Dynamic Quiz Maternal Newborn Retake Notes PDF

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LowCostMoldavite4752

Uploaded by LowCostMoldavite4752

ECPI University

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maternal and newborn care obstetrics nursing midwifery

Summary

This document provides key notes on maternal and newborn care, covering various topics including procedures like External and Internal Cephalic Version, vital signs of newborns, and complications like mastitis and neonatal abstinence syndrome. It also delves into different aspects of labor and delivery, including contractions, decelerations, and premature newborns.

Full Transcript

External Cephalic Version: provider uses their hands on the mother's abdomen to turn the baby from breech or transverse position to a head-down position - Typically done around 37 weeks gestation - Often receives a tocolytic prior to procedure to allow the uterus to relax Internal Cephali...

External Cephalic Version: provider uses their hands on the mother's abdomen to turn the baby from breech or transverse position to a head-down position - Typically done around 37 weeks gestation - Often receives a tocolytic prior to procedure to allow the uterus to relax Internal Cephalic Version: provider inserts their hand into the uterus through the cervix to manually turn the baby - Typically performed during labor Graafian Follicle expels the mature ovum A blastocyst is group of cells formed during embryonic development, usually shortly after fertilization The corpus luteum is a structure within the ovary that produces the progesterone needed to establish and maintain pregnancy Vital signs of a Newborn: - RR -- 30 to 60 breaths/min with short periods of apnea (less than 15 seconds) occurng most frequently during the rapid eye movement sleep cycle - HR -- 110-160/min - BP -- 60 to 80 mm Hg systolic and 40 to 50 mm Hg diastolic - Temperature -- 36.5 C to 37.5 C (97.7 F to 99.5 F) Clients must not become pregnant for 28 days following rubella immunization Phototherapy for a newborn: - Monitor number of stools - Reposition every 2 to 3 hours - Dress the newborn in diaper only - Cover the eyes with an eye shield - Check temperature frequently - Inform parents not to apply lotion Meperidine: opioid medication - Should not be administered to laboring clients who are expected to deliver within 4 hours of the medication administration - Crosses the placenta and causes respiratory depression in the newborn, which peaks in 2 to 3 hours after administration - Narcan is ineffective at reversing the respiratory depression caused by this medicine - Maternally, it can cause tachycardia, nausea, vomiting, dizziness, and altered mental status - Neonatal abstinence syndrome occurs in newborns who are exposed to opioids over a long period of time during pregnancy - Receiving an opiate during labor will not lead to opiate dependence in the newborn Methylergonovine: promotes uterine contractions It's Not My Time: - Nifedipine, Terbutaline, and Magnesium Sulfate -- a smooth muscle relaxant; used for a client experiencing preterm labor Mastitis: inflammation of the breast tissue that can involve an infection - Releasing the newborn's grasp on the nipple with a finger before removing the newborn from the breast helps prevent injury to the nipples, which can lead mastitis - Waiting too long between feedings can result in clogging or plugging of the nipples, which can increase the risk of mastitis Lactation Suppression for Clients Bottle Feeding: - Clients should wear supportive bra that fits securely continuously for the first 3 days postpartum to help promote suppression of lactation - Avoid stimulation of the breast (no massaging) - Avoid expressing breast milk - Avoid running warm water on breasts, this promotes lactation, rather than suppression - Place ice packs on breasts using a "15 minute on and 45 minutes off" schedule to decrease swelling of the breast tissue True labor: - Contractions are typically felt in the lower back and radiate to the lower abdomen - Bloody show -- passage of the mucus plug, tinged with blood, indicating the cervix is beginning to dilate - ROM - Cervical changes -- dilate and effacement (thinning out) When the fundus is deviated to the right or left, it can indicate that her bladder is full. The nurse should assist the client to empty her bladder to prevent uterine atony and excessive lochia A client's fundus should descend about 1 to 2 cm every 24 hours - After 1 hour of giving birth and sometime within the first 24 hours, the client's fundus rises to about 1 cm above the umbilicus and then gradually descend over the next several days Decelerations: - Early decelerations -- - Head compression - Continue to monitor - Variable decelerations -- - Umbilical compression - Reposition mother ( turn on left side) - Administer oxygen - Stop oxytocin - In some cases, amnioinfusion - Late decelerations -- - Uteroplacental insufficiency (reduced blood flow to the placenta) - Reposition mother (turn to left side) - Administer oxygen - Increase IV fluids - Stop oxytocin - Notify provider Premature Newborns: - Abundant lanugo, especially over their back - Hypotonia and a relaxed posture - Few heel creases - Abundant vernix caseosa (post-mature newborns have dry, parchment-like skin) Magnesium sulfate toxicity signs: - RR of less than or equal to 12/min - Muscle weakness - Depressed deep-tendon reflexes Newborn physical assessment: - Measure the circumference of the newborn's head at its largest diameter, the occipitofrontal area (just above the eyebrows) - Measure the length from the top of the head to heel - Measure the chest circumference at the nipple line Signs of Septic Shock in a Newborn: - Hypotension - Tachypnea - Tachycardia - Mottled or gray colored skin Anemia during pregnancy is defined by hemoglobin levels less than 10.5 to 11 g/dL. It is treated with iron supplementation with added vitamin C to aid in iron absorption - Hemoglobin levels in clients who have sickle cell anemia are significantly lower than 10.4 g/dL, at approximately 6 to 8 g/dL Placenta Previa: uterus will be relaxed, soft, and painless (bright red bleeding) Abruptio Placenta: uterus is firm and board-like, very painful (dark red blood) Neonatal Abstinence Syndrome: - Tremors - Tachypnea - Nasal flaring - Apnea - Retractions - Incessant crying - Frequent yawning and sneezing - Mottling of the skin - Excessive sucking - Vomiting and fevers Hyperemesis Gravidarum - Patients will have ketonuria due to inadequate dietary intake, resulting in the breakdown of protein and stored fat - Ketonuria -- - Ketones are present in urine, which means the body is breaking down fats for energy instead of carbohydrates Moro reflex: - A "C" formation of the thumb and forefinger and an extension of the legs before pulling upward are expected components - Present at birth and absent by 6 months of age Meperidine Hydrochloride: - Opioid analgesic used for moderate to severe pain during labor - Possible adverse effects: - Hypotension - Confusion - Sedation - Headaches - Respiratory depression - Constipation - Urinary retention Heel stick on Newborn: - Warm heel with a warm washcloth for 5 to 10 minutes prior to procedure to enhance blood flow to the heel - Puncture the outer aspect of the newborn's heel to avoid nerves and vessels - Place in a dependent position prior to the procedure McRoberts Maneuver: - Includes helping the client flex her knees apart, which rotates the pubic bone anteriorly; this movement releases the anterior shoulder; do not apply pressure directly to the anterior shoulder - Can be used on clients with or without epidural anesthesia - Used to relieve shoulder dystocia

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