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Questions and Answers
What are the components assessed in the APGAR score at 1 minute and 5 minutes post birth?
What are the components assessed in the APGAR score at 1 minute and 5 minutes post birth?
Appearance, Pulse, Grimace, Activity, Respiration
What is the main cause of postpartum hemorrhage due to early blood loss after delivery?
What is the main cause of postpartum hemorrhage due to early blood loss after delivery?
Uterine atony
Which of the following are risk factors for postpartum hemorrhage? (Select all that apply)
Which of the following are risk factors for postpartum hemorrhage? (Select all that apply)
True or False: The closure of the foramen ovale in newborn circulation happens within minutes after birth.
True or False: The closure of the foramen ovale in newborn circulation happens within minutes after birth.
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Neonatal Abstinence Syndrome may present with symptoms such as irritability, jitteriness, excessive activity, and ______ cry.
Neonatal Abstinence Syndrome may present with symptoms such as irritability, jitteriness, excessive activity, and ______ cry.
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Match the following symptoms with the corresponding postpartum infection:
- Fever, chills, malaise, abdominal pain
- Hot spot, localized lump, redness
- Yellow drainage, edema, tenderness
Match the following symptoms with the corresponding postpartum infection:
- Fever, chills, malaise, abdominal pain
- Hot spot, localized lump, redness
- Yellow drainage, edema, tenderness
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What is the term for the swelling that crosses suture lines and is caused by pressure from the cervix during birth?
What is the term for the swelling that crosses suture lines and is caused by pressure from the cervix during birth?
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What can cause fontanelles to bulge in newborns?
What can cause fontanelles to bulge in newborns?
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What is the term for the localized edema caused by pressure from the cervix during birth?
What is the term for the localized edema caused by pressure from the cervix during birth?
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Which hormone is responsible for activating milk production in breastfeeding mothers?
Which hormone is responsible for activating milk production in breastfeeding mothers?
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What is the main reason Vitamin K is given to newborns?
What is the main reason Vitamin K is given to newborns?
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Bilirubin needs to be converted to its conjugated form in the liver before it can be eliminated through stool.
Bilirubin needs to be converted to its conjugated form in the liver before it can be eliminated through stool.
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_______ is when the cessation of breathing for 5 to 10 seconds followed by 10 to 15 seconds of ventilation occurs in newborns.
_______ is when the cessation of breathing for 5 to 10 seconds followed by 10 to 15 seconds of ventilation occurs in newborns.
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Study Notes
APGAR Score
- APGAR score is used to assess newborn's overall health and well-being at 1 and 5 minutes after birth
- The score is based on five criteria: appearance, pulse, grimace, activity, and respiration
- Each criterion is scored from 0 to 2, with a total score ranging from 0 to 10
- A score of 7 or higher indicates that the newborn is in good condition
- A score below 7 may indicate that the newborn needs medical attention
APGAR Criteria
- Appearance:
- 0: pale or blue
- 1: acrocyanosis (blue hands and feet)
- 2: normal color
- Pulse:
- 0: no pulse
- 1: pulse under 100
- 2: pulse over 100
- Grimace:
- 0: no response
- 1: grimace in response to stimulation
- 2: cry in response to stimulation
- Activity:
- 0: flaccid
- 1: minimal flexion
- 2: strong movement
- Respiration:
- 0: no breathing
- 1: weak cry
- 2: strong cry
Postpartum Hemorrhage (PPH)
- Defined as a blood loss of more than 500 mL for a vaginal delivery or more than 1000 mL for a cesarean section
- Early PPH: occurs within the first 24 hours after delivery
- Late PPH: occurs after 24 hours and up to 12 weeks postpartum
- Causes of PPH:
- Uterine atony (failure of the uterus to contract)
- Uterine rupture
- Placenta previa or abruption
- Lacerations or trauma
- Coagulopathy
- Risk factors for PPH:
- Prolonged labor
- Oxytocin use
- Multiple pregnancy
- Uterine fibroids
- History of PPH
Fetal Circulation and Newborn Transition
- Fetal circulation:
- Oxygen and nutrients are received from the mother's bloodstream
- Deoxygenated blood returns to the placenta
- Shunts direct blood flow from the right atrium to the left atrium
- Newborn transition:
- Initiation of respiration triggers closure of the shunts
- Foramen ovale closes within minutes
- Ductus arteriosus closes within hours
- Ductus venosus takes days to close
Risks for Postpartum Infections
- Puerperal infection: any infection that occurs after delivery
- Mastitis:
- Caused by bacteria entering the breast tissue
- Symptoms: flu-like symptoms, fever, localized pain, and swelling
- Treatment: antibiotics, continued breastfeeding, and supportive measures
- Endometritis:
- Caused by bacteria entering the uterine tissue
- Symptoms: fever, chills, malaise, and abdominal pain
- Treatment: antibiotics and supportive measures
Newborn Reflexes
- Rooting reflex: stimulates the baby to turn towards the nipple
- Sucking reflex: stimulates the baby to suckle
- Tonic neck reflex: stimulates the baby to turn its head
- Moro reflex: stimulates the baby to extend its arms and legs
Physiologic Jaundice
- Normal, non-pathologic condition that occurs in newborns
- Caused by the breakdown of fetal hemoglobin
- Appears 2-3 days after birth and peaks at 5-7 days
- Bilirubin levels rise and fall gradually
Vitamin K
- Given to newborns to prevent bleeding due to vitamin K deficiency
- IM injection is administered to help the baby clot
- Education: teach parents that it is not a vaccine
- Reason: gut is sterile, and until good bacteria colonize, vitamin K is not synthesized
Newborn Skin Assessment
- Cyanosis: indicates respiratory depression
- Acrocyanosis: a normal finding in newborns
- Vernix caseosa: a protective substance on the skin
- Stork bites: benign, blanching, and disappear in 2 years
- Millia: caused by immature sebaceous glands, no intervention needed
- Erythema toxicum: 70% of babies have this, educate parents not to pick at it
- Harlequin sign: caused by vasomotor changes, goes away
- Nevus flammeus: permanent, non-blanchable
- Nevus vasculosus: strawberry-like mass, goes away in a couple of years
Lochia
- Rubra: bright red, 1-3 days from placental site
- Serosa: pink/brown, 4-10 days, blood and wound exudate from placenta and cervical mucosa
- Alba: white/yellow, 10-14 days up to 6 weeks, WBCs and trophoblastic tissue debris
- Normal to have moderate lochia, heavier bleeding expected after sleeping or lying down
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Description
Prepare for your exam with this study guide on APGAR scores, covering appearance, pulse, grimace, activity, and respiration.
