Exam 4 Review Maternal Newborn PDF

Exam 4 Review: - **Amnioinfusion**: - Putting fluid back into uterus - Baby will be hypotonic (unable to move freely) - **Indications** -- ***severe variable deceleration*** due to ***cord compression*** (***most common***) - Oligohydramnios due to placental in...

Exam 4 Review: - **Amnioinfusion**: - Putting fluid back into uterus - Baby will be hypotonic (unable to move freely) - **Indications** -- ***severe variable deceleration*** due to ***cord compression*** (***most common***) - Oligohydramnios due to placental insufficiency - **Induction**: - Medical or mechanical start of labor - Ripening (***softening and dilation of the cervix***) may be needed - **Indications** -- ***maternal exhaustion***; ***gestational hypertension***/***diabetes***; ***prolonged labor***, prolonged premature ROM, prolonged gestation; dystocia - **Bishop Score**: *6+ is favorable; used to consider potential candidate for VBAC (Vaginal Birth After Cesarean)* Score Dilation (cm) Effacement (%) Station Cervical Consistency Position of Cervix ------- --------------- ---------------- ---------- ---------------------- -------------------- 0 Closed 0-30 -3 Firm Posterior 1 1-2 40-50 -2 Medium Misposition 2 3-4 60-70 -1 or 0 Soft Anterior 3 5-6 80 +1 or +2 Very soft Anterior - **Forceps**: assess for ***facial palsy*** (petechiae) - **Vacuum-assisted**: assess for ***cephalohematoma*** (swelling ***does not cross suture lines***; appears one the second or third day after birth and disappears within weeks or months) - **Caput Succedaneum**: swelling ***crosses suture*** ***lines***; dissipates in 3 days without treatment - **Cord prolapse**: - Partial or total ***occlusion of cord*** with ***rapid fetal deterioration*** - Common in breech babies - **Gross** -- hanging outside vagina; **Occult** -- at the back of vagina, not showing - Client should be in ***hands and knees position*** to ***relive compression*** - **Postpartum Complications** (***Contact Provider*** if Any ***Abnormalities*** in Assessment): - **B**: **breast** -- *contour, size/fullness, pain, temperature* - **U**: **uterus** -- *fundal height and firmness*; should be ***midline*** and ***firm*** - **B**: **bladder** -- *bladder distention*, has ***patient voided***; report ***dysuria***, ***burning***, or ***incomplete emptying of the bladder*** - **B**: **bowel** -- *has patient had a BM* - **L**: **lochia** -- *rubra (dark red), 1-4 days; serosa (pinkish brown), 5-9 days; creamy white (alba), \>10 days*; report ***foul-smelling*** or ***unexpected change in color or amount***; report ***large blood clots*** or ***bleeding that saturates a peripad in an hour*** - **E**: **episiotomy** (*perineum/epidural*) -- *proper wound healing*; report ***pain*** or ***inflammation*** (*swelling, redness, or discharge*) at the ***episiotomy***, ***epidural***, or ***abdominal site*** - **E**: **extremities** -- *check for swelling, redness, tenderness*; report ***calf pain*** with ***dorsiflexion of the foot*** - **E**: **emotional status**; *depression or mood swings* - **Causes of Postpartum Hemorrhage: Four T's**: - ***Tone*** -- uterine atony, distended bladder - ***Tissue*** -- retained placenta and clots; uterine subinvolution - ***Trauma*** -- lacerations, hematoma, inversion, rupture - ***Thrombin*** -- coagulopathy (preexisting or acquired) - **Uterine Atony**: - ***Causes*** -- multiple gestations, gestational diabetes/hypertension, polyhydramnios, prolonged labor - **Dystocia**: - ***Causes*** -- obesity, macrosomia, maternal exhaustion, ineffective pushing, less than 18 years of age and greater than 35 years of age - **Baby weight loss**: - Normal for them to lose weight after birth; ***should not exceed 10%*** - **Ortolani Test**: - Testing for ***hip dysplasia*** - Take the baby's legs and extend the hip outward, if a ***sound is heard***, that could be ***indicative of hip dysplasia*** - **Necrotizing Enterocolitis**: - ***Inflammation*** of the ***stomach*** and ***colon*** - ***Breastmilk*** helps ***fight against*** NEC - **Retinopathy of Prematurity**: - When premature newborn is ***on oxygen***, ***too much pressure*** on the eyes can cause retinopathy - **Temperature Control**: - ***Most important factor*** to look for in newborns; if temperature is ***lower than 97.7***, intervention is needed - - Skin to skin (kangaroo method -- baby and mom practice skin-to-skin with blanket over top both) - Radiant warmer - Swaddled - **Postterm Babies**: - *Thin umbilical cord* - *Dry, cracked skin* - *Macrosomia* - *Long fingernails* - **Transient Tachypnea of newborn (TTN)**: - Mild degree of respiratory distress; result of a ***delay in clearance of fetal lung liquid*** - An infant born by ***cesarean birth***; fluid in the lungs; no "squeeze" effect has occurred - **Tracheoesophageal Fistula**: - Trachea and esophagus are connected; ***choking will occur on first feeding*** - **Newborn Sleeping**: - *Alone, on their back, in a crib* - **Umbilical Cord:** - Wash with ***antibacterial soap and water*** to clean around stump; sponge baths only until stump falls off in 10-14 days - **PKU**: - Part of newborn screening - ***Heel stick test is used*** - In the **first 24 hours**: - ***Respirations*** are ***irregular***, *shallow, unlabored; short periods of "non-breathing" (\