OB EAQs prior to HESI
Kernicterus manifestations
*Abnormalities in tone and reflexes*, *choreoathetosis, tremor, oculomotor paralysis*, sensorineural *hearing loss* and *cognitive impairment*.
PURPLE crying
*P* peak of crying *U* unexpected *R* resists soothing *P* pain-like face *L* long-lasting *E* evening
Below the spine
+!
1 cm above the spine is noted as?
-1
Preterm infant enteral feedings should be how many calories?
105-130 kcal/kg/day
Multiparas often feel movement by?
16th week of gestation
Crying may increase weekly peaking in month?
2 then decreasing month 3-5
How long does it take for physiologic jaundice to resolve?
5 to 7 days (Bili peaks 2-4 days of life and is normal in 5 to 7)
Newborn Environment safety temperature for a health unclothes full-term newborn
92.1 F (89.6 F to 92.3 F)
Abnormal temperature in infants may lead to hypoglycemia or hypoxia this ranges from?
97.7 as the low-end abnormal and 110.4
NEC is an acute inflammatory disease diagnosed by?
A
During the second stage of labor the woman experiences what?
A strong urge to bear down
What is vernix caseosa?
A white cheese like substance covering the lanugo
Signs of feeding intolerance
Apnea, cyanosis, coughing, choking, spitting up, drooling, gulping, falling asleep early during feeding (may be fatigued), feeding time of >20-30 minutes (may require feeding support, or a specialist consultation)
Preterm infants are at risk for what conditions?
Apnea, hyperbilirubinemia, feeding difficulties, temperature instability
What findings concern the oncoming nurse during handoff report of a preterm infant on continuous feedings?
Aspiration was green with bile, stomach contents were brown, residual was more than half the previous feeding (too large), and the gastric residual was checked after 6 hours (Check every 2-4 hours)
Signs of an epidural hematoma usually do not appear for 24 hours or more. Parents are instructed to care for children with a mild concussion by?
Assessing responsiveness every 2 hours for 2 days
Where should temperature probes be placed on preterm infants?
Axilla, flank, abdomen
Small for the date (SFD) or small for gestation age (SGA), large gestational age
Between the 10th percentile on intrauterine growth curves, above the 90th percentile on intrauterine growth curves
The breakdown of RBCs is the principle source of?
Bilirubin, (Unconjugated bilirubin causes jaundice)
Facial nerve paralysis may be due to?
Birth trauma from a difficult birth
Urinary frequency increases during the first trimester of pregnancy due to?
Bladder pressure from the enlarged uterus
Petroleum gauze helps control?
Bleeding and prevents adherence to the diaper
If concerned about weight gain, overfeeding, and fluid retention what interventions may be included?
Blood glucose assessment, assessment of fluid state and urinary output, individualized by the HCP
Passage of the mucus plug (Operculum) occurs as the cervix ripens and is also called?
Bloody show
Encopresis should be assessed by?
Bowel habits, nutrition, psychosocial factors, and a physical exam
The nurse tells the patient of a preterm infant who has birth asphyxia and is at risk of necrotizing enterocolitis?
Breast milk will be given enterally (Breast milk provides passive immunity, macrophages, and lysosomes)
Presentation refer to the fetus entering the pelvic inlet first and lead on. What presentations may be seen?
Breech, cephalic, shoulder
Hood therapy is used to oxygenate infants with Spo2 <92%. If saturation levels are not maintained after hood therapy initiate what intervention?
CPAP
A lump on the right side of an infant's head wasn't there at birth 36 hours ago. After assessment of the infant, which response by the nurse is appropriate?
Cephalhematoma may be present, I'll make a note and have the pediatrician assess it, develops over 24-48n hours of life
Infants born in the 90th percentile may requires?
Cesarean birth, assessment for shoulder dystocia, examination for injuries after birth due to large gestational age
Fetal macrosomia may be a cause of?
Cesarean delivery in patients with GD
Signs of stress and overstimulation
Changes in respiration Cyanosis, pallor, or mottling Flaring nares Sneezing, coughing Stiff, extended arms and legs Fisting of the hands or splaying (spreading wide apart) of the fingers Arching Alert, worried expression Turning away from eye contact (gaze aversion) Regurgitation, gagging, hiccupping Yawning
Kernicterus is a permanent neurological injury from?
Chronic accumulation of unconjugated bilirubin in the blood
Postpartum hemostasis occurs due to?
Compression of intramyometrial blood vessels as the uterine muscles contract
When a newborn is placed on a scale what heat loss occurs?
Conduction
Prolonged immobility can result in?
Constipation and demineralization of bone recommend oatmeal, raisins, and milk for prolonged rest
What factors affect labor and birth?
Contractions, birth canal, fetus and placenta
What heat transfer occurs when an infant is warmed in an incubator?
Convection
CHOP
Cord compression Head compression Okay Placental insufficiency
A 43-week gestation client has just given birth. What postmature signs might be identified by the nurse?
Cracked and peeling skin, long scalp hair and fingernails, creases covering the neonate's full soles and palms
Respiratory function
Decreased number of functional alveoli Deficient surfactant levels Smaller lumen in the respiratory system Greater collapsibility or obstruction of respiratory passages Insufficient calcification of the bony thorax Weak or absent gag reflex Immature and friable capillaries in the lungs Greater distance between functional alveoli and the capillary bed
Mechanical ventilation is used for respiratory failure, apnea, and bradycardia. CPAP is delivered by nasal prongs, mask, or ET tube to provide constant distending pressure to promote lung expansion and prevent alveolar collapse. High-frequency oscillation (HFO) is used to?
Deliver fast, frequent, respirations with less pressure and volume, which decreases lung injury from pressure and volume (Barotrauma, Volutrauma)
Macrosomia is seen in infants born to?
Diabetic mothers
Multiple fetuses may cause overdistention of the abdomen and separation of abdominal walls and muscles. This condition is called?
Diastasis recti abdominis
Inevitable abortion signs are?
Dilated cervix, uterine contractions, ruptured membranes
Increased uric blood acid levels result from the destruction of cells and may lead to renal problems. Increased fluid intake will help?
Dilute the urine and is an indicator the fluid intake needs to increase
Serum AFT is used in conjunction with unconjugated estriol levels, and Human Chorionic Gonadotropin levels to help determine?
Down Syndrome
What maturational factor would the nurse recognize is most associated with participating in risk-taking behaviors?
Early developing girl, late developing boy
TPN is used to avoid?
Electrolyte loss
Women with mastitis should be taught to?
Empty their breast frequently
Every 4 weeks see your provider until you reach 28 weeks then see your provider?
Every 2 weeks
A 7-year-old diagnosed with diabetes type 1 is being educated on how to give insulin injections. Which would be included in the first lesson?
Explaining why insulin is needed, providing a syringe for the child to practice manipulating, seeking a return demonstration of how to give an injection to a doll
Overhydration signs and symptoms
Facial edema or extremity, weight gain greater than expected, bulging fontanels, difficulty breathing, crackles
The nurse is assessing a child diagnosed with acute lymphocytic leukemia. What early findings would you suspect to identify?
Fatigue, ecchymosis areas
NEC clinical signs
Feeding intolerance, abdominal distention, tenderness, decreased bowel sounds, a visible loop of bowel, erythema of intestinal wall, blood stools, signs of infection, apnea, bradycardia, temperature instability, lethargy, hypotension, shock, thrombocytopenia, increased or decreased leukocytes, metabolic acidosis
Nonstress test at 36 weeks are used to observe for?
Fetal activity and accelerations of the FHR to determine fetal well being of the baby
First stage of labor priorties?
Frequent position changes
Signs of neonatal opioid withdrawal are made up of?
Frequent sneezing, high-pitched crying, difficulty feeding, hyperactive DTRs, Hyperactivity, and a diminished Moro Reflex
Ultrasound requires a?
Full bladder
How do you soothe a crying baby?
Gentle, rhythmic rocking Skin-to-skin contact Patting and/or back rubbing Swaddling White noise or soothing sounds
VLBW infant who has a preterm birth is likely to show what condition?
Germinal matrix hemorrhage-intravascular hemorrhage (GMH-IVH) (increase or decreased cerebral blood flow subsequent to asphyxia makes preterm infants vulnerable to ischemic injury
School-aged general safety equipment
Helmet, padding, eye shields, mouth shields
The average head circumference is 12.6-14.5 inches (32-36.8 cm), about 1 inch or 2.5 cm larger than the chest circumference. What condition is the nurse concerned about?
Hydrocephalus
Seizures and flushed skin are signs of?
Hyperthermia
Small frequent meals over a 24-hour period help decrease the risk of?
Hypoglycemia and ketoacidosis
Mottled skin results from?
Hypothermia
LBW newborns are at risk for?
Hypothermia a polyethylene bag may be used to prevent heat and water loss
As tissue sloughs off from internal radiation what adverse reaction might be seen?
Increased temperature
Bronchopulmonary dysplasia occurs most often in?
Infants born prior to 32 weeks gestation
Retinopathy commonly occurs in?
Infants less than 2 lb 12 oz
Parenteral nutrition such as TPN involves?
Infusions per the HCP orders, scrupulous hand hygiene, frequent repositioning and maintain body alignment and protect the IV site
A spinal cord lesion has increased cranial pressure. What assessment finding leads the nurse to suspect this?
Irritability, high-pitched cry, ineffective feeding behavior, bulging fontanels
Droplet precautions are used to?
Keep the child away from uninfected people
Android pelvis is heart shaped and the?
Least favorable for vaginal birth
LBW is defined as? LVLBW is defined as? ELBW is defined as?
Less than 2,500 G, 1,500 G, 1,000 G
Less than 2,000 g is?
Less than low but too high for extremely low
Newborn enzyme defficiency
Lipase (fat digestion), Pancreatic amylase (complex carb digestion)
Low gestational age is predictive of?
Low physiologic function, low birth weight with worsened function
What factors limit the survival of a 23-week preterm infant?
Lung oxygenation capability, CNS function
VEAL CHOP
MINE
Congenital sepsis may be seen in an infant caused by a?
Maternal UTI
What nursing intervention promotes maturation of the intestinal tract and intestinal motilities in premature newborns?
Minimal enteral feedings (Trophic) promote maturation of the intestinal tract, intestinal motility, and gastric hormone production
Thermoregulation
Minimal insulating subcutaneous fat Limited stores of brown fat (an internal source for the generation of heat present in normal term infants) Fragile capillaries Decreased or absent reflex control of skin capillaries (shiver response) Inadequate muscle mass activity (rendering the preterm infant unable to produce his or her own heat) Poor muscle tone, resulting in more body surface area being exposed to the cooling effects of the environment Immature temperature regulation center in the brain
To minimize skin infection focus primarily on what prevention?
Minimize adhesives, gentle cleaners tubes, positioning, hand hygiene, infection prevention, catheters, tape
Subinvolution is the failure of the uterus to return to the?
Nonpregnant state due to retained placental fragments and infection
Circumoral pallor (Cyanotic hands and feet) and the infant cries when he feeds. What action should be done?
Notify HCP, circumoral pallor may indicate cardiac problems
Signs common in the days preceding labor are?
Persistent low backache, blood-tinged cervical mucosa, profuse vaginal mucus, loss of 0.5-1.0 kg
Children with ASD for lab testing should be?
Placed in a private room to decrease stimulation by placing the child in a private room may lessen the disruptiveness of hospitalization
Infants less than 29 weeks may be placed in a?
Polyethylene bag or wrap that covers them from shoulder down, bags prevent heat loss by evaporation and decrease insensible water loss
Signs of poor thermoregulation in newborns include?
Poor feeding or intolerance, irritability, lethargy, weak cry or suck, decreased muscle tone, skin pale, cool to touch, mottled, respiratory distress, poor weight gain
Infant calories requirements
Preterm 105-130 kcal/kg/day
Weak gag reflex, small and scrawny with a soft cranium are characteristics of a?
Preterm infant
Hypotonia, bradycardia, and feeding intolerance indicate the need for the neonate to be treated with a?
Prewarmed radiant warmer (Hypothermia below 36.5 C)
Gavage feedings are enteral feedings used to?
Provide nutritional support using a feeding tube directly to the stomach
Overstimulation treatment
Reduce environmental stimuli (lights, noise) Cluster care activities to provide time for rest periods Decrease handling and allow for rest in quiet, dark space Swaddle and offer pacifier if not contraindicated
Administration of surfactant tends to lead to?
Reduced ventilator and oxygen therapy support increasing survival rate
School health programs perform what activities for ongoing health maintenance in children?
Referrals, screenings, assessment
Palliative care is aimed at?
Relieving discomfort without curing the problem
Hydrogel and hydrocolloid dressings may be used to?
Reposition every 2 to 3 hours,
Signs of Nonreadiness for Nipple Feedings
Respiratory rate >60 breaths/min No rooting or sucking Absent gag reflex Excessive gastric residuals
During the reactivity period (first 30 minutes after birth) what findings should you expect?
Retractions, nasal flaring, audible grunting, tremors
Preterm infant skin care precautions
Rinse with water after using alcohol on the skin, use hydrocolloid adhesives on the skin, avoid solvents to remove tape
Signs of nipple feeding readiness include?
Rooting Respiratory rate <60 breaths/min An increasing ability to tolerate holding and handling Sucking on the gavage tube, a finger, or a pacifier
Feeding readiness cues
Rooting reflex, hand-to-mouth, sucking on gavage tube, finger, pacifier, mouthing
High-risk preterm infants should routinely have what done in their care plan?
Routinely monitor BP, assess I&Os, Assess for respiratory distress, encourage skin-to-skin contact (Kangaroo)
Immune function
Shortage of stored maternal immunoglobulins Impaired ability to produce antibodies Compromised integumentary system (thin skin and fragile capillaries)
Coombs test titer of 1:* indicates?
Significant Rh incompatibility
Preterm newborn appearance
Skin appears bright pink or red, shiny, smooth, and is often translucent (blood vessels may be visible) Vernix caseosa and fine lanugo hair may be present on body Ear cartilage is soft and pliable Minimal creases to soles and palms; appear smooth Male infants may have undescended testes and few scrotal rugae Female infants may have prominent labia minora and clitoris
Unreadiness cues
Sleepiness, tachypnea (increases the risk for aspiration)
Fabric-insulate or wool hats are more effective than?
Stockinette hats
To promote safe sleep for newborn they should be?
Supine, on a firm surface with only a fitted sheet, don't use a crib with drop rails, remove soft objects, loose bedding, and crib bumpers, consider a pacifier during sleep, avoid overheating, dress the infant in a sleep sack or one-piece sleeper
Hypoglycemia symptoms
Sweating, pallor, clammy skin, shallow slow respirations,
Clinical signs of RDS
Tachypnea > 60 breaths per minute, Dyspnea, Retractions. crackles, expiratory grunting, nasal flaring of the nares, apnea, cyanosis,
What factors increase injury in school-aged children?
The protection offered by adults, the behavior pattern of the child, and the dangers present in the environment
The infant less than 32 weeks is being cared for by a nurse and her student. What action by the student nurse is inappropriate?
The student removes the silicon-based adhesive from the infant's skin by pulling horizontally parallel to the skin
Secondary powers of labor
The use of abdominal muscles to push during the second stage of labor with expulsive in nature contractions
Vaginal bleeding is a sign of?
Threatened abortion
Early postpartum ambulation helps prevent complications of?
Thrombophlebitis and constipation
How is fluid balance monitored?
Tracking number of wet diapers each day and monitoring signs of fluid overload and dehydration
Pattern-paced breathing is suggested during what phase?
Transition stage
kangaroo care
Treatment for preterm infants that involves skin-to-skin contact.
Risk factors for SGA
Turner syndrome, history of alcohol abuse, poorly controlled diabetes
Necrotizing enterocolitis is caused by?
Unknown causes but results in inflammatory condition of the intestinal tract and may lead to necrosis, it's most uncommon in infants whose GI tract experiences vascular compromise, intestinal ischemia, immature GI host defenses, bacterial proliferation, feeding substrate
Signs of dehydration
Urine output <2 mL/kg/hr Urine specific gravity >1.01 Weight loss greater than expected Dry skin and mucous membranes Sunken anterior fontanel Poor tissue turgor Blood: elevated sodium, protein, and hematocrit levels
Extremely low birth weight is categorized as less than 1000 g for high-risk infants less than 1,500 g is considered?
Very low birth weight
Chickenpox is communicable until the?
Vesicles have dried
What characteristics might be seen in an infant born after 42 weeks gestation?
Wasted physical appearance (Intrauterine deprivation), green vernix caseosa or skin,
Nutrition and feeding signs and symptoms of preterm newborns
Weak or absent suck, swallow, and gag reflex Difficulty coordinating sucking, swallowing, and breathing Small stomach capacity Weak abdominal muscles Limited store of nutrients Decreased ability to digest proteins or absorb nutrients Immature enzyme systems
Preterm newborn assessment findings
Weight gain of 15-20 g/kg/day, premature may lose up to 15% of birth weight the first week of life compared to 10% in normal newborns, axillary temperature of 36.3 to 46.9
When does fertilization occur?
When 1 sperm penetrates the wall of the ovum
3-day-old newborn circumcision teaching
Yellow exudate is normal after 24 hours and should not be wiped off, 6-8 diapers in a 24-hour period are normal, wash with warm water only, apply the diaper loosely over the penis to prevent pressure on the circumcised area
Neonatal Abstinence Syndrome (NAS)
a condition in which a child, at birth, goes through withdrawal as a consequence of maternal drug use
APGAR score
a scale of 1-10 to evaluate a newborn infant's physical status at 1 and 5 minutes after birth, appearance (pink body blue extremities 1), pulse, less than 100 BPM is 1, grimace, activity tone, respirations (strong cry)
Primary powers
dilation, expulsion, effacement,
nodule
solid, round, or oval elevated lesion 0.5 cm or more in diameter
ECMO (extracorporeal membrane oxygenation)
takes blood out of the lungs, oxygenates it & puts it back in the lungs; last line treatment for ARDS
VEAL
Variable deceleration Early deceleration Acceleration Late deceleration
Inhaled nitrous oxide promotes pulmonary vasodilation in pulmonary circulation and is administered through the?
Vent circuit w blended oxygen
Placenta previa painless and abruptio placentae
Abdominal pain
Trendelenburg position increase what resulting in what?
ICP and reduced lung capacity
What is the primary measure to promote placental perfusion during labor?
Placing a folded blanket under one hip during urine catheterization
ARDS (acute respiratory distress syndrome)
respiratory insufficiency marked by progressive hypoxia
Cervix function
allow flow of menstrual blood from the uterus into the vagina, and direct the sperms into the uterus during intercourse, allows fetal descent into the vagina by effacing and dilating
Couplet Care (Mother-Baby care)
nursing care management approach in which one nurse cares for both the mother and her infant
Premature newborn appearance
Small size Head appears large related to the size of body (due to cephalocaudal growth) Scrawny due to limited subcutaneous fat Low muscle tone (hypotonicity)Low activity level, related to low muscle tone Extremities limp and in the extended position
Hematologic status
Increased capillary fragility Increased tendency to bleed (prolonged prothrombin time and partial thromboplastin time) Slowed production of red blood cells resulting from rapid decrease in erythropoiesis after birth Loss of blood due to frequent blood sampling for laboratory tests Decreased red blood cell survival related to the relatively larger size of the red blood cell and its increased permeability to sodium and potassium
Adverse signs of nipple feeding
Increased or decreased heart rate Increased or decreased respiratory rate Markedly decreased oxygen saturation level Apnea Cyanosis, pallor Coughing, choking Gagging, spitting up Drooling, gulping Falling asleep early in the feeding Feeding time more than 20 to 30 minutes
Signs of pain
Increased or decreased respiration, apnea High-pitched, intense, harsh cry Whimpering, moaning "Cry face" Eyes squeezed shut Grimacing Bulging or furrowing of the brow Sleep-wake pattern changes Tense, rigid muscles or flaccid muscle tone Rigidity or flailing of extremities
Asymmetric IUGR
growth restriction in which the head circumference remains within normal parameters while the birth weight falls below the 10th percentile
Cephalohematoma
hemorrhage between skull-periosteum, may develop jaundice, hypotension- takes weeks to resolve
Clinical signs of IVH
lethargy, poor muscle tone, respiratory deterioration, cyanosis, apnea, decreased HCT, acidosis, decreased reflexes, tense fontanels, seizures
MINE
maternal repositioning, identify labor progress, no intervention, execute interventions
Late preterm infants most commonly have problems of?
Hypothermia, hypoglycemia, hyperbilirubinemia
What factor is associated with reduced pain and euphoria feelings during labor?
Increased beta-endorphin levels
What newborn assessment finding indicates follow-up care?
30-degree abduction of the hips (Developmental Hip Dysplasia)
hyperemesis gravidarum diet
-Start with dry toast, crackers, cereal, baked chicken -Move to a soft diet -Then to normal diet as tolerated.
Bronchopulmonary dysplasia (BPD) is most common in infants born at 28 weeks weight less than?
1,000 G, resulting from acute lung injury among infants receiving supplemental O2 and mechanical ventilation, related to alveolar damage from lung disease, prolonged exposure to mechanical ventilation, high peak inspiratory pressures and oxygen, immature alveoli
Intraventricular hemorrhage is bleeding around and into the ventricle of the brain. 30% of preterm infants weighing less than?
1,500 G 3.3 lb, develop IVH, occur most in first few days, graded 1-3 1 small bleeding, 2 extends into lateral ventricles, 3 distention of ventricles
Following delivery intestinal peristalsis is slow for?
2 to 3 days because of decreased intestinal muscle tone, if no BM occurs after 2 to 3 days administer an enema
Newborn weight gain is?
20-25 g/day
Most primigravida's feel movement by the?
20th week of gestation
RDS is caused by insufficient production of surfactant, which is usually produced beginning at
34 to 36 weeks of gestation. Surfactant reduces alveolar surface tension, allowing alveoli to remain open during exhalation. Insufficient surfactant production results in alveolar collapse on exhalation. Widespread atelectasis occurs because infants are unable to keep lungs inflated.
What information would the nurse include in parental education about bullying?
A cyberbully can remain anonymous, bullying usually takes place at school, and cyberbully attacks can reach a wide audience
Suction should be performed for?
5 to 10 seconds due to decreasing oxygenation, often hyper-oxygenated before or after suction, risks trauma to mucous membranes and may result in narrow airway, or edema
NEC generalized signs
Abdominal distention, temperature instability, grossly blood stool, decreased activity, hypotonia, pallor, recurrent apnea, bradycardia, decreased Spo2, respiratory distress, oliguria, metabolic acidosis, hypotension, decreased perfusion, cyanosis, residual gastric aspirates, vomiting, erythema of the abdominal wall, tenderness
Central Nervous System Function
Birth trauma with damage to immature structures Bleeding from fragile capillaries An impaired coagulation process, including prolonged prothrombin time Recurrent hypoxic and hyperoxic episodes Predisposition to hypoglycemia Fluctuating systemic blood pressure with concomitant variation in cerebral blood flow and pressure
Excessive uterine bleeding after birth may cause the bladder to become?
Distended because it pushes the uterus up and to the side and prevents it from contracting firmly
club foot treatment
Do early Serial casting Change every 1-2 weeks Wear a splint with a crossbar Shoes that point outward
What questions does the nurse ask the parent of a child suspected of being bullied at school?
Does your son exhibit anxiety, has your child tried to harm themselves, how is your child's academic performance
BPD clinical signs
Dyspnea, barrel chest, inability to wean from mechanical ventilation after RDS (Surfactant deficiency), wheezing, tachycardia, tachypnea, weight loss, poor weight gain, poor feeding, irritability, restlessness
Caput Succedaneum is?
Edematous swelling on the scalp caused by pressure during birth. This swelling may cross the suture line. It usually disappears in a few days found on the occiput
Dehydration signs and symptoms
Fewer than 5-6 wet diapers per day for newborn 3-4 days old or older, weight loss greater than expected, dry skin and mucous membranes, sunken anterior fontanel, poor skin turgor
What conditions alert concern relating to a preterm infant with respiratory distress syndrome?
Hypoxemia (Prolonged hypoxemia increases lactic acid and results in metabolic acidosis), Metabolic Acidosis, Hypercapnia
Traction is used to?
Immobilize the area and minimize injury to the spinal cord, extend the muscles, allow the vertebrae to separate and minimize cord compression
Renal Function
Inadequate excretion of metabolites and drugs Impaired ability to concentrate urine Inability to maintain acid-base, fluid, and electrolyte balance
A newborn with a heart rate of 76 and gasping should have what action taken?
Initiate positive-pressure ventilation and monitor Spo2
Late preterm infants have difficulty with?
Latching when breastfeeding, immature sucking reflexes, shorter awake periods, increased caloric needs, and immature swallowing abilities
Antepartum fetal assessment risk factors include
Obesity, cholestasis, thrombophilia, and chronic HTN
As the fetus head crowns on the perineum what breathing technique is instructed?
Open glottis (prevents Valsalva and permits a controlled birth of the head)
Gavage feedings are administered by?
Oral or nasal route over 30-60 minutes by bolus
Nonpharmacologic comfort for newborns in pain
Pacifier for nonnutritive sucking, soft rocking, holding, prone position, skin-to-skin contact, breastfeeding, containment (Facilitated sucking), the position of the extremities flexed and midline, one hand near mouth or sucking
The decreased responsiveness period occurs 60-100 minutes after the first period of reactivity and manifest signs of?
Pink skin color, quick shallow respirations
Classification of gestational age?
Preterm- Before 37 weeks Late Preterm- 34 0/7- 37 Early Term- 37 0/7- 38 6/7 Full Term- 39 0/7- 40 6/7 Late Term- 41 0/7- 41 6/7 Post-term (Postmature)- After 42 weeks
Pulmonary hemorrhage and mucus plugging are side effects of?
Surfactant therapy used in infants with RDS
A full bladder places the uterus in the optimal position for imaging because it raises the uterus out of the pelvis. True or false?
True
A gentle cleaner with a pH of 5.5-7 may be used for bathing true or false?
True
RhoD administration after amniocentesis is standard practice true or false?
True
Sitting devices such as car seats, swings, and infant carriers are not recommended for sleep due to the risk of suffocation or airway obstruction true or false?
True
Signs of overhydration
Urine output >5 mL/kg/hr Urine specific gravity <1.002 Edema Weight gain greater than expected Bulging fontanels Moist breath sounds Difficulty breathing Blood: decreased sodium, protein, and hematocrit levels
Nursing interventions to maintain fluid and electrolyte balance
Use IV infusion control devices that administer fluid with a precision of 0.1 mL/hr. IV medication dilution should be the minimal amount needed for the safe administration of the drug. Promote IV patency by assessing often; use of restraint may be needed to prevent infiltration. Frequent laboratory testing may necessitate a blood transfusion. Interventions for infants with increased stooling or voiding, evaporative losses, and/or inadequate fluid administration may include adjusting incubator temperature and providing high humidity under cover in radiant warm (known as swamping).Adjusting the volume of fluid administered. Assessing blood glucose if hyperglycemia is suspected, which may cause diuresis
Coombs test
a test for the presence of anti-Rh factor antibodies in the blood (this is often given to pregnant women that are Rh- to see if they will mount an immune response against the blood of their fetus)