity (this is done by placing cribs away from windows where there's a draft) 3. Evaporation s the loss off heat that occurs when a liquid is converted to a vapour (failing to dry newborn where moisture occurs) 4. Conduction is the loss of heat from the body surface to cooler surfaces in direct contact (scales should have a cover to minimize conductive heat loss)

Answer 18

father and mother gazing at baby for prolonged periods of time

Answer 19

direct eye contact which is the beginning of attachment

Answer 20

BP- 70/45 Pulse- 110-160 and 90/140 Temperature- 37.5 Oxygen Sat- 95-100

Answer 21

the waxy or cheese-like white substance found coating the skin of newborn human babies

Answer 22

acro- bluish or purple colouring of the hands and feet caused by slow circulation. lanugo- fine, soft hair, especially that which covers the body and limbs of a human fetus or newborn.

Answer 23

small, bump-like cysts found under the skin.

Answer 24

common rash

Answer 25

edema of the scalp, resolves in a few days

Answer 26

collection of blood between periosteum and skull bone due to birth trauma and may take weeks to resolve. may be more prone to jaundice

Answer 27

softening of the cranial bones in utero that takes several months to resolve. normal in newborns but not in older infants etc