CMCA Lec Finals
Cervical mucus/ovulation
• It is a fluid produced by small glands near the cervix. • this fluid changes throughout the cycle, from scant and sticky, to cloudy and thick, to slick and stringy
crossed extension reflex
• One leg of newborn is lying in supine is extended and the sole of the foot is irritated by being rubbed with sharp object, such as thumb nail.
magnet reflex
• Pressure applied to the sole of the foot of the baby lying in supine position, the baby pushes back against the pressure. • Test the spinal cord integrity
rooting reflex
• This reflex starts when the corner of the baby's mouth is stroked or touched and lasts about 4 months
trunk incurvation reflex
• When a newborn lies in prone position and is touched along the paravertebral area on the back by a probing finger, the newborn flexes the trunk swings the pelvis toward the touch.
plantar grasp reflex
• When an object touches the sole of the newborn's foot at the base of the toes, the toes grasp in the same manner as the finger's do. • Disappears at about 8-9 months of age in preparation for walkin
babinski reflex
• When the side of the sole of the foot is stroke in an inverted J curve from the heel upward the newborn fan the toes. • Remain positive until 3 months of age.
rhythm (calendar method)
• abstaining from coitus on the days of menstrual cycle when a woman is most likely to conceive ( 3 or 4 days before or until 3 or 4 days after ovulation). • Woman keeps a diary of 6 menstrual cycle
Coitus interruptus (withdrawal)
• one of the oldest known method of contraception • couple proceeds with coitus until moment of ejaculation which offers little protection.
extrusion reflex (tongue thurst reflex)
•A new born will extrude any substance that is placed on the anterior portion of the tongue • Disappear at about 4 months
vernix caseosa
cheese like material, serves as insulator
▪Early as possible ▪Exclusive for 4-6mos ▪Extended up to 2 y.o
what are the 3 e's in breastfeeding?
1. the area where the placenta was implanted is sealed off to prevent bleeding. 2. Organ is reduced to its pregestational size.
what is the 2 processes of involution?
Labia minora and majora remain atrophic and softened
what part of perineum that never returned to the prepregnant state?
6 weeks
when is the time involution is complete?
landau's (parachute) reflex
• A newborn who is held in a prone position with a hand underneath supporting the trunk should demonstrate some muscle tone
diaphragm
- most common and easiest to fit and use. - the device is introduced 3 hrs before intercourse and be kept at least 6 hours after intercourse.
nevi (stork bites)
- pink or red flat areas of capillary dilatation seen on upper lids, nose, upper lip, nape and neck; disappears at 1st and 2ndyear
Acrocyanosis
(cyanosis of the hands & feet) is so common in newborns that a score of one in this category is normal
spermicides
- available as vaginal foam, gel, tablets, creams and suppositories - alter sperm cell membrane permeability resulting to killing of sperm.
cavernous hemangiomas
- dilated vascular spaces; do not disappear with time.
letting go phase
- interdependent phase
B
A 23 year-old nulliparous client visiting the clinic for a routine examination tells the nurse that she desires to use the basal body temperature method for family planning. The nurse should instruct the client to do which of the following? A) Check the cervical mucus to see if it is thick and sparse B) Take her temperature at the same time every morning C) Document ovulation when the temperature decreases at least 1 F D) Avoid coitus for 10 days after a slight rise in temperature
all of the above
According to World Health Organization " the use of range of methods of fertility regulation to help individuals / couples attain certain objectives: • Avoid unwanted birth • Bring about wanted birth • Produce a change in the number of children born • Regulate the intervals between pregnancy • Control time at which birth occur
after the first breath
Color of the baby grow pink shortly...?
letting go phase
Focuses on forward movement of family as unit with interacting members, reassertion of relationship with partner, resumption of sexual intimacy, resolution of individual roles.
FSH remains low for about 12 days and then begins to rise as new menstrual cycle is initiated
How long does FSH remains low?
2
How many times do we take the APGAR Score?
Do not wait for the umbilical pulsation to stops and immediately clamp and make the baby cry.
If the baby goes out not crying, what should be the intervention?
abdominal distention
Most newborns have protruding bellies. But if your baby's belly feels hard and swollen in between feeds, do some sleuthing (burp)
1. genetic composition 2.the competency of the recent intrauterine environment 3. the care received during labor and birth 4. and the care received during the newborn or neonatal period
Newborn adjustment depends on:
reflex irritability
Newborn's response to a suction catheter in the nostrils or the response to having the sole of the feet slapped
Immediate Newborn Care and Newborn Assessment
Newborns are adjusting to the new environment. Newborn needs to be warm by means of drying thoroughly and putting in the mother's abdomen which is the skin to skin contact.
All the choices
Postpartum blues is said to be normal provided that the following characteristics are present. These are: • All the choices • Resolves within 10-14 days • May be more severe in primipara • Exhibits the following attitude; mood swings fatigue, headaches and anxiety
Resuscitation ASAP
Score interpretation of APGAR: 0-3
transverse/crossover hold
The proper way to hold the baby is chest-to-chest, at the level of the breast. Baby's head should be in the crook of your arm and your hand should hold baby's buttocks
True
True or False All infants appear cyanotic at the moment of birth
R - edness E - dema E - cchymosis D - ischarge A - approximation
What does REEDA means?
1 minutes after birth and the next is 5 minutes after birth
When do we take the APGAR Score?
suck reflex
When the roof of the baby's mouth is touched, the baby will start to suck. This reflex doesn't start until about the 32nd week of pregnancy and is not fully developed until about 36 weeks
stepping reflex
a baby appears to take steps or dance when held upright with his or her feet touching a solid surface. This reflex lasts about 2 month
rubella vaccine
a live virus and is contraindicated during pregnancy. Therefore, all women should be instructed to avoid becoming pregnant for the four weeks following the administration of the vaccine
family planning
a term used for pre-pregnancy planning and action to delay, prevent or actualize a pregnancy
nevus flammeus
aka portwine stain; red to purple in color; do not blanch on pressure and do not disappear
tonic reflex
also known as fencing reflex
REEDA
an acronym used to assess episiotomy wound healing after vaginal delivery
Routine Newborn Care
an important factor for the adjustment and survival of the newborn in the new environment
postpartal infection
an increased of temp of 38C after 24 hours may mean ?
postpartum blues
are considered a transient period of depression, occurs 1st few days of puerperium
mongolian spots
bluish-black/ slate gray pigmentation across the sacrum or buttocks; disappear by SCHOOL AGE
Ecchymosis
bruising
progressive maternal
changes like production of milk for lactation, restoration of normal menstrual cycle and beginning of a parenting role.
a uterine cervix is soft and malleable.
characteristic of cervix during postpartum
moro/startle reflex
causes the baby to cry, throw back his or her head, and then u his or her limbs into the body
retrogressive maternal
changes like involution of the uterus and vagina.
by 10th day
day when regeneration of the epithelium is completed
On the 3rd to 5th day
day when the breast may become engaged (full and firm)
by 16th day
day when the endometrium is restored
at about 6 weeks
day when the endometrium of placental site is restored
Properly timed cord clamping and cutting until the umbilical cord pulsation
decreases anemia in one out of every seven-term babies and one out of every three preterm babies. It also prevents brain (intraventricular) hemorrhage in one of two preterm babies.
taking hold phase
dependent/independent phase • Starts end of 3rd day pp, last for 10 days to several weeks
forceps marks
disappears in 1-2 days
dyspareunia
dryness and coital discomfort
strawberry hemangioma
e l e v a t e c a p i l l a r i e s a n d endothelial cells; complete disappearance by 10 years old
lying down hold
especially useful after Cesarean birth. Side lying position allows mother and baby to rest while breastfeeding
lanugo
fine, downy hair at shoulders, back and upper arms; disappear by 2 weeks.
erythema toxicum
fleabite rash; pink papules with vesicles seen at nape, back and buttocks; appears usually 2nd day; no treatment needed.
prolactin
hormone which is stimulated by the baby's sucking to promote lactation.
500-1000 ml
how many blood loss during cesarean birth?
300-500 ml
how many blood loss with vaginal birth
lactational amenorrhea
if the mother is breastfeeding, a menstrual flow may not return for 3 or 4 months
football hold
is a good position for latch-on problems, or for premature or Cesarean birth babies
involution
is the process whereby the reproductive organs return to their nonpregnant state.
taking hold phase
it focuses on focuses on care of baby, desire to take charge, still need nurturing and acceptance by others, eagerness to learn (period to teach most receptive time to learn), possible experience pp "blues"
desquamation
peeling of skin; indicates postmaturity
POSTPARTAL/PUERPERIUM
refers to the 6 week period after childbirth or fourth trimester of pregnancy
milia
plugged or unopened sebaceous gland on the cheek or across the bridge of the nose; disappear by 2-4 week
Breastfeeding initiation within the first hour of life
prevents an estimated 19.1% of all neonatal deaths
Immediate and thorough drying of the newborn
prevents hypothermia which is extremely important to newborn survival
Keeping the mother and baby in uninterrupted skin-to-skin contact
prevents hypothermia, hypoglycemia, and sepsis, increases colonization with protective bacterial flora and improved breastfeeding initiation and exclusivity
0
score of the color when color blue in the APGAR Score
diastasi recti
separation between the abdominal wall where the muscle tone is diminished and abdominal wall is weak
Prolactin
this hormone causes the engorgement
taking in phase
this is the dependent phase. • 1st 24 hours range 1-2 days, focus on self and meeting basic needs, reliance on others to meet needs of comfort, rest, closeness, nourishment, relives birth, excited and talkative
vagina
this returns to pre-pregnant state by 3rd or 4th week
true
true or false extensive diuresis begins to take place after birth
true
true or false diaphoresis is also present after birth
lochia
uterine flow, consisting of blood, fragments of decidua, white blood cells, mucus, and some bacteria.