Practice questions and rationales (Maternal Exam 2) PDF

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Summary

 Prevent heat loss by evaporation  dry infant with warm blanket  Wet umbilical cord moist/with drainage  bring infant to clinic  Circumcision with red and small blood  document the findings  Respiratory distress  cyanosis, tachypnea, retractions, and grunts  Hyperbilirubinemia  continue to...

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Prevent heat loss by evaporation  dry infant with warm blanket Wet umbilical cord moist/with drainage  bring infant to clinic Circumcision with red and small blood  document the findings Respiratory distress  cyanosis, tachypnea, retractions, and grunts Hyperbilirubinemia  continue to breast feed. Addicted to drug mom s/s in baby  irritability, constant crying, difficult to comfort. NAS baby priority  monitors newborn response to feedings and weight gain pattern Erythromycin  prevents ophthalmia neonatorum Phototherapy  monitor skin temp closely, reposition the newborn every 2 hours, cover eye with shield/patches HIV mom  standard precautions Mom has DM  maintain safety because of low glucose Vitamin K  prevents bleedings and newborns are deficient in vitamin K HIV mom: cannot breastfeed Low set ears  notify health care provider Cord teaching need for further instruction  diaper over cord to prevent infection Alcohol withdrawal S/S  tremors, irritability, poor feeding Bath need for further teaching  mother baths newborn after feeding Uncircumcised bathing for boy  avoid pulling back the foreskin, Bathing newborn  begin with eyes and face Elicit the moro reflex  abrupt noise to startle the newborn APGAR of 5 at 1 minute  oxygen supplementation and suctioning APGAR of 4  administer oxygen via resuscitation bag to the newborn infant Loss of heat of conduction  place a warm blanket on the examining table APGAR 5  newborn requires some resuscitative interventions Rubella non-immune  get vaccinated and avoid pregnancy for at least a few months Temp of 100.2 in 8hrs PP  give fluids Prevent infection  educate mom to change pad at each void. Breast firm/warm  encourage mom to exclusively breastfeed Prevent engorgement  breastfed every 2-3 hours. Fundus firm, at umbilicus, perineum intact with heavy bleeding  notify provider Bottle feeding mom  turn back to shower, and wear supportive bra 24hrs. Breast firm, red, and warm  apply ice. Abdominal cramps with breastfeeding  educate mom on the release of hormones Sore nipples with breastfeeding  rotate position + breastfeeding  reduces DM later in life Sex  can have sex once cleared after PP check up Sex discomfort 1st time  vaginal drying may occur with breastfeeding use a lubricant due to low estrogen Early PP physiological change to monitor  decrease blood volume 24hr PP complaining of diaphoresis  explain this is normal Elevated WBC  normal Kegel exercise  practice stopping urine midflow. 3 day PP  -3fundus with rubra or serosa expected 14 day PP  alba expected Most important assessment immediately after birth  fundus

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C-section mom 2 hours ago  have mom turn, and deep breathe 2nd degree laceration  apply ice C-section mom scared to cough  teach to splint with a pillow. C-section mom with constipation 2 days  normal, encourage fluids and walking. Episiotomy  well approximated edges (no drainage, redness or ecchymosis) 1hr post SVD needs to urinate  assist up the BR Fundus assessment  stabilize the bae of the uterus with dependent hand and use the flat part of the fingers to feel. Hematacrit of 26%  report to provider. Hct should not go below 30% Exercise for PP day 2 SVD  kegel excerise okay, slowly increase tone exercise. Boggy, deviated and elevated fundus  massage FIRST. Proper peri care  wash hands before and after, spray perinium from front-back After pain tx  ibuprofen for antiprostaglandin effect PP chills  give mom a blanket. Prevent infection goal  stable WBC, normal temp, no smelling discharge Taking in phase  discuss labor and birth with mother, Taking hold phase  reassure mom she is an excellent mother, 2hours PP wanting to eat and sleep and have nurse change diaper  normal PP behavior. 2 year old sister happy for baby to come home  warn mom about likelihood of jealousy Assessment before methergine  check BP Side effect of methergine  cramps PP assessment: palpate breast, check vaginal discharge, asse extremities, inspect the perineum PP assessment cection  listen to abdomen, palapte fundus, assess nipple integrity, listen to lungs....