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Questions and Answers
A woman who is breastfeeding should rub a mild emollient cream or a few drops of breast milk (or ______) on the nipples after each feeding.
A woman who is breastfeeding should rub a mild emollient cream or a few drops of breast milk (or ______) on the nipples after each feeding.
colostrum
Breastfeeding mothers should increase their fluid intake to ______ to 3 qt (2,500 to 3,000 ml) daily.
Breastfeeding mothers should increase their fluid intake to ______ to 3 qt (2,500 to 3,000 ml) daily.
2½
Human immunodeficiency virus (HIV) can be transmitted by an HIV-positive mother who ______ her infant.
Human immunodeficiency virus (HIV) can be transmitted by an HIV-positive mother who ______ her infant.
breastfeeds
The initial weight loss for a healthy neonate is ______% to 10% of birth weight.
The initial weight loss for a healthy neonate is ______% to 10% of birth weight.
The neonatal period extends from birth to day ______.
The neonatal period extends from birth to day ______.
A very-low-birth-weight neonate weighs ______ g (3 lb 5 oz) or less at birth.
A very-low-birth-weight neonate weighs ______ g (3 lb 5 oz) or less at birth.
The specific gravity of a neonate’s urine is 1.003 to ______.
The specific gravity of a neonate’s urine is 1.003 to ______.
Prolactin stimulates and sustains ______ production.
Prolactin stimulates and sustains ______ production.
When providing phototherapy to a neonate, the nurse should cover the neonate’s ______ and genital area.
When providing phototherapy to a neonate, the nurse should cover the neonate’s ______ and genital area.
The narcotic antagonist ______ may be given to a neonate to correct respiratory depression caused by narcotic administration.
The narcotic antagonist ______ may be given to a neonate to correct respiratory depression caused by narcotic administration.
In a neonate, symptoms of respiratory distress syndrome include expiratory grunting or whining, sandpaper breath sounds, and ______ retractions.
In a neonate, symptoms of respiratory distress syndrome include expiratory grunting or whining, sandpaper breath sounds, and ______ retractions.
Neonates born to mothers who smoke weigh, on average, ______ oz (170 g) less than those born to nonsmoking mothers.
Neonates born to mothers who smoke weigh, on average, ______ oz (170 g) less than those born to nonsmoking mothers.
In a neonate, long, brittle fingernails are a sign of ______.
In a neonate, long, brittle fingernails are a sign of ______.
Lanugo covers the fetus’s body until about ______ weeks gestation.
Lanugo covers the fetus’s body until about ______ weeks gestation.
Erythromycin is given at birth to prevent ______ neonatorum.
Erythromycin is given at birth to prevent ______ neonatorum.
Milia may occur as ______ spots over a neonate’s nose.
Milia may occur as ______ spots over a neonate’s nose.
The Apgar score is used to assess the neonate’s ______ functions.
The Apgar score is used to assess the neonate’s ______ functions.
The normal blood glucose level in the neonate is between ______ to 90 mg/dl.
The normal blood glucose level in the neonate is between ______ to 90 mg/dl.
Hepatitis B vaccine is usually administered within ______ hours of birth.
Hepatitis B vaccine is usually administered within ______ hours of birth.
Mongolian spots commonly appear as patches across the sacrum, buttocks, and ______.
Mongolian spots commonly appear as patches across the sacrum, buttocks, and ______.
Caput succedaneum is edema that develops in and under the fetal ______ during labor.
Caput succedaneum is edema that develops in and under the fetal ______ during labor.
To assess coordination of sucking and swallowing, the nurse should observe the neonate’s first ______.
To assess coordination of sucking and swallowing, the nurse should observe the neonate’s first ______.
To avoid contact with blood, the nurse should wear ______ when handling the neonate.
To avoid contact with blood, the nurse should wear ______ when handling the neonate.
Vernix caseosa is a cheeselike substance that protects the fetus’s skin in ______.
Vernix caseosa is a cheeselike substance that protects the fetus’s skin in ______.
The presence of meconium in the amniotic fluid during labor indicates possible fetal ______ and the need to evaluate the neonate for meconium aspiration.
The presence of meconium in the amniotic fluid during labor indicates possible fetal ______ and the need to evaluate the neonate for meconium aspiration.
To assess a neonate’s rooting reflex, the nurse touches a finger to the cheek or the corner of the ______.
To assess a neonate’s rooting reflex, the nurse touches a finger to the cheek or the corner of the ______.
Harlequin sign is present when a neonate who is lying on his side appears red on the dependent side and ______ on the upper side.
Harlequin sign is present when a neonate who is lying on his side appears red on the dependent side and ______ on the upper side.
Because of the anti-insulin effects of placental hormones, insulin requirements ______ during the third trimester.
Because of the anti-insulin effects of placental hormones, insulin requirements ______ during the third trimester.
Gestational age can be estimated by ultrasound measurement of maternal abdominal circumference, fetal femur length, and fetal head ______.
Gestational age can be estimated by ultrasound measurement of maternal abdominal circumference, fetal femur length, and fetal head ______.
Skeletal system abnormalities and ventricular septal defects are the most common disorders of infants born to ______ women.
Skeletal system abnormalities and ventricular septal defects are the most common disorders of infants born to ______ women.
The patient with preeclampsia usually has puffiness around the eyes or ______ in the hands.
The patient with preeclampsia usually has puffiness around the eyes or ______ in the hands.
Kegel exercises require contraction and relaxation of the ______ muscles.
Kegel exercises require contraction and relaxation of the ______ muscles.
If a woman suddenly becomes hypotensive during labor, the nurse should increase the infusion rate of I.V. ______ as prescribed.
If a woman suddenly becomes hypotensive during labor, the nurse should increase the infusion rate of I.V. ______ as prescribed.
During fetal heart monitoring, early deceleration is caused by compression of the ______ during labor.
During fetal heart monitoring, early deceleration is caused by compression of the ______ during labor.
After the placenta is delivered, the nurse may add ______ to the patient’s I.V. solution to promote postpartum involution of the uterus.
After the placenta is delivered, the nurse may add ______ to the patient’s I.V. solution to promote postpartum involution of the uterus.
Cervical suturing is usually done between ______ weeks gestation to reinforce an incompetent cervix.
Cervical suturing is usually done between ______ weeks gestation to reinforce an incompetent cervix.
The mechanics of delivery include engagement, descent, flexion, internal rotation, extension, external rotation, restitution, and ______.
The mechanics of delivery include engagement, descent, flexion, internal rotation, extension, external rotation, restitution, and ______.
The most common method of inducing labor after artificial rupture of the membranes is ______ infusion.
The most common method of inducing labor after artificial rupture of the membranes is ______ infusion.
To prevent her from developing Rh antibodies, an Rh-negative primigravida should receive ______ after delivering an Rh-positive neonate.
To prevent her from developing Rh antibodies, an Rh-negative primigravida should receive ______ after delivering an Rh-positive neonate.
Amniocentesis increases the risk of spontaneous abortion, trauma to the fetus or placenta, premature labor, infection, and Rh ______ of the fetus.
Amniocentesis increases the risk of spontaneous abortion, trauma to the fetus or placenta, premature labor, infection, and Rh ______ of the fetus.
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Study Notes
Breastfeeding Guidelines
- Apply mild emollient or breast milk on nipples post-feeding and let breasts air-dry to prevent cracking.
- Increase fluid intake to 2½ to 3 qt (2,500 to 3,000 ml) daily for breastfeeding mothers.
- Rinse the mouth of an infant with a cleft lip or palate using sterile water after feeding.
- HIV can be transmitted through breastfeeding; HIV-positive mothers should not breastfeed.
- Colostrum is the first breast secretion post-delivery.
- Allow infants to breastfeed until satisfied, typically between 5 to 20 minutes.
- Most medications taken by nursing mothers can appear in breast milk.
- Prolactin is crucial for milk production.
- Premature infants (32 weeks gestation) can be fed expressed milk via gavage.
- Hot compresses are effective for alleviating breast tenderness post-feeding.
- Breast milk provides maternal antibodies, unlike formula.
Neonatal Care Essentials
- Healthy neonates may lose 5% to 10% of their birth weight initially.
- Normal hemoglobin levels in neonates range from 17 to 20 g/dl.
- Neonate head circumference is typically 2 to 3 cm larger than chest circumference.
- Establishing a neonate's airway is the first nursing action after delivery.
- Neonates' urine specific gravity ranges from 1.003 to 1.030, indicating hydration status.
- The neonatal period lasts from birth to day 28.
- Low-birth-weight is defined as weighing 2,500 g (5 lb 8 oz) or less at birth.
- Very-low-birth-weight represents neonates weighing 1,500 g (3 lb 5 oz) or less at birth.
- During phototherapy, protect a neonate's eyes and genitals.
Common Conditions in Neonates
- Symptoms of respiratory distress syndrome include expiratory grunting, sandpaper breath sounds, and seesaw retractions.
- Assess breech-birth neonates for potential issues like hydrocephalus or fractures.
- Postmature neonates often exhibit long, brittle fingernails and skin peeling (desquamation).
- Infants born to smoking mothers weigh on average 6 oz (170 g) less than those born to non-smoking mothers.
- Neonatal jaundice within the first 24 hours is indicative of pathological jaundice, signaling erythroblastosis fetalis.
- Lanugo typically disappears from the fetus by around 20 weeks gestation.
- Hypoglycemia in neonates can result in temperature instability and seizures.
- Neonates require about 50 to 55 calories per pound of body weight daily.
Monitoring and Interventions
- Variable decelerations during fetal heart rate monitoring suggest umbilical cord issues.
- Monitor neonates of diabetic mothers for hyperinsulinism.
- Assess jaundice by blanching the nose or above the umbilicus.
- Milia may appear as spots on a neonate's nose; strabismus is normally observed.
- Respiratory distress syndrome is common in premature infants due to insufficient surfactant.
- Rubella during pregnancy can cause serious fetal complications, including defects and stillbirths.
Postnatal Care
- The Apgar score evaluates a newborn's conditions post-delivery, considering respiratory effort, heart rate, and muscle tone.
- Administer erythromycin at birth to prevent ophthalmia neonatorum.
- Normal blood glucose levels for neonates are between 45 and 90 mg/dl.
- Hepatitis B vaccine and immune globulin typically administered soon after birth.
- Hypospadias in boys should delay circumcision due to potential surgical needs later.
- Cold stress in neonates impacts various body systems, necessitating careful monitoring.
Maternal Health Considerations
- Preterm neonates may require feeding assistance due to weak sucking reflexes.
- Hypotension during labor should prompt immediate IV fluid rate adjustments.
- The fetal heart rate contraction duration is measured from tension onset to complete relaxation.
- Inducing labor after amniotic rupture commonly involves oxytocin (Pitocin) infusion.
- Post-delivery monitoring should start with an assessment of the fetal heart rate.
- Cesarean births are often due to fetal distress, malpresentation, or inadequate labor progress.
Pregnancy and Drug Safety
- The FDA categorizes drugs by birth defect risk, from Category A (no risk) to X (evidence of fetal anomalies).
- Cervical suturing for incompetent cervix is usually performed between 14 to 18 weeks’ gestation, removed by 35 weeks.
- Meconium presence in amniotic fluid may indicate fetal distress, warranting careful evaluation post-delivery.
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