OB Lectures 1-3

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Questions and Answers

Which factor is NOT typically associated with an increased risk of preterm birth?

High socioeconomic status (correct)

Previous preterm birth

Carrying multiples

Unhealthy weight

What is a significant factor that can contribute to maternity mortality rates?

Paternal age

Increased access to prenatal care

Tobacco use (correct)

Physical exercise during pregnancy

Which method is NOT included in the SAVE model for addressing intimate partner violence?

Validate

Educate (correct)

Evaluate

Assess

In postpartum care, lochia serosa is characterized by which description?

Pinkish watery discharge Signup and view all the answers

How should the caregiver assess the position of the uterus post-delivery?

One finger width below the umbilicus and dropping daily Signup and view all the answers

What condition may have a lasting impact on the mother and family after childbirth?

Postpartum depression Signup and view all the answers

Which complementary and alternative medicine is focused on treating the whole person?

Aromatherapy Signup and view all the answers

Which one is NOT a common aspect of family-centered care in maternal and newborn nursing?

Family exclusion from decision making Signup and view all the answers

Identifying which prenatal factor can lead to chronic diseases during pregnancy can mitigate risks to maternal health?

Smoking Signup and view all the answers

What is characterized as primary infertility?

Never been able to conceive Signup and view all the answers

What is the primary reason for a mother to avoid expressing all the milk when bottle feeding?

The body will continue to refill the milk supply. Signup and view all the answers

Which of the following interventions is considered safe for breastfeeding mothers experiencing discomfort?

Using ibuprofen for pain management. Signup and view all the answers

Which of the following statements regarding breastfeeding positioning is most accurate?

The baby's ear, shoulder, and hip should be aligned. Signup and view all the answers

What is the ideal timespan for most babies to eat throughout the day?

Every 2-3 hours. Signup and view all the answers

What should be used for formula preparation to ensure safety for an infant?

Infant or purified water. Signup and view all the answers

Which vaccine is recommended for the mother around week 27 of pregnancy to protect newborns?

TDAP vaccine. Signup and view all the answers

When providing education for discharge, which topic is considered essential for new mothers?

Newborn sleep-wake cycles. Signup and view all the answers

What is the consequence if a Rh-negative mother has an Rh-positive baby in future pregnancies?

She may produce Rh+ antibodies that harm future fetus. Signup and view all the answers

What occurs as a normal physiological response to delivery that peaks around Day 4 and resolves by Day 10?

Baby Blues Signup and view all the answers

What is a crucial step in assessing the baby's ability to latch during breastfeeding?

Ensuring the nipples are erect and accessible. Signup and view all the answers

What sign indicates a distended bladder that may lead to complications after delivery?

Fundus deviating to the right Signup and view all the answers

What is a potential risk of the mother continuing to feed only at the tip of the nipple?

It may cause cracked nipples and increase infection risk. Signup and view all the answers

Which of the following phases of maternal adaptation follows the 'Taking-In' phase?

Taking-Hold Phase Signup and view all the answers

What is a critical nursing intervention to prevent postpartum hemorrhage related to bladder distention?

Ensure full emptying of the bladder Signup and view all the answers

Which assessment technique is most appropriate for evaluating the state of the perineum postpartum?

Using the REEDA scale Signup and view all the answers

What dietary change should be made for breastfeeding mothers?

Increase calorie intake by 500 calories per day Signup and view all the answers

What should be included in the postpartum nursing assessment for assessing emotional status?

Verbal expressions of anxiety or sadness Signup and view all the answers

Which of the following describes a safe position for an infant during sleep to reduce the risk of suffocation?

On their back in a crib free of objects Signup and view all the answers

If a breastfeeding mother experiences engorgement around day 5, what intervention should be prioritized?

Breastfeeding to alleviate pressure Signup and view all the answers

What is a common consequence of sudden changes in cardiovascular status immediately after delivery?

Transient drops in heart rate and blood pressure Signup and view all the answers

What is the primary purpose of administering RhoGAM to an RH-negative mother during pregnancy?

To prevent antibody production that could harm the fetus Signup and view all the answers

What respiratory rate indicates a newborn is experiencing distress?

Grunting sound on expiration Signup and view all the answers

Which statement correctly describes how the circulatory system of a newborn differs from that of a fetus?

Blood bypasses the lungs via the foramen ovale Signup and view all the answers

What is the recommended action to prevent cold stress in newborns?

Prompt immediate skin-to-skin contact with the mother Signup and view all the answers

What is the main role of the liver in the newborn's body regarding bilirubin?

To break down bilirubin into an excreted form Signup and view all the answers

What physiological change occurs when a newborn is born, specifically relating to circulation?

The foramen ovale closes and pulmonary circulation begins Signup and view all the answers

What is a common nursing intervention for a newborn experiencing signs of jaundice?

Increase frequency of feedings to promote bilirubin excretion Signup and view all the answers

What is a critical nursing consideration during post-operative care for a cesarean birth?

Monitor for signs of infection closely Signup and view all the answers

Which of the following is NOT a factor that affects heat loss in newborns?

High levels of shivering Signup and view all the answers

What behavioral characteristic might indicate a newborn is in the second period of reactivity?

Eating and crying for food Signup and view all the answers

Study Notes

Changes in Childbirth Methods

The involvement of support persons like Certified Nurse Midwives (CNMs) and doulas enhances childbirth experiences.
Birth settings have diversified, allowing for options such as home births and birth centers.
Hospital stays post-delivery have become shorter, emphasizing the importance of outpatient care.

Family Centered Care

Childbearing is viewed as a normal, healthy process deserving of supportive care.
Collaborative decision-making involves families in the care process.
Health care providers should be sensitive to different cultural beliefs and practices.

Prenatal and Postpartum Care

Early and adequate prenatal care is crucial for preventing complications.
Home births may pose higher risks due to potential delays in medical care.
Postpartum care encompasses six weeks post-delivery, involving various support options like clinics, phone consults, and home visits.
Postpartum depression (PPD) is common, significantly affecting the mother and family dynamics.

Factors Contributing to Preterm Birth

High-risk behaviors include smoking, hypertension, unhealthy weight, diabetes, and previous preterm births.
Multiple pregnancies also increase the likelihood of preterm birth.

Mortality and Morbidity

Maternal mortality rates have doubled since 2019, with 700-900 deaths annually related to pregnancy.
Fetal mortality occurs after 20 weeks, while neonatal mortality refers to deaths within the first 28 days, and infant mortality within the first year.
Morbidity can arise from chronic conditions like cardiovascular disease or diabetes and is influenced by lifestyle factors and environmental hazards.

Prioritizing Maternal and Newborn Health

Family dynamics and changes in parental roles impact health outcomes.
Communication styles and signs of abuse should be assessed steadily.
Non-traditional family structures require open-mindedness from healthcare providers.

Intimate Partner Violence and Screening

Universal screening for intimate partner violence is essential for all patients.
Establishing trust is crucial; direct questions should be asked to assess safety.
The cycle of violence includes tension building, physical abuse, reconciliation, and repetition.

Sexual Violence Response

Sexual assault requires specially trained Sexual Assault Nurse Examiners (SANE).
Victims should receive coordinated care, evidence collection, and support for PTSD or counseling if needed.

Complementary and Alternative Medicine

Focuses on holistic treatment approaches, including aromatherapy, herbal medicine, and acupuncture.

Understanding Infertility

Defined as unable to conceive after 12 months of unprotected intercourse.
Types of infertility include primary (never pregnant) and secondary (previous pregnancies but unable to carry to term).

Postpartum Assessments and Nursing Care

The physical assessment framework (BUBBLE-EE): Breast, Uterus, Bowels, Bladder, Lochia, Episiotomy, Extremities, Emotional status.
Lochia stages include Rubra (dark red), Serosa (pinkish), and Alba (yellowish), requiring careful monitoring for signs of infection.

Postpartum Nursing Interventions

Prioritize pain management, assess for sources of discomfort, and implement both pharmacologic and non-pharmacologic interventions.
Encourage postpartum education regarding self-care, infant feeding methods, and support for family adjustment.

Cardiovascular and Respiratory Adaptations in Newborns

Newborns experience significant cardiovascular changes at birth, with vital signs typically showing a heart rate of 110-160 bpm.
Respiratory rates should be noted as 30-60 breaths per minute, with normal variations in breathing patterns expected.

Thermoregulation in Newborns

Newborns are vulnerable to heat loss due to thin skin and a large surface area.
Skin-to-skin contact is essential for temperature regulation and attachment.

Hepatic and GI Adaptations

The liver is responsible for bilirubin conjugation, critical for avoiding jaundice in newborns.
Normal bowel elimination includes meconium followed by transitional stools to help prevent bilirubin buildup.

Immune and Neurologic Adaptations

Newborns rely on passive immunity from maternal antibodies while developing their immune responses.
Sensory capabilities and reflexes are established early; newborns exhibit predictable periods of alertness and sleep patterns.

Preparing for Discharge

Educate mothers on newborn care, developmental milestones, signs of illness, and postpartum changes.
Ensure moms receive necessary immunizations, such as TDAP and rubella vancomycin, and understand rh immunoglobulin administration post-delivery if RH negative.

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Description

This quiz covers the core concepts of maternal and newborn nursing, highlighting changes in childbirth methods, family-centered care, and cultural sensitivity. It emphasizes the importance of collaboration in decision-making and being supportive to both mother and family during pregnancy and childbirth.