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Questions and Answers
What is the most appropriate nursing action when the fundus is level with the umbilicus, firm, and midline 24 hours after a cesarean delivery?
What is a key sign of a distended bladder following delivery?
Which medication is commonly administered to enhance uterine contractions after delivery?
What type of feedback should a nurse provide to parents caring for their infant?
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What condition is characterized by the head of the femur being displaced due to a shallow hip socket?
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Which of the following medications can be used to stimulate uterine contractions during labor?
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During a newborn assessment, what is the best approach for a nurse to promote parental confidence?
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What can increase lochia and indicate a possible issue after delivery?
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What condition describes a shallow hip socket causing femoral head displacement?
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Which factors are most often associated with Periventricular-Intraventricular Hemorrhage?
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Rho(D) immune globulin is provided to which group of mothers?
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Which teaching points are essential for parents of infants undergoing phototherapy?
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What are the complications associated with post maturity in infants?
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Which definition best describes hydrocephalus?
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What characterizes postpartum hemorrhage?
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What condition is most likely linked to immature blood vessel damage in neonates?
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Which symptoms are associated with enterocolitis in infants?
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What is the recommended method for umbilical cord care for a newborn at home?
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Which classification does Mylicon belong to?
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Which symptom is associated with an infant suspected to have phenylketonuria (PKU)?
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What are the most common causes of late postpartum hemorrhage?
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Intraventricular hemorrhage (IVH) in a newborn is most commonly associated with which condition?
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What dietary instruction is most important for a child with phenylketonuria (PKU)?
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What is the purpose of an alpha-fetoprotein test during pregnancy?
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What autosomal abnormality is indicated by a single palmar crease and an ulnar loop in a child?
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Which of the following is NOT a symptom of phenylketonuria (PKU)?
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Which statement accurately describes the risks associated with Intraventricular Hemorrhage (IVH)?
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What is a neural tube defect characterized by the protrusion of the spinal cord and meninges from the back?
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What condition involves the presence of pearly white pinpoint papules on the face and nose of a newborn?
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Which method helps keep an infant warm through skin-to-skin contact?
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What is administered to prevent eye infections in newborn babies?
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What is the composition of colostrum produced in the first week after delivery?
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What condition may result from poor peripheral circulation in newborns, reflected by a bluish discoloration of hands and feet?
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Which term describes the thick white substance that protects the fetus's skin in utero?
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What is a common consequence of hypoprothrombinemia in newborns?
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What is administered to a Rh-negative mother to manage potential blood incompatibility with a Rh-positive infant?
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What does delayed maturation in infants often require?
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Study Notes
Postpartum Fundus Assessment
- A firm fundus at the level of the umbilicus, midline, is considered normal in the first 24 hours after a cesarean birth.
- A soft fundus is concerning and requires intervention.
- Massage the uterus to firm it up and control bleeding.
- Notify the provider if unable to firm the uterus or if signs of hemorrhage are present.
- A displaced fundus, upward and laterally, may indicate a full bladder.
- Encourage the patient to empty their bladder and re-assess afterward.
Encouraging Parental Infant Care
- Positive feedback is essential when parents provide care for their newborns.
- Providing encouragement and support helps parents feel confident and competent in caring for their baby.
Pitocin and Methergine
- Pitocin and Methergine are most commonly used to stimulate uterine contractions.
- These medications help the uterus contract and control bleeding after delivery.
Developmental Hip Dysplasia (DDH)
- DDH occurs when the head of the femur is partially or completely displaced due to a shallow hip socket.
- Ortolani's sign is a clinical test for DDH.
Umbilical Cord Care
- The best practice for umbilical cord care is to clean it with water when necessary and keep the site clean and dry.
Mylicon
- Mylicon is an anti-flatulent medication.
- It helps reduce gas and bloating in infants.
Phenylketonuria (PKU)
- A musty odor in the breath, skin, or urine is a sign of PKU.
- PKU patients also present with eczema and seizures.
- Diet is the primary treatment for PKU.
Late Postpartum Hemorrhage
- Late postpartum hemorrhage occurs more than 24 hours after delivery.
- The most common causes are subinvolution of the uterus and retained placental fragments.
Intraventricular Hemorrhage (IVH)
- Hypoxic injury is the most likely cause of IVH in newborns.
- IVH occurs when blood vessels in the brain rupture due to a lack of oxygen.
Phenylketonuria (PKU)
- PKU is a rare inherited disorder.
- Individuals with PKU have a change in the PAH gene, which prevents the breakdown of phenylalanine.
- PKU patients need a special formula low in phenylalanine and should avoid products containing aspartame.
Alpha-Fetoprotein Test
- The alpha-fetoprotein test is used to screen for Down syndrome.
- This test is usually performed between 15 and 20 weeks of gestation.
Trisomy 21 (Down Syndrome)
- Some physical characteristics of Down syndrome include:
- Upward slanting eyes
- A flat nasal bridge
- A protruding tongue
- A single palmar crease
- A simian crease
- A wide space between the second and third toes.
Periventricular-Intraventricular Hemorrhage (PVH/IVH)
- PVH/IVH can occur due to:
- Hypoxic injury
- Increased or fluctuating cerebral blood flow
- Rapid change in blood pressure
Breastfeeding: Limited Time at the Breast
- Limiting breastfeeding time may cause frequent infant hunger and more feedings.
- This is because the baby may not receive enough of the richer milk.
Rho(D) Immune Globulin
- RhoGAM is given to Rh-negative mothers who have Rh-positive infants.
- It prevents the development of maternal antibodies that could harm future Rh-positive pregnancies.
Phototherapy
- Parents should be educated about jaundice, phototherapy care, and the importance of follow-up visits and lab tests.
- Encourage parents to participate in infant care activities like feeding, bathing, and cuddling.
Post-maturity
- Complications associated with post-maturity include:
- Higher risk of asphyxia and hypoxia
- Increased risk of meconium aspiration
- Poor nutrition status
- Increased risk for hypothermia and hyperbilirubinemia.
Postpartum Psychosis
- Postpartum psychosis is a medical emergency requiring immediate attention and hospitalization.
- Mothers with postpartum psychosis need to be referred to psychiatric specialists.
Hydrocephalus
- Hydrocephalus is a buildup of fluid in the ventricles within the brain.
- Hydrocephalus can lead to increased pressure on the brain.
Postpartum Hemorrhage
- Postpartum hemorrhage is defined as blood loss greater than 500 mL after vaginal delivery or 1,000 mL after cesarean delivery.
Postpartum Blues
- Postpartum blues is characterized by mild depression, usually lasting less than 2 weeks.
- Symptoms include insomnia, irritability, fatigue, tearfulness, mood instability, and anxiety.
Retinopathy of Prematurity (ROP)
- ROP is a common complication in premature infants.
- ROP is damage to immature blood vessels in the retina, often associated with oxygen use.
Bronchopulmonary Dysplasia (BPD)
- BPD is a chronic condition most often found in infants weighing less than 1,500 grams at birth.
- Damage to the bronchial epithelium from oxygen exposure, oxygen-free radicals, and high positive-pressure ventilation can lead to BPD.
Necrotizing Enterocolitis (NEC)
- NEC is acute inflammation of the bowel that can lead to cellular death.
- Signs of NEC include abdominal distention, decreased or absent bowel sounds, bloody stools, diarrhea, and bilious vomiting.
Myelomeningocele
- Myelomeningocele is a neural tube defect in which the spinal cord and meninges protrude from the child's back.
Ventriculoperitoneal (VP) Shunt
- A VP shunt can be used to drain excess cerebrospinal fluid (CSF) from the brain.
Milia
- Milia are pearly-white, pinpoint papules on a newborn's face and nose.
- Milia are due to clogged sweat and oil glands.
- They usually disappear within a few weeks.
Mongolian Spots
- Mongolian spots are bluish discolorations on the lower back, buttocks, and anterior trunk that resemble bruises.
- They are common in infants of African American, Native American, or Mediterranean ancestry.
Epstein's Pearls
- Epstein's pearls are white spots on the hard palate of a newborn.
Lanugo
- Lanugo is fine, soft hair that covers the fetus.
Vernix Caseosa
- Vernix caseosa is a thick, white substance that protects the fetus's skin in utero.
Desquamation
- Desquamation is a process in which the cornified layer of the epidermis is sloughed off in scales.
Kangaroo Care
- Kangaroo care is a method for keeping an infant warm using skin-to-skin contact.
- The infant is placed on the mother's or father's naked chest, wearing only a diaper and a small cap.
Acrocyanosis
- Acrocyanosis is a bluish discoloration of the hands and feet in infants, especially during the first day of life.
- It is caused by poor peripheral circulation.
Vitamin K (Phytonadione)
- Vitamin K is given to newborns to prevent bleeding due to hypoprothrombinemia and to promote blood coagulation.
RhoGAM (Rho(D) Immune Globulin)
- RhoGAM prevents the development of naturally occurring maternal antibodies that could harm future Rh-positive pregnancies.
Oxytocin (Pitocin)
- Oxytocin is used to stimulate uterine contractions.
Erythromycin Ophthalmic Ointment
- Erythromycin ointment is applied to the newborn's eyes soon after delivery to prevent eye infections, such as gonorrhea.
Colostrum
- Colostrum is the first milk produced by the mother.
- It is rich in protein, minerals, fat-soluble vitamins, and immunoglobulins.
Transitional Milk
- Transitional milk replaces colostrum after about a week.
- It contains more calories than colostrum.
Mature Milk
- Mature milk is established about two weeks after delivery.
- It provides complete nutrition for the infant.
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Description
Test your knowledge on postpartum fundus assessment, parental infant care, and the use of Pitocin and Methergine in childbirth. Understand the implications of developmental hip dysplasia and essential nursing interventions during the postpartum period. This quiz will help reinforce important concepts for maternal and newborn care.
