MNN FINAL REVIEW
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Questions and Answers

What are the nursing interventions for a high-risk newborn in regards to temperature?

  • Minimize cold stress
  • Prevent rapid warming or cooling
  • Use a cap to prevent heat loss from the head
  • All of the above (correct)

What are the signs and symptoms of increased intracranial pressure in a newborn with hydrocephalus?

  • Increased blood pressure
  • Decreased heart rate and respiratory rate
  • Bulging fontanelles
  • All of the above (correct)

The primary prevention measure for spina bifida is the intake of _____ acid during pregnancy.

folic

After surgery for spina bifida, the child will likely have paralysis in their legs.

<p>True (A)</p> Signup and view all the answers

What are some of the goals of care for a child with a cleft palate?

<p>All of the above (D)</p> Signup and view all the answers

What are some of the nursing cares for a newborn with a club foot?

<p>All of the above (D)</p> Signup and view all the answers

What is the name of the genetic disorder that requires babies to be tested for at birth?

<p>PKU</p> Signup and view all the answers

What are some of the common physical signs of Down syndrome?

<p>All of the above (D)</p> Signup and view all the answers

RhoGAM administration has increased the incidence of erythroblastosis fetalis in newborn babies.

<p>False (B)</p> Signup and view all the answers

What are some of the manifestations of erythroblastosis fetalis?

<p>All of the above (D)</p> Signup and view all the answers

Phototherapy is a treatment for infants with jaundice that uses light therapy to break down excess bilirubin.

<p>True (A)</p> Signup and view all the answers

Which of the following is a serious complication of meconium aspiration syndrome?

<p>All of the above (D)</p> Signup and view all the answers

A baby born to a diabetic mother is at risk for hypoglycemia.

<p>True (A)</p> Signup and view all the answers

What are the nursing care interventions for a high-risk newborn with regards to temperature?

<p>All of the above (D)</p> Signup and view all the answers

What are some signs of increased intracranial pressure (ICP) in a newborn with Hydrocephalus?

<p>All of the above. (D)</p> Signup and view all the answers

What is the recommended treatment for Hydrocephalus?

<p>Surgery (B)</p> Signup and view all the answers

Spina bifida occulta is the most severe form of spina bifida.

<p>False (B)</p> Signup and view all the answers

A baby with Spina bifida will always need surgery.

<p>True (A)</p> Signup and view all the answers

What is the primary goal of nursing care for a baby with Cleft Lip?

<p>All of the above (D)</p> Signup and view all the answers

Club Foot can be treated with casting and stretching exercises.

<p>True (A)</p> Signup and view all the answers

What are some of the potential complications associated with PKU?

<p>All of the above (D)</p> Signup and view all the answers

Which of the following is NOT a common physical sign of Down Syndrome?

<p>Enlarged colon (A)</p> Signup and view all the answers

What is the primary concern for a baby with Erythroblastosis Fetalis?

<p>Jaundice (C)</p> Signup and view all the answers

RhoGam administration is given to the baby to prevent Erythroblastosis Fetalis.

<p>False (B)</p> Signup and view all the answers

Phototherapy is a treatment for jaundice, but can also pose a risk of injury to the baby's eyes and gonads.

<p>True (A)</p> Signup and view all the answers

What is the primary cause of Meconium Aspiration Syndrome?

<p>Breathing in meconium during labor (B)</p> Signup and view all the answers

Babies born to mothers with diabetes are at a higher risk for hypoglycemia.

<p>True (A)</p> Signup and view all the answers

Neonatal Abstinence Syndrome (NAS) is a condition that can only occur in babies born to mothers who use heroin or cocaine.

<p>False (B)</p> Signup and view all the answers

Which of the following is NOT a common symptom of Neonatal Abstinence Syndrome?

<p>Weight gain (C)</p> Signup and view all the answers

Match the following newborn conditions with their primary causes:

<p>Hydrocephalus = Excess cerebrospinal fluid accumulation in the brain Spina Bifida = Incomplete closure of the spinal cord Cleft Lip/Palate = Incomplete fusion of the lip and/or palate Clubfoot = Abnormal positioning of the foot in the womb PKU = Inborn error in metabolism of phenylalanine Down Syndrome = Trisomy 21: an extra copy of chromosome 21 Erythroblastosis Fetalis = Blood incompatibility between mother and baby Meconium Aspiration Syndrome = Breathing meconium before or during birth Infant of Diabetic Mother = Mother's diabetes can cause infant's blood sugar fluctuation Neonatal Abstinence Syndrome = Withdrawal from drugs used by the mother during pregnancy</p> Signup and view all the answers

What is the primary nursing care intervention for an infant displaying signs of jaundice?

<p>Administer phototherapy (B)</p> Signup and view all the answers

Which of the following is a potential risk factor associated with a post-term newborn?

<p>Asphyxia (D)</p> Signup and view all the answers

How should a preterm infant's feeding be managed according to nursing goals?

<p>Consider using kangaroo care (D)</p> Signup and view all the answers

Which nursing assessment is critical when evaluating a preterm infant's hydration status?

<p>Assessing turgor and weight (D)</p> Signup and view all the answers

What condition can arise from an infant's immature liver function?

<p>Jaundice (B)</p> Signup and view all the answers

Which position is recommended for optimal care of a preterm infant?

<p>Side-lying (C)</p> Signup and view all the answers

What is an important consideration for nursing care during discharge planning for an infant?

<p>Ensuring family support is in place (D)</p> Signup and view all the answers

What is a common complication that may occur due to meconium aspiration in newborns?

<p>Pneumonia (D)</p> Signup and view all the answers

What aspect is crucial in assessing during jaundice treatment in infants?

<p>Skin, sclera, and mucous membranes (D)</p> Signup and view all the answers

Which of the following is a special need for nursing care in preterm infants?

<p>Providing supplemental vitamins (D)</p> Signup and view all the answers

What weight is categorized as large for gestational age (LGA) in newborns?

<p>Over 8.8 pounds (4000 g) (B)</p> Signup and view all the answers

Which characteristic is NOT typically associated with preterm newborns?

<p>Well-developed muscles (A)</p> Signup and view all the answers

What is a common respiratory issue observed in preterm newborns?

<p>Apnea and bradycardia (B)</p> Signup and view all the answers

What is a potential consequence of cold stress in newborns?

<p>Hypoglycemia (B)</p> Signup and view all the answers

What is a sign of hypoglycemia in newborns?

<p>Bulging fontanelles (D)</p> Signup and view all the answers

Which factor contributes to feeding difficulties in preterm newborns?

<p>Immature sphincter muscles (B)</p> Signup and view all the answers

What can be a cause of respiratory distress syndrome (RDS) in preterm newborns?

<p>Oxygen toxicity (D)</p> Signup and view all the answers

What primarily affects the nutritional needs of preterm newborns?

<p>Small stomach capacity (B)</p> Signup and view all the answers

What condition should be monitored due to its association with respiratory problems in preterm newborns?

<p>Bradycardia (A)</p> Signup and view all the answers

Which of the following statements about vernix caseosa is true regarding preterm newborns?

<p>It is abundant in preterm infants. (A)</p> Signup and view all the answers

Which of the following indicates a nursing intervention for a preterm infant regarding thermoregulation?

<p>Utilizing an incubator or warmer (A)</p> Signup and view all the answers

What is a significant risk factor for a post-term newborn?

<p>Greater chance of meconium aspiration (A)</p> Signup and view all the answers

Which nursing assessment is essential to evaluate an infant for jaundice?

<p>Observing skin, sclera, and mucous membranes (A)</p> Signup and view all the answers

What is a common nutritional challenge faced by preterm infants?

<p>Difficulty with adequate feeding volumes (B)</p> Signup and view all the answers

Which of the following nursing interventions is important for a preterm infant regarding positioning?

<p>Positioning the infant side-lying or prone (C)</p> Signup and view all the answers

Which characteristic is commonly associated with preterm newborns?

<p>Superficial veins displayed (A)</p> Signup and view all the answers

What is a common sign of hypoglycemia in newborns?

<p>Bulging fontanelles (A)</p> Signup and view all the answers

Which statement is true regarding the feeding difficulties in preterm newborns?

<p>They have an immature suck and swallow mechanism (B)</p> Signup and view all the answers

What is a reason for temperature regulation issues in preterm newborns?

<p>Lack of adequate SQ fat (C)</p> Signup and view all the answers

Which factor is a common cause of respiratory distress in preterm infants?

<p>Insufficient surfactant production (B)</p> Signup and view all the answers

What contributes to the risk of cold stress in preterm newborns?

<p>Excessive body surface area relative to mass (B)</p> Signup and view all the answers

Which assessment is crucial for monitoring a preterm infant's oxygenation?

<p>Pulse oximetry monitoring (C)</p> Signup and view all the answers

What indicates a risk of inadequate nutrition in preterm newborns?

<p>Small stomach capacity (B)</p> Signup and view all the answers

What is the main difference between the 'ParaGuard' and 'Mirena' intrauterine devices?

<p>'ParaGuard' is effective for 12 years without hormones. (B)</p> Signup and view all the answers

Which side effect is NOT commonly associated with the use of intrauterine devices?

<p>Weight gain (C)</p> Signup and view all the answers

What is a key teaching point for patients using barrier methods of contraception?

<p>Diaphragms and cervical caps should be refitted yearly. (B)</p> Signup and view all the answers

What is the primary function of male condoms?

<p>To block sperm and prevent STIs. (D)</p> Signup and view all the answers

What should a patient do if they suspect the placement of their intrauterine device has changed?

<p>Check the strings weekly for the first month. (D)</p> Signup and view all the answers

Why might a patient using a diaphragm be advised to reapply spermicides?

<p>Spermicides become ineffective after 1 hour. (A)</p> Signup and view all the answers

What is a significant risk associated with using hormonal contraceptives like the 'Mirena' IUD?

<p>Risk of ectopic pregnancy. (D)</p> Signup and view all the answers

What instructions should be provided regarding the storage of male condoms?

<p>They should not be stored in a wallet to avoid damage. (A)</p> Signup and view all the answers

What is the primary genetic difference between monozygotic and dizygotic twins?

<p>Monozygotic twins share 50% of their genes. (A)</p> Signup and view all the answers

Which hormonal contraceptive method requires injections every three months?

<p>Medroxyprogesterone acetate (Depo-Provera). (A)</p> Signup and view all the answers

What is one of the warning signs associated with hormonal contraceptive use described by the acronym ACHES?

<p>Severe leg pain or swelling. (B)</p> Signup and view all the answers

What does Natural Family Planning (NFP) NOT include as a method?

<p>Hormonal contraceptives. (B)</p> Signup and view all the answers

Which contraceptive method has the potential to decrease effectiveness when certain antibiotics are taken?

<p>Oral contraceptives. (C)</p> Signup and view all the answers

What is a characteristic of dizygotic twins during fertilization?

<p>They result from two separate eggs and sperm. (B)</p> Signup and view all the answers

Which side effect is most commonly associated with the use of Medroxyprogesterone acetate?

<p>Irregular menstruation. (D)</p> Signup and view all the answers

What effect does hormonal contraception have on the cervical mucus?

<p>Prevents ovulation and makes it thicker. (A)</p> Signup and view all the answers

What phase of the human sexual response involves the body preparing for sexual activity through increased blood flow and muscle tension?

<p>Excitement phase (C)</p> Signup and view all the answers

What is the primary site of fertilization in the female reproductive system?

<p>Fallopian tubes (B)</p> Signup and view all the answers

During which stage of fetal development does the major organ systems begin to form?

<p>Embryonic stage (A)</p> Signup and view all the answers

What is one of the primary functions of the placenta during pregnancy?

<p>Transporting oxygen and nutrients to the fetus (A)</p> Signup and view all the answers

Which contraception method is considered a permanent solution to prevent pregnancy?

<p>Tubal litigation (C)</p> Signup and view all the answers

In the context of the menstrual cycle, which hormone is primarily responsible for triggering ovulation?

<p>Luteinizing hormone (LH) (D)</p> Signup and view all the answers

Which stage of the human sexual response is characterized by a gradual release of sexual tension and a return to the pre-arousal state?

<p>Resolution phase (C)</p> Signup and view all the answers

What is an essential aspect of the reproductive cycle that is necessary for implantation of the fertilized egg?

<p>Formation of the corpus luteum (D)</p> Signup and view all the answers

What is a potential consequence of untreated gestational diabetes?

<p>Macrosomia in the infant (A)</p> Signup and view all the answers

What is the function of RhoGAM in cases of Rh incompatibility?

<p>To prevent maternal immunization against Rh+ blood cells (B)</p> Signup and view all the answers

Which sign could indicate heart disease in a pregnant woman?

<p>Pitting edema of lower extremities (D)</p> Signup and view all the answers

Which symptom is associated with iron deficiency during pregnancy?

<p>Restless leg syndrome (C)</p> Signup and view all the answers

What is a common complication due to gestational diabetes for the newborn?

<p>Hyperbilirubinemia (D)</p> Signup and view all the answers

What should be monitored in a pregnant woman with heart disease?

<p>Blood pressure changes (D)</p> Signup and view all the answers

Which dietary recommendation is crucial for preventing folic acid deficiency?

<p>Consume more leafy green vegetables (A)</p> Signup and view all the answers

What is a primary effect of magnesium therapy during pregnancy?

<p>Relax uterine muscles (B)</p> Signup and view all the answers

Which of the following recommendations is appropriate to manage leg cramps during pregnancy?

<p>Dorsiflex the foot and increase calcium intake (D)</p> Signup and view all the answers

What is the ideal weight gain for an overweight individual during pregnancy after the first trimester?

<p>0.6 pound per week (A)</p> Signup and view all the answers

Which nutrient is critical for preventing neurological birth defects during pregnancy?

<p>Folic acid (D)</p> Signup and view all the answers

What is recommended to alleviate symptoms of supine hypotensive syndrome during the third trimester?

<p>Lay on the left side to relieve pressure on vena cava (B)</p> Signup and view all the answers

Which of the following statements about edema in pregnancy is correct?

<p>Elevating the legs can help reduce swelling in feet and ankles (B)</p> Signup and view all the answers

What dietary component is essential for bone development during pregnancy?

<p>Calcium (A)</p> Signup and view all the answers

Which position is beneficial for a pregnant woman experiencing faintness and dizziness?

<p>Laying on her left side (B)</p> Signup and view all the answers

What is pica, and why can it be harmful during pregnancy?

<p>A craving for nonfood substances that can cause nutritional deficiencies (D)</p> Signup and view all the answers

What is the recommended exercise type during pregnancy to reduce risks?

<p>Mild to moderate activities like walking (D)</p> Signup and view all the answers

What is a significant physiological change that occurs during the second trimester of pregnancy?

<p>Increase in narcissism and emotional stability (A)</p> Signup and view all the answers

What should be avoided during pregnancy to prevent overheating?

<p>Saunas and tanning beds (B)</p> Signup and view all the answers

Which of the following is advised for managing travel during pregnancy?

<p>Avoiding locations with high infectious disease risks (B)</p> Signup and view all the answers

During pregnancy, what is a critical consideration for older expectant parents?

<p>They are categorized as elderly primiparas. (A)</p> Signup and view all the answers

How is fetal well-being assessed in relation to fetal movements?

<p>Counting fetal movements after meals for one hour (C)</p> Signup and view all the answers

What is a common emotional response experienced during the first trimester of pregnancy?

<p>Intense feelings of ambivalence and mood swings (B)</p> Signup and view all the answers

What diagnostic test is used to visually confirm pregnancy and assess the gestational sac?

<p>Ultrasound examination (C)</p> Signup and view all the answers

What is a common cause of late postpartum hemorrhage?

<p>Retention of placental fragments (B)</p> Signup and view all the answers

Which intervention is crucial for preventing uterine atony post-delivery?

<p>Keeping the bladder empty (B)</p> Signup and view all the answers

What should nurses monitor to assess blood loss effectively?

<p>Pad saturation and weight (D)</p> Signup and view all the answers

Which of the following is a potential symptom of endometritis?

<p>Prolonged and severe cramps (B)</p> Signup and view all the answers

What is a recommended position for a patient at risk for thromboembolic disorders?

<p>Seated with legs elevated (C)</p> Signup and view all the answers

What is the primary treatment for a deep venous thrombosis (DVT)?

<p>Anticoagulation drugs (D)</p> Signup and view all the answers

Which action is NOT recommended for pregnant women to avoid thromboembolic complications?

<p>Crossing their legs for comfort (A)</p> Signup and view all the answers

What should be done if a mother starts experiencing hemolytic complications after delivery?

<p>Place the mother on NPO status (D)</p> Signup and view all the answers

What is the recommended timeframe for removing a urinary catheter after vaginal delivery?

<p>Within 24 hours after delivery (A)</p> Signup and view all the answers

During which phase of milk production does the milk contain the highest amount of antibodies?

<p>Colostrum (D)</p> Signup and view all the answers

What is the appropriate technique for breastfeeding regarding the position of the mother?

<p>Hold the breast with one hand and support the baby's head with the other (A)</p> Signup and view all the answers

What is an important piece of advice for a mother monitoring her newborn's intake during breastfeeding?

<p>Newborns should nurse for about 10-15 minutes per breast for 8-10 times a day (A)</p> Signup and view all the answers

Which of the following should NOT be used for pain management during afterpains?

<p>Aspirin (B)</p> Signup and view all the answers

What nursing intervention can help reduce the risk of thrombophlebitis in postpartum patients?

<p>Administering prophylactic anticoagulants and early ambulation (C)</p> Signup and view all the answers

During lactation, the mother's milk undergoes changes; which of the following is true for transitional milk?

<p>It contains increased lactose and calories compared to colostrum (C)</p> Signup and view all the answers

What is the recommended method for breaking the seal when removing an infant from the breast?

<p>Use the mother's finger to break the seal (B)</p> Signup and view all the answers

What physiological change occurs in the cardiovascular system postpartum?

<p>Increased blood clot formation risk (C)</p> Signup and view all the answers

What should be monitored in a cesarean section patient regarding the abdominal dressing?

<p>Inspect for REEDA (redness, edema, ecchymosis, discharge, approximation) (C)</p> Signup and view all the answers

Which factor affects the abdominal wall postpartum?

<p>The abdominal wall may appear 'dough-like' due to stretching (D)</p> Signup and view all the answers

What is a common nursing consideration for moms receiving RhoGAM postpartum?

<p>Administer within 72 hours if they are Rh+ (A)</p> Signup and view all the answers

What change occurs in the integumentary system soon after childbirth?

<p>Striae will fade to silver as hormone levels decrease (C)</p> Signup and view all the answers

Which of the following indicates a possible complication in a postpartum patient?

<p>Persistent fever after 24 hours with chills (D)</p> Signup and view all the answers

Which statement regarding breastfeeding techniques is accurate for new mothers?

<p>Proper latch is essential for effective breastfeeding. (B)</p> Signup and view all the answers

What is a key consideration for bottle feeding guidelines for infants?

<p>Hold the bottle horizontally to reduce air swallowing. (D)</p> Signup and view all the answers

What is the primary action to take during an emergency delivery scenario?

<p>Stay with the client and use the call light to get help (C)</p> Signup and view all the answers

Which of the following is essential to monitor prior to the onset of labor?

<p>Amniotic fluid characteristics (B)</p> Signup and view all the answers

What is a significant intervention for nursing care after birth?

<p>Wear gloves until after the first bath (B)</p> Signup and view all the answers

Which vital sign monitoring is necessary during labor?

<p>Both maternal and fetal heart rates (C)</p> Signup and view all the answers

What physiologic changes should be observed during labor?

<p>Increased uterine contractions (A)</p> Signup and view all the answers

What is the recommended frequency for contractions during labor to ensure safety?

<p>More than every 2 minutes (A)</p> Signup and view all the answers

What should be done if a client is undergoing oxytocin infusion and contractions exceed 90 seconds?

<p>Stop the infusion of oxytocin (A)</p> Signup and view all the answers

Which factor is NOT included in the admission data collection for fetal condition?

<p>Nutrition history (A)</p> Signup and view all the answers

Which of the following is NOT part of the 'Powers' in labor?

<p>Position of the mother (D)</p> Signup and view all the answers

What is the normal range for fetal heart rate (FHR) during labor?

<p>110-160 bpm (B)</p> Signup and view all the answers

Which statement correctly describes the control over contractions during labor?

<p>Contractions must be monitored for frequency and duration (D)</p> Signup and view all the answers

Which of the following components is part of the 'Passenger' during childbirth?

<p>Fetus (C)</p> Signup and view all the answers

What should be assessed as part of the maternal condition during labor admission?

<p>Maternal vital signs (C)</p> Signup and view all the answers

What is a primary nursing care action during labor before birth?

<p>Perform perineal prep (A)</p> Signup and view all the answers

Which nursing intervention is essential when monitoring fetal status during labor?

<p>Check fetal position and presentation (C)</p> Signup and view all the answers

What should a nurse do if an emergency delivery is required?

<p>Use the call light to get assistance (A)</p> Signup and view all the answers

Which of the following is a physiologic change during labor?

<p>Increased maternal heart rate (C)</p> Signup and view all the answers

What critical step should be taken for the baby immediately following birth?

<p>Wear gloves until after the first bath (A)</p> Signup and view all the answers

What should be reported to the registered nurse regarding contractions during labor?

<p>Contractions occurring every minute (A), Contractions lasting longer than 90 seconds (B)</p> Signup and view all the answers

Which of the following factors represent 'The Passenger' in the labor process?

<p>Fetal positioning and size (B)</p> Signup and view all the answers

What is an important consideration during admission data collection for labor?

<p>Fetal heart rate monitoring from 120-160 (D)</p> Signup and view all the answers

Which action should be taken if oxytocin infusion is currently being administered and contractions are noted to last longer than established time limits?

<p>Stop the oxytocin infusion (C)</p> Signup and view all the answers

What constitutes 'The Powers' in the labor process?

<p>Uterine contractions and maternal pushing efforts (C)</p> Signup and view all the answers

Which of the following is not a safety alert associated with contractions during labor?

<p>Contractions that cease for more than 30 minutes (B)</p> Signup and view all the answers

When assessing the psyche during labor, which factor is most critical?

<p>Evaluating maternal anxiety levels (A)</p> Signup and view all the answers

Which of the following is a critical aspect when evaluating fetal condition during labor?

<p>Monitoring of Fetal Heart Rate (FHR) (C)</p> Signup and view all the answers

What is a primary source of pain during labor?

<p>Dilation and stretching of cervix (C)</p> Signup and view all the answers

Which prenatal class focuses specifically on assisting siblings in adjusting to a new baby?

<p>Sibling (B)</p> Signup and view all the answers

What effect does childbirth pain typically have on a woman's motivation during labor?

<p>It motivates her to assume different positions to assist the fetus (D)</p> Signup and view all the answers

What is one of the common sources of pain related to the pressure exerted during childbirth?

<p>Pressure from the fetus on pelvic structures (B)</p> Signup and view all the answers

Which of the following methods might help alleviate pain during labor?

<p>Engaging in light exercise and massage (D)</p> Signup and view all the answers

Which of the following is a disadvantage of non-pharmacologic pain management techniques during childbirth?

<p>They require prior rehearsal. (C)</p> Signup and view all the answers

What is the primary focus of the Bradley Method during childbirth preparation?

<p>Husband coached birth with relaxation techniques. (B)</p> Signup and view all the answers

Which of the following interventions is avoided within one hour of birth when using opioids for pain management?

<p>Naloxone, a narcotic antagonist. (A)</p> Signup and view all the answers

Which principle underlies the Dick Read Method of childbirth preparation?

<p>The relaxation of the fear-tension-pain cycle. (C)</p> Signup and view all the answers

What is a potential limitation of pharmacologic pain management methods during childbirth?

<p>They can lead to hypotension. (B)</p> Signup and view all the answers

What is the most likely reason the woman is relatively comfortable at 5 cm dilation?

<p>Her contractions are mild and infrequent. (A)</p> Signup and view all the answers

What observation should a nurse promptly report for a woman with ruptured membranes at 31 weeks gestation?

<p>Maternal vital signs with a temperature of 38.2 C (100.7 F) (D)</p> Signup and view all the answers

After a vaginal birth complicated by shoulder dystocia, what should the nurse primarily assess in the newborn?

<p>Clavicle for potential fracture (D)</p> Signup and view all the answers

In which situation is external version most likely to be performed?

<p>At 38 weeks gestation with a breech fetus (B)</p> Signup and view all the answers

What is the first nursing action if a visibly prolapsed umbilical cord occurs?

<p>Relieve pressure on the cord (B)</p> Signup and view all the answers

What is a common characteristic of hypotonic labor dysfunction?

<p>Dilation with abnormally slow progress (D)</p> Signup and view all the answers

Which intervention will likely enhance comfort for a woman with a perineal laceration in the first two hours post-birth?

<p>An ice pack to reduce swelling (C)</p> Signup and view all the answers

What fetal heart rate variation indicated potential concern during labor?

<p>Consistent low heart rate of 95 bpm (D)</p> Signup and view all the answers

Which nursing intervention is critical after an amniotomy?

<p>Record fetal heart rate for at least 1 minute (D)</p> Signup and view all the answers

What is the purpose of amnioinfusion during labor?

<p>To reduce umbilical cord compression (C)</p> Signup and view all the answers

What maternal condition requires immediate reporting if temperature reaches 100.4°F or higher?

<p>Maternal infection risk (B)</p> Signup and view all the answers

What color of amniotic fluid indicates the need to notify the physician?

<p>Green (A)</p> Signup and view all the answers

Which complication can arise from prolonged labor?

<p>Maternal dehydration (D)</p> Signup and view all the answers

What condition is associated with premature rupture of membranes?

<p>Higher risk of uterine tenderness (C)</p> Signup and view all the answers

What are the risks associated with oligohydramnios during labor?

<p>Decrease in fetal heart rate (A)</p> Signup and view all the answers

What vital sign assessment is crucial for monitoring infection after amniotomy?

<p>Maternal temperature every 2-4 hours (B)</p> Signup and view all the answers

What is a critical nursing action after fetal heart rate is noted as abnormal?

<p>Notify the healthcare provider immediately (D)</p> Signup and view all the answers

What factor increases the risk of complications related to premature rupture of membranes?

<p>Presence of meconium (C)</p> Signup and view all the answers

What deficiency causes a preterm infant respiratory distress syndrome?

<p>Surfactant (D)</p> Signup and view all the answers

How will the nurse safely ensure tube placement when preparing to initiate a gavage feeding?

<p>Aspirate stomach contents. (C)</p> Signup and view all the answers

When assessing a preterm infant, the nurse observes nasal flaring, sternal retractions, and expiratory grunting. What do these findings indicate?

<p>Respiratory distress syndrome (A)</p> Signup and view all the answers

Flashcards

Hydrocephalus

A condition where there's too much cerebrospinal fluid (CSF) in the brain, causing increased pressure and potentially brain damage.

Increased ICP

Increased intracranial pressure, a dangerous condition that can occur due to hydrocephalus.

Hydrocephalus Treatment

Often involves surgery to drain excess CSF.

Pre-op Hydrocephalus Care

Daily head measurements, positioning, preventing skin breakdown, monitoring feeding, and reporting observations.

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Post-op Hydrocephalus Care

Routine care, monitoring for increased ICP and infections; checking operative sites for inflammation. Monitoring fluids, feeding, and parent education.

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Spina Bifida

A birth defect where the spine doesn't close completely during pregnancy, potentially leading to paralysis and other issues.

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Spina Bifida Nursing Care (Pre-op)

Preventing injury and infection to the spinal opening. Routine newborn care and recording of observations are also important.

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Spina Bifida Nursing Care (Post-op)

Neurological and urological monitoring, preventative infection measures, skin care, feeding, and a latex-free environment.

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Cleft Lip

A birth defect where the upper lip doesn't fuse properly during development, which can affect feeding and speech.

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Cleft Lip Pre-op Care

Monitor for oral, respiratory, and systemic infections, and report to the nurse.

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Cleft Lip Post-op Care

Prevent sucking, crying, and positioning. Also prevent infections and injuries, address emotional needs and pain.

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Cleft Palate

Similar to cleft lip, a birth defect where the roof of the mouth doesn't fuse completely.

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Cleft Palate Post-op Care

Focus on nutrition, oral hygiene, speech therapy, and monitoring for complications.

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Clubfoot

A birth defect involving the foot's malformation.

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Clubfoot Nursing Care

Early splinting/casting, passive stretching exercises, and parent teaching/guidance.

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Erythroblastosis Fetalis

A condition where a mother's blood type conflicts with the baby's, potentially causing baby issues.

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RhoGAM

An injection to prevent Rh incompatibility issues.

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Meconium Aspiration Syndrome

A lung condition in newborns potentially due to inhaling meconium.

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Meconium Aspiration Syndrome Nursing Care

Assisting with amnioinfusion, assessing for respiratory distress, and providing supportive care like warmth and oxygen.

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Infant of Diabetic Mother

A newborn whose mother has diabetes.

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Transient Tachypnea of the Newborn (TTN)

A temporary breathing difficulty in newborns.

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Neonatal Abstinence Syndrome (NAS)

A condition where newborns experience withdrawal symptoms from exposure to drugs during pregnancy.

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Down Syndrome

A genetic condition associated with intellectual disability, physical characteristics, and developmental delays.

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Setting Sun Eyes

A sign of hydrocephalus where the pupils appear to be pushed downward, leaving only a sliver of white visible above the iris.

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Hydrocephalus Manifestations

Include a large head (macrocephaly), delayed development, lack of appetite, vomiting, and decreased resistance to infections.

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Daily Head Measurement

A crucial nursing intervention for newborns suspected of or diagnosed with hydrocephalus.

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Frequent Position Changes for Hydrocephalus

Support the newborn's head and change positions frequently to prevent pressure sores and promote proper circulation.

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Prevent and Treat Skin Breakdown (Hydrocephalus)

Regularly check the skin for redness and irritation. Use protective measures like padding and moisture barriers.

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Signs of Increased Intracranial Pressure (ICP)

Include increased blood pressure (BP), decreased heart rate (HR), and decreased respiratory rate (RR).

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Pre-Op Nursing Care (Hydrocephalus)

Measure head daily, frequent position changes, prevent skin breakdown, monitor feeding, and report observations promptly.

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Post-Op Nursing Care (Hydrocephalus)

Routine care, monitor for increased ICP and infection, check the surgical site, position the newborn, and provide skin assessment.

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Prevent Injury/Infection to Sac (Spina Bifida)

A critical nursing intervention to protect the exposed sac and minimize the risk of complications.

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Spina Bifida Surgery

Often required to close the open spine and potentially repair other associated defects.

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Spina Bifida Outcomes

Can include paralysis of legs, incontinence, and developmental delays.

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Spina Bifida Habilitation

Refers to programs and therapies focused on enhancing the newborn's functional abilities.

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Pre-Op Nursing Care (Spina Bifida)

Prevent injury/infection to the sac, routine newborn care, and record observations.

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Post-Op Nursing Care (Spina Bifida)

Neurological and urological monitoring, preventative infection measures, skin care, feeding, and latex-free environment.

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Cheiloplasty

The surgical procedure to repair a cleft lip.

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Prevent Sucking Motions (Cleft Lip)

Important after surgery to prevent disrupting the healing process.

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Post-Op Nursing Care (Cleft Lip)

Focus on preventing sucking/crying, positioning, preventing infection, and addressing emotional needs and pain.

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Post-Op Nursing Care (Cleft Palate)

Focus on nutrition, oral hygiene, speech therapy, and monitoring for complications.

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Amnioinfusion

A procedure where saline solution is introduced into the amniotic sac to help dilute meconium.

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Meconium Aspiration Support

Includes warmth, supplemental oxygen, energy-conserving care, and potentially intubation/mechanical ventilation.

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Infant of Diabetic Mother (IDM)

A newborn whose mother has diabetes, potentially at risk for various complications related to blood sugar levels.

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IDM Nursing Care

Close monitoring of vital signs, early feeding, frequent blood glucose checks, and monitoring for signs of hypoglycemia.

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NAS Nursing Care

Swaddling, quiet environments to reduce stimulation, and observation for seizures.

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Counseling Parents (Down Syndrome)

Providing support and guidance to help parents cope with the diagnosis and understand their child's needs.

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Supporting Siblings (Down Syndrome)

Ensuring siblings feel informed, included, and have opportunities to express their feelings.

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National Association for Down Syndrome

A valuable resource providing information, support, and advocacy for individuals with Down Syndrome and their families.

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Preterm Newborn

A baby born before 37 weeks of pregnancy.

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Post-term Newborn

A baby born after 42 weeks of pregnancy.

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Large for Gestational Age (LGA)

A baby whose weight is above the 90th percentile for their gestational age.

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Small for Gestational Age (SGA)

A baby whose weight is below the 10th percentile for their gestational age.

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Respiratory Distress Syndrome (RDS)

A breathing problem in preterm newborns caused by a lack of surfactant in the lungs.

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Cold Stress

A condition where a newborn's body temperature drops too low.

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Hypoglycemia

Low blood sugar in a newborn.

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Gavage Feeding

Giving a newborn food through a tube directly into the stomach.

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Immature Kidneys

A condition where a newborn's kidneys are not fully developed.

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Cluster Care

A nursing approach where all necessary procedures and care are done together to minimize disturbance for the baby.

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Jaundice in Newborns

A yellowish discoloration of the skin and eyes in newborns, often caused by an immature liver's inability to break down bilirubin effectively.

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Phototherapy for Jaundice

A treatment for jaundice in newborns that involves exposing the baby to a special light. The light helps break down bilirubin in the skin.

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Preterm Infant Feeding

Providing nutrition to a preterm baby, which may involve special formulas, frequent feedings, and monitoring for adequate intake.

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Thermoregulation in Preterms

Maintaining a stable body temperature for a preterm baby, which can be challenging due to their underdeveloped temperature control mechanisms.

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Kangaroo Care

A method of providing skin-to-skin contact between a preterm infant and parent to help stabilize body temperature, promote bonding, and reduce stress.

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Meconium Aspiration

A serious condition where a newborn inhales meconium (first stool) into the lungs, potentially leading to breathing difficulties.

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Polycythemia in Newborns

A condition where a newborn has an abnormally high red blood cell count, which can cause problems with blood flow and oxygen delivery.

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Difficult Deliveries

Births that are complicated or require special interventions, potentially putting the newborn at risk for complications.

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Post-Term Newborn Problems

Complications that can arise in newborns born after 42 weeks of gestation, such as asphyxia, meconium aspiration, and birth defects.

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Nursing Goals for Preterm Infants

Specific objectives for nursing care provided to a preterm infant, focusing on areas like nutrition, thermoregulation, and special needs.

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Monozygotic Twins

Identical twins formed from one egg fertilized by one sperm, sharing 100% of their genes.

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Dizygotic Twins

Fraternal twins formed from two separate eggs fertilized by two different sperm, sharing 50% of their genes.

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Natural Family Planning (NFP)

A fertility awareness-based method of contraception that relies on tracking the woman's menstrual cycle and using methods such as cervical mucus monitoring, basal body temperature tracking, and calendar-based methods.

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Hormonal Contraception

A method of contraception that uses hormones to prevent ovulation, thicken cervical mucus, and make the uterine lining less hospitable for a fertilized egg.

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Oral Contraceptives

A type of hormonal contraception taken orally, usually daily, for monthly contraception.

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Extended Dose

Oral contraceptives come in extended doses where some 'sugar pills' can be taken to induce a period rather than continuous hormone intake.

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Hormonal Implants

A small, long-acting hormonal contraceptive implant placed in the arm that releases hormones continuously for a few years.

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Medroxyprogesterone Acetate (Depo-Provera)

Injectable hormonal contraception that releases a slow-releasing progestin every 3 months, offering long-term protection.

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Intrauterine Device (IUD)

A small, T-shaped device inserted into the uterus to prevent pregnancy. It can be hormonal or non-hormonal.

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IUD Side Effects

Common side effects include cramps, irregular bleeding, dysmenorrhea (painful periods), and possibly amenorrhea (absence of periods).

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IUD Pt Teaching

Teach patients to check the placement string weekly for the first four weeks and monthly after that. Report any signs of infection (fever, pain, change in discharge). IUDs do not protect against STIs. Report severe abdominal pain, as this could indicate an ectopic pregnancy.

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Transdermal Patch

A hormonal contraceptive patch applied to the skin once a week for three weeks, followed by one week patch-free.

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Vaginal Ring

A flexible ring inserted into the vagina that releases hormones for three weeks, then removed for one week.

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Barrier Methods

Contraceptives that physically block sperm from entering the uterus. They can include diaphragms, cervical caps, and male condoms.

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Diaphragm/Cervical Cap

Used with spermicides, these devices are inserted into the vagina and can be left in place for up to 24 hours, but ideally for at least 6 hours after intercourse.

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Male Condoms

Used to cover the penis during intercourse. Latex condoms offer protection against some STIs, while natural membrane condoms do not.

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Testosterone's Impact

Testosterone, a male hormone, plays a crucial role in development by increasing bone growth, muscle mass, red blood cell production, basal metabolic rate, vocal cord size, and hair distribution.

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Undescended Testes

When a testicle fails to descend into the scrotum, it's called an undescended testicle. This can increase infertility risk due to the testes' sensitivity to heat.

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Female Anatomy: Perineum

The perineum is the area between the vagina and anus. It's prone to tearing during childbirth.

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Uterus Layers

The uterus has three layers: endometrium (innermost, where implantation occurs), myometrium (middle), and perimetrium (outermost).

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Fallopian Tubes

The fallopian tubes are where fertilization occurs. They connect the ovaries to the uterus.

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Favorable Pelvis for Delivery

A gynecoid pelvis is considered the most favorable for vaginal delivery, while a platypelloid pelvis is unfavorable.

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Reproductive Hormones: FSH & LH

FSH (follicle-stimulating hormone) and LH (luteinizing hormone) are crucial for the reproductive cycle.

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Changing Tampons

Changing tampons every 4 hours is essential to prevent toxic shock syndrome.

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Supine Hypotensive Syndrome

A condition that occurs during pregnancy when the weight of the uterus compresses the inferior vena cava, reducing blood flow back to the heart. This can cause dizziness and fainting.

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Weight Gain in Pregnancy

Recommended weight gain varies based on pre-pregnancy BMI. Underweight women should gain 28-40 lbs, normal weight women 25-35 lbs, overweight women 15-25 lbs, and obese women 11-20 lbs.

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Iodine's Role in Pregnancy

Iodine is crucial for brain development in the fetus. Adequate intake supports healthy cognitive development.

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Folic Acid's Importance

Folic acid helps prevent neural tube defects like spina bifida. The recommended daily intake is 400 mcg.

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Calcium's Role in Pregnancy

Calcium is essential for strong bones in both the mother and baby. The recommended daily intake is 1000 mg.

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Why is Iron Important During Pregnancy?

Iron is needed to produce more blood to supply oxygen to the growing baby. The recommended daily intake is 30 mg.

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Pica

A craving for and ingestion of nonfood substances such as clay, starch, or ice. It's common during pregnancy but potentially harmful.

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Risks of Pica

Pica can lead to nutritional deficiencies, parasitic infections, and potential ingestion of harmful substances.

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Hypotension during labor

Low blood pressure during labor, often caused by medications like oxytocin, which can lead to uterine relaxation and weak contractions.

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Rh incompatibility

A condition where a Rh-negative mother carries an Rh-positive baby, leading to the mother developing antibodies that can harm future pregnancies.

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Gestational Diabetes

Diabetes that develops during pregnancy. High blood sugar levels can lead to complications for the baby including macrosomia, hyperglycemia, hyperbilirubinemia, and more.

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Heart disease and pregnancy

Pregnant women with heart disease are at higher risk for complications like preterm labor, fetal growth restriction, and even fetal death. They may also have increased clotting factors, making them prone to thrombosis.

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Iron deficiency

Insufficient iron levels leading to lower than normal production of red blood cells, causing fatigue, shortness of breath, and other symptoms.

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Folic acid deficiency

Lack of folic acid can cause various symptoms like fatigue, mouth sores, memory problems, and can lead to birth defects like anencephaly and spina bifida.

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Toxoplasmosis during pregnancy

An infection caused by a parasite that can be found in undercooked meat, cat feces, and soil. It can cause serious complications for the fetus.

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Rubella immunization

Vaccination against rubella, a viral infection that can cause serious birth defects. It's important to get vaccinated before getting pregnant.

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Pregnancy Exercise

Mild to moderate exercise like walking is good during pregnancy. Avoid overheating activities like saunas and strenuous exercise.

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Pregnancy Travel

Wear a seatbelt below your belly. Avoid long periods of sitting due to increased risk of blood clots. Avoid areas with high risk of infectious diseases.

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1st Trimester Emotions

Women may experience ambivalence and emotional instability, including mood swings.

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2nd Trimester Emotions

Women often experience narcissism and greater emotional stability during this trimester.

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3rd Trimester Emotions

Mood swings may return, and women prepare for infant care.

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Partner Announcement Phase

Confirmation of pregnancy and acceptance.

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Partner Adjustment Phase

The partner revises financial plans, makes purchases for the baby, and listens to the fetal heartbeat.

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Partner Focus Phase

The partner focuses on labor plans, lifestyle changes, and starts feeling like a parent.

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Postpartum Hemorrhage

Excessive bleeding after childbirth, defined as blood loss greater than 500 ml for vaginal delivery and 1000 ml for cesarean delivery.

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Late Postpartum Hemorrhage

Excessive bleeding that occurs after 24 hours but before 6 weeks postpartum.

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Causes of Late Postpartum Hemorrhage

Late postpartum hemorrhage is often caused by retained placental fragments or subinvolution of the uterus, where the uterus doesn't return to its normal size quickly enough.

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Thromboembolic Disorder

A condition involving blood clots forming in the veins, which can lead to deep vein thrombosis (DVT) or pulmonary embolism (PE).

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Pulmonary Embolism (PE)

A serious complication where a blood clot travels to the lungs, blocking blood flow and causing potentially life-threatening symptoms like chest pain, cough, and shortness of breath.

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Endometritis

An infection of the lining of the uterus, often causing pain, fever, and foul-smelling discharge.

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Monitor Pad Saturation

Frequently checking the amount of blood on a postpartum pad is crucial for detecting and managing potential postpartum hemorrhage.

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Early Ambulation

Encouraging the postpartum mother to walk around as soon as possible is vital for preventing blood clots and improving circulation.

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Letting-Go Phase

The time new parents adjust to their new reality with a child, embracing the differences between their ideal and actual experiences and accepting the child as they are.

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Postpartum Cardiovascular Changes

New moms experience increased blood volume and cardiac output due to placenta/uterus blood recirculation, increasing risk of blood clots. They may also experience chills and blood pressure drops.

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Postpartum Integumentary Changes

Hyperpigmentation and stretch marks fade as hormone levels decrease post-delivery.

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Postpartum Musculoskeletal Changes

The abdominal wall weakens due to stretching, leading to diastasis recti (separated abdominal muscles). Joints become hypermobile but stabilize within 6 weeks.

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Postpartum Immune System

Rh-negative mothers need RhoGAM within 72 hours postpartum to prevent blood incompatibilities. They may also need a rubella vaccine if indicated.

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Cesarean Birth Dressing Monitoring

Monitor the abdominal dressing for signs of infection using REEDA (redness, edema, ecchymosis, discharge, approximation).

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Postpartum Lochia

Lochia, the vaginal discharge after delivery, may be less profuse after a Cesarean birth compared to a vaginal delivery.

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Postpartum Orthostatic Hypotension

The sudden drop in blood pressure when standing up after delivery may cause dizziness or fainting.

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Vaginal Delivery - Foley Catheter

A urinary catheter (Foley) is typically removed within 24 hours after vaginal delivery. Monitor urine output for color, amount, and presence of blood. Be alert for signs of a UTI (fever, painful urination, frequent urination).

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Vaginal Delivery - Respiratory Care

Assess lung sounds regularly. Encourage deep breathing exercises and turning every 2 hours for bedridden mothers. Teach splinting with a pillow for coughing and the use of an incentive spirometer.

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Vaginal Delivery - Thrombophlebitis Risk

C-section mothers are at higher risk for blood clots (thrombophlebitis). Prophylactic anticoagulants and compression therapy may be used. Encourage early ambulation.

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Vaginal Delivery - Pain Management

Pain control is crucial for reducing stress and anxiety. Use a 1-10 pain scale to assess and assist with pain management strategies.

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Colostrum

The first milk produced after birth (for the first few days). It's rich in antibodies, proteins, and vitamins A and E. Lower in calories and has a laxative effect for the baby.

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Transitional Milk

Produced 7-10 days after birth, this milk has fewer immunoglobulins and proteins but increased lactose, fat, and calories.

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Mature Milk

Produced after 14 days, this milk is nutrient-rich and contains all the baby needs. Its blue color and high calorie content support healthy growth.

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Afterpains

Intermittent uterine contractions that can cause pain (similar to menstrual cramps). More common in women who have had multiple babies or an overstretched uterus. Breastfeeding can also trigger afterpains.

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Emergency Delivery

A situation where a baby needs to be born immediately without reaching a hospital. This can happen due to complications or rapid labor.

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Nursing Care Before Birth

A nurse assesses a woman in labor by checking vital signs, amniotic fluid, and fetal monitoring. This helps track the progress of labor and identify any potential issues.

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Late Deceleration

This is a pattern on a fetal heart monitor that shows the baby's heart rate slowing down during a contraction and remaining low afterward. It can indicate problems with the baby's oxygen supply.

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Physiologic Changes in Labor

The body goes through several physical changes during labor, including dilation of the cervix, contractions, and the baby's descent. Nurses manage these changes with interventions like pain relief and support.

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Nursing Care During Labor

Nurses play a vital role in providing support, encouragement, and education to the mother and partner throughout the labor process. They monitor the mother's progress and address any concerns.

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What are the 4 Ps of Labor?

The four factors that influence labor and birth: Powers, Passage, Passenger, and Psyche.

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Powers: Contractions

Uterine muscle contractions that cause the cervix to dilate and the baby to descend through the birth canal.

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Passage: Birth Canal

The path the baby travels through during delivery, consisting of the cervix, vagina, and pelvic floor.

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Passenger: The Baby

The fetus, including its size, position, and presentation.

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Psyche: Maternal State

The woman's emotional and psychological well-being, which influences her ability to cope with labor.

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Mechanisms of Labor

The movements a baby goes through as it descends through the birth canal. These include descent, flexion, internal rotation, extension, restitution, and external rotation.

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What are some admission data collected during labor?

Vital signs (maternal), fetal heart rate (110-160bpm), signs of impending birth, and other data like consent forms, lab tests.

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What are the major considerations for fetal condition during labor?

Assessing the fetal heart rate (FHR), which should be between 110-160 beats per minute.

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Perineal Prep

Preparing the area between the vagina and anus for childbirth, often involving shaving or cleansing to minimize infection risk.

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Fetal Position

The way the baby is positioned in the uterus, described using letters and numbers referring to the baby's body parts (e.g., LOA - Left Occiput Anterior).

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What are the four Ps of labor?

The four Ps of labor are: Powers (contractions and maternal pushing), Passage (pelvic anatomy), Passenger (fetus), and Psyche (mother's emotional and psychological state). These factors work together to deliver the baby.

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What is the role of contractions during labor?

Contractions are involuntary muscle contractions of the uterus that help dilate the cervix and push the baby down the birth canal.

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What are the vital signs to monitor in a laboring mother?

During labor, monitor the mother's vital signs, including temperature, pulse, respiration, blood pressure, and fetal heart rate (FHR) to ensure both mother and baby are safe and healthy.

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What is the difference between internal and external fetal monitoring?

Internal fetal monitoring involves placing a small electrode on the baby's scalp to get a more accurate and precise reading of the fetal heart rate. External monitoring uses sensors placed on the mother's abdomen to monitor FHR.

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What are some signs that labor is imminent?

Signs of impending labor include: water breaking (rupture of membranes), increased vaginal discharge, bloody show (bloody mucus), and regular contractions.

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What is the cardinal movement of labor?

The cardinal movements of labor are the series of positions the baby goes through as it descends through the birth canal. These movements include engagement, descent, flexion, internal rotation, extension, external rotation, and expulsion.

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What is the significance of the fetal heart rate?

The fetal heart rate (FHR) is a crucial indicator of the baby's health during labor. A normal FHR is between 110 and 160 beats per minute.

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What is the importance of the Psyche in labor?

The Psyche refers to the mother's emotional and psychological state. A positive and supportive environment can help the mother cope with labor, manage pain, and stay calm.

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Fear-Tension-Pain Cycle

A cycle where fear leads to tension, which in turn increases pain, making the fear worse. This cycle can be very difficult to break.

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Dick Read Method

A childbirth preparation method that focuses on relaxation techniques to interrupt the Fear-Tension-Pain cycle.

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Bradley Method

A childbirth preparation method that emphasizes the husband's role in supporting the mother through childbirth.

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Lamaze Method

A childbirth preparation method that focuses on relaxation and breathing techniques.

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Non-Pharmacologic Pain Management Advantages

Non-pharmacologic pain management techniques offer several advantages including being safe, not slowing down labor, and having no risks for allergies or adverse effects.

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Childbirth Pain

Normal and expected part of the birthing process. It's temporary and usually declines quickly after birth.

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Sources of Labor Pain

Includes cervical dilation, reduced blood supply to the uterus, fetal pressure, and stretching of the vaginal tissues.

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Pain Management Options During Labor

Women have several months to prepare for pain management options, ranging from non-pharmacological methods like massage and movement to pain relief medications.

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Labor Pain's Purpose

While uncomfortable, labor pain motivates a woman to assume various positions that help the baby move down the birth canal.

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Pain Relief During Labor: Non-Pharmacological Options

These options include massage, movement, warm baths, and relaxation techniques. They can be effective for some women.

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Hypotonic Labor Dysfunction

A condition where uterine contractions are weak or infrequent, slowing down the labor process. The uterus may not be strong enough to effectively dilate the cervix.

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Hypertonic Labor Dysfunction

A condition involving strong but painful contractions that are too frequent and too short, preventing the cervix from effectively dilating.

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Shoulder Dystocia

A complication during childbirth where the baby's shoulder gets stuck behind the mother's pelvic bone after the head is delivered.

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Prolapsed Umbilical Cord

A serious complication where the umbilical cord descends into the vagina before the baby. This can cut off oxygen to the baby.

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External Version

A procedure performed during pregnancy to try to turn a breech baby (feet first) into a head-down position.

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Ruptured Membranes

When the amniotic sac breaks, leading to a release of amniotic fluid. This can occur naturally or be induced by procedures.

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Perineal Laceration

A tear or cut in the perineum, the area between the vagina and anus, which often happens during childbirth.

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Fetal Heart Rate (FHR) Monitoring

Regularly assessing the baby's heart rate during labor to ensure its well-being. It helps identify potential issues and guide interventions if needed.

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Amniotomy

The artificial rupture of the amniotic sac (water breaking) to induce or speed up labor.

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Oligohydramnios

A condition where there's too little amniotic fluid, potentially jeopardizing the baby's well-being.

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Variable decelerations

Sudden decreases in fetal heart rate that are often caused by umbilical cord compression.

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Premature Rupture of Membranes (PROM)

When the amniotic sac breaks before labor starts, potentially leading to complications.

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Prolonged Labor

Labor lasting longer than expected, increasing risks for both mother and baby.

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Risks of Prolonged Labor

Potential complications from prolonged labor include maternal and newborn infection, maternal exhaustion, postpartum hemorrhage, and increased anxiety for the mother.

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Foley Bulb (in Labor)

A balloon-like device used for labor induction or augmentation by applying pressure to the cervix.

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Forceps (in Labor)

A specialized tool used to assist with the delivery of the baby's head when there's difficulty during labor.

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Vacuum (in Labor)

A suction device used to assist with the delivery of the baby's head when there's difficulty during labor.

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Study Notes

Newborn with Perinatal Injury or Congenital Malformation

  • Temperature Management: Maintain skin temperature between 36.1°C and 36.7°C (96.8°F and 97.7°F) to minimize cold stress. Continuously monitor temperature and prevent rapid warming or cooling. Use a cap to prevent heat loss from the head.

  • Food and Fluids: Monitor for hypoglycemia. Assess tolerance of oral or tube feedings. Monitor hydration closely and assess for gastric residuals, bowel sounds, changes in stool pattern, and abdominal girth. Monitor weight gain or loss.

  • Respiratory Function: Position infants in a semiprone or side-lying position. Maintain a patent respiratory tract and stimulate breathing as needed. Monitor oxygen therapy and assess respiratory effort. Note signs such as grunting, nasal flaring, cyanosis, and apnea.

Hydrocephalus

  • Manifestations: Large head, delayed development, lack of appetite, tendency to vomit easily, and poor resistance to infection are common. Visual aids depicting enlarged ventricles and a compressed brain are present.

  • Nursing Care (Pre-Op): Measure head circumference daily. Maintain frequent position changes to support the head. Prevent skin breakdown. Observe and record food intake, vomiting, skin condition, and motor abilities. Monitor for signs of increased intracranial pressure (ICP). Note signs such as increased blood pressure, decreased heart rate, and respiratory rate and report to the healthcare provider immediately.

  • Nursing Care (Post-Op): Monitor for signs of increased ICP and infection. Check the operative area for inflammation. Positioning will depend on the fontanelle. Monitor I&O and for fluid overload. Skin assessments. Measure head, chest, and abdomen. Control pain; observe feeding; and keep surgical suture lines clean. Instruct parents to report any signs of infection.

Spina Bifida

  • Prevention: Adequate folic acid intake during pregnancy reduces the risk of spina bifida.

  • Pre-Op Nursing Care: Prevent injury/infection to the sac; cover with sterile dressing and keep moist. Maintain routine newborn care. Record observations. Position infant prone to prevent sac pressure.

  • Post-Op Nursing Care: Perform neurological assessments. Prevent infection. Monitor urological functions. Care for skin. Ensure appropriate feeding. Maintain a latex-free environment. Connect with support resources.

Cleft Lip and Palate

  • Cleft Lip Pre-Op Care: Monitor for signs of oral, respiratory, or systemic infection and report to the RN. Prevent infant sucking motions by using elbow restraints.

  • Cleft Lip and Palate Post-Op Care (general): Prevent sucking. Observe for positioning. Prevents infection and injury. Provide emotional support and pain management.

  • Cleft Palate Goals: Improved feeding, improved speech, improved dental development, nurturing a positive self-image, and instructions to parents for reporting any signs of infection.

Club Foot

  • Nursing Care: Splinting/casting start early in the course of treatment. Implement passive stretching exercises. Educate parents.

PKU (Phenylketonuria)

  • Safety Alert: PKU is an inherited metabolic disorder. Children with PKU must follow a special diet free of phenylalanine to prevent developmental issues. Foods to avoid include meat, dairy products, nuts, eggs, and cereals.

Down Syndrome

  • Physical Signs: Decreased muscle tone at birth, excess skin on the nape of the neck, flattened nose, upward-slanting eyes, small ears and mouth, wide/short hands/fingers, separated joints between the bones of the skull, single palmar crease, and white spots on the colored part of the eye.

  • Nursing Care: Counseling parents. Involve parents in care-planning: be empathetic and respectful to their grief. Inform and support siblings. Engage parents in open communication. Support family groups or resources like the National Association for Down Syndrome.

Erythroblastosis Fetalis

  • Manifestations: Hyperbilirubinemia (jaundice) is a common manifestation.

  • Treatment: RhoGam administration is used to prevent the condition. Administration typically follows the delivery of a Rh+ infant, as well as at 28th week of pregnancy, and after spontaneous/therapeutic abortion or amniocentesis.

Meconium Aspiration Syndrome

  • Nursing Care: Assist with amnioinfusion. Assess respiratory distress. Provide supportive care (warmth). Supplemental oxygen. Energy-conserving care plan. NICU intubation or mechanical ventilation.

Infant of Diabetic Mother

  • Nursing Care: Close monitoring of vital signs, early feeding, frequent blood glucose assessments (must be above 40 mg/dL). Monitor for signs of irritability, tremors, and respiratory distress.

Neonatal Abstinence Syndrome (NAS)

  • Nursing Care: Swaddling. Maintain quiet environment. Minimize external stimuli. Observe for seizures.

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This quiz covers essential management strategies for newborns with perinatal injuries or congenital malformations, focusing on temperature management, nutrition, and respiratory function. It also addresses the manifestations of hydrocephalus in infants. Test your knowledge on vital care practices for these conditions.

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