Maternity Final Exam 2

The nurse is assessing a male client who is concerned about his ability to produce enough sperm to have a child. He tells the nurse, "I have had some issues in my younger years." What questions would be important for the nurse to ask this client? Select all that apply. "Do you use drugs or use alcohol excessively? "Are you exposed to X-rays or other radioactive substances?" "Have you ever had any type of trauma or surgery on or near your testicles?" "When was the last time you had sex?" "Do you have a regular girlfriend?"

"Do you use drugs or use alcohol excessively? "Are you exposed to X-rays or other radioactive substances?" "Have you ever had any type of trauma or surgery on or near your testicles?" Conditions that may inhibit sperm production are trauma to the testes, surgery on or near the testicles that results in impaired testicular circulation, and endocrine imbalances, particular of the thyroid, pancreas, or pituitary glands. Drug use or excessive alcohol use and environmental factors such as exposure to X-rays or radioactive substances have also been found to negatively affect spermatogenesis. Men exposed to radioactive substances in their work environments should be provided adequate protection for the testes.

During a routine health visit for an 11-year-old girl, her mother asks the nurse, "My daughter just got her period about 4 months ago, but they haven't been very regular so far. How long might it take until she gets regular?" Which response by the nurse would be most appropriate?

"It can take up to 2 years once she starts for the periods to become regular." Once menarche has occurred, cycles may take up to 2 years to become regular, ovulatory cycles. Telling the mother that her daughter's periods would get regular in 2 to 3 months or that she should be having regular periods by now is incorrect. Also, telling the mother that her daughter's periods will continue to be irregular is untrue and inappropriate.

Describe the underlying mechanisms involved in gestational diabetes and the appropriate treatment as well as the maternal and fetal risks

-Diagnosis for GDM= 24-28 weeks gestation. 2 step test= 1 hour glucose tolerance(130-140) and 3 hour glucose tolerance test. More common in pregnancy because of insulin requirements rise with mom and fetus. -Maternal Risks=hypertension, preeclamspia, c-section(large baby), type 2 diabetes , polyhydraminos -Fetal Risk= Fetal macrosomia (>4000g), Large Gestational Age(head and shoulders get shoulder dystonia), premature birth, respiratory distress -Treatment= controlling diet

Define and describe the Bishop Scoring system

-It's a score that assigns value to whether or not induction of labor will be needed. -Factors include= cervical dilation, cervical effacment, fetal station, cervical consistency, and cervical position. - Score of 8 or higher indicates high chances of vaginal delivery are good(induction) and score of 6 or less means chance of vaginal delivery are not good (no induction)

Describe the common presentations and warning signs of preterm labor

-Labor that presents before 37 weeks of gestation, cervical effacement -uterine contractions, dull backache, feeling of pressure in the pelvic area or thighs, increased vaginal discharge, menstrual-like cramps, vaginal bleeding

What is the approximate rate of unintended pregnancy currently in the US? 60% 45% 25%

45%

Approximately what percentage of women will experience hot flashes during the menopausal transition? 50% 25% 75-85%

75-85%

Amenorrhea*

Absence of menses If the patient is 16 with secondary sex characteristics, but has not had menses, she will need a workup

MGMT of placenta previa

Bed rest Monitor pain Vitals Cross match Rhfactor Monitor FHR IV fluids betamethasone for baby development c-section is necessary Post delivery there is an increased risk of maternal hemorrhage

Describe and explain appropriate techniques for breastfeeding and bottle feeding including care of non-nursing breasts, sore nipples, promotion of breastfeeding and proper education and support of bottle feeding

Breastfeeding= LATCH tool. (latching onto the breasts, audible swallowing, type of nipple, comfort of nipple, hold or position of baby) Bottle feeding= same type of formula, gradual introduction of formula, Non-nursing breasts= wear supportive bras Sore nipples= baby is improperly positioned Breastfeeding education= if baby is sucking from the beasts, then it must come out in the diaper which means its sucessful breast feeding. First 3 days breast have colostrum and then after become more mature milk(increase in quantity)

Genital Herpes (cronic viral)

Characteristics: HSV-1 (Cold sores) HSV-2 (genital herpes) - more frequent recurrences. Can be triggered by stressful events Symptoms: Asymptomatic shedding in the first 12 months. Can be transmitted unknowingly. prodromal (fatigue and body aches) Prevention: Condom use but do not cover everything so it can still spread. Treatment: Acyclovir, famciclovir or valacyclovir PCR for herpes test

HPV

Characteristics: Double stranded DNA virus Types 16 and 18 - high risk are oncogenic (Cervical Cancer, anal and other cancers) (2/3 of all cervical cancers) types 6 and 11 are nononcogenic - low risk (warts and benign cervical changes). 80% of sexually active people will acquire it in their lifetime Prevention: Vaccines cover the 4 subtypes - good for preventing cancer.

Gonorrhea

Characteristics: Particular problem because of antimicrobial resistance so we need to change the antibiotics frequently Symptoms: Prevention:

Chlamydia

Characteristics: Untreated chlamydia leads to pelvic inflammatory disease (PID) which can lead to chronic pain and infertility and increases the chance of ectopic pregnancy Symptoms: asymptomatic, yellow discharge and odor. Azithromycin (1 dose) and Doxcycline can treat chlamydia Prevention: NAATs test (nucleic acid tests) for chlamydia that can be self collected urine tests also

Structure of the Cervix

Ectocervix: Covered by non-keratinizing stratified squamous epithelium The transformation zone is in the middle. This is where we swab during testing because it is constantly being renewed and easy for STDs to be taken up. Endocervix is lined by simple columnar epithelium with lots of cracks for STDs to hide in

The collection of symptoms that define preeclampsia are: Elevated blood pressure, possible proteinuria, possible edema Seizure and blood pressure above 160/110 on 2 separate occasions. Epigastric pain and elevated enzymes Excretion of protein greater than 500 grams

Elevated blood pressure, possible proteinuria, possible edema

sub-involution of uterus

Failure of the uterus to return to non-pregnant state caused by placental fragments and infection. It should be felt in the midline - patient may need to void if bladder is full.

Identify and describe the key nursing interventions and expected findings for the infant in the postpartum period including: feeding, sleeping, circ and umbilical cord care, rationale for Vit K, normal newborn assessment findings

Feeding= two to five stools, steady weight gain, Sleeping= sleeps well Circumcision= observe first void, observe bleeding, careful diaper change, apply vaseline, heals in 10 days Umbilical Cord Care= natural healing, soap and water, alcohol, or povidone-iodine and falls off appx 10 days Vitamin K= helps with clotting factors Normal Newborn Findings= RAPP and APGAR

The school nurse is counseling a sexually active 16-year-old adolescent about the various forms of contraception. She is afraid of getting pregnant or contracting a sexually transmitted infection because her boyfriend refuses to use a condom. In answering the client's questions as to which option will be best suit her needs, which form should the nurse recommend?

Female condom The female condom would be the best choice for this client, as it provides protection against both STIs and conception. A tubal ligation would not be recommended for a 16-year-old girl, as it is a permanent measure and she may decide to have children in the future. Neither an oral contraceptive nor coitus interruptus would provide protection against STIs.

Postpartum headaches

Gestational hypertension Sleep disruption/stress Leakage of CSF into the epidural space

The subtype of HPV that causes cervical cancer is called? Low risk High risk Genital warts

High risk

Differentiate between hypertension, gestational hypertension, preeclampsia, preeclampsia with severe features and eclampsia in pregnancy and maternal and fetal risks

Hypertension= can continue before current pregnancy or after birth Gestational Hypertension= differs from chronic which is before 20 weeks gestation and without proteinuria or preeclamspia Preeclampsia= >140/90 after 20 weeks gestation Preeclampsia with sever features= >160/110 with headache Eclampsia= preeclampsia with seizures Maternal risks= proteinuria fetal risks= poor placental perfusion (hypoperfusion) causes restriction in growth

Moro reflex

Infant reflex where a baby will startle in response to a loud sound or sudden movement.

Possible consequences of PCOS include? SELECT ALL THAT APPLY: Infertility Anovulation Irregular menses PMS

Infertility Anovulation Irregular menses

Describe the hormonal events involved in ovulation

LH= levels increases and help mature follicles to release ovum Estrogen= levels drop (estrogens task is to thicken the lining) FSH= produces the 5 to 20 immature follicles Progesterone: dilates the blood vessels in the uterus

Describe important maternal hormones involved in the immediate postpartum period(think lactogenesis 2)

Lactogenisis helps with milk secretion, oxcytocin elicit the let-down reflex during breastfeeding prolactin stimulates milk production

Women are more prone to infection during which phase of menstruation?

Leutial phase There is slightly less estrogen.

What hormones are added to oral contraceptives? why?

Low levels of synthetic Estrogen & Progesterone are added so they keep a consistent level in blood serum. There is an inhibition of the mid-cycle surge. They can also effect cervical mucus (progesterone only) they must be taken within 1 hour every day to maintain this barrier.

*Describe and explain the mechanism of action and the risks, benefits and side effects of hormonal oral contraceptives*

MOA= Suppression of gonadotropin secretion during the follicular phase of the cycle prevents follicular maturation which leads to the surge of LH, (maturation of follicles or releasing of ovum) Endometrial effects= less suitable for implantation Cervical mucus effects= less permeable to penetration by sperm Tubular effects= impairment of motility Oral contraception can lead to thromboembolism Benefits= decreased cancer, decreased anemia, and 99.9% effective

Post-partum muscular support

May take up to 6 months to regain tone - recommend that they do kegal exercises

Describe the normal characteristics of the vaginal environment, as well as deviations from this norm including common findings in bacterial vaginosis, candidiasis and trichomoniasis

Normal Characteristics of Vagina= acidic environment that is 3.5-4.5. This helps with lubrication. Think of it like a microbiome containing many lactobacilli that produce lactic acid to create a potent microbiocide to block the spread of pathogens and maintain normal healthy flora. glycogen is important as it is the energy source for lactobacilli.

Differentiate between placenta previa and abruptio placentae(peels off) including the presentation and underlying mechanisms

Placenta Previa(painless bleeding)= placenta is abnormally positioned. (found in cervix, instead of fundus) and can increase post-partum hemmorage "quiet and sneaky" Abruptio Placentae(painful bleeding)= seperation of placenta from uterine wall. "sudden and stormy" -Marginal or apparent=seperation at the edge -Complete= extreme bleeding -central or concealed=bleeding may not be visible Can be due to smoking, cocaine, HTN, trauma, age (think vasoconstriction)

placenta previa "complete"

Placenta completely covers/obstructs the os

*STI prevention and Education*

Pre-exposure vaccination Abstinence Reduction of number of sex partners Condom use - the site of potential exposure needs to be covered.

The #1 cause of neonatal mortality (death in the first 28 days of life) in the US is: Gestational diabetes/macrosmia Placenta abruption Prematurity/preterm labor Placenta Previa

Prematurity/preterm labor

Babinski reflex

Reflex in which a newborn fans out the toes when the sole of the foot is touched

Complete placenta separation

Same risks as central

Which information is important for a woman to understand before undergoing a scheduled tubal ligation?

She must think of the procedure as irreversible. Sterilization by fallopian tube obstruction does not alter menstrual symptoms or flow. Ectopic pregnancy could result if it is done following ovulation; reversing the process is difficult.

lochia

Should get lighter and lower in volume over time Lochia rubes - can last 3-4 days Serosa - can last 2 weeks - old blue Alba - 2-6 weeks

Bowel evacuation postpartum

Spontaneous bowel evacuation may not occur for 2 to 3 days after childbirth Fear of perineal trauma / sutures - milk of magnesia can help

pregnancy rhinitis

Stuffy nose that goes away after birth

A major cause of gestational diabetes is: Hormonal changes in the first trimester leading to a decreased need for insulin Changes in carbohydrate metabolism in early pregnancy The increased peripheral tissue resistance to insulin that occurs during pregnancy. Inadequate amounts of insulin throughout pregnancy

The increased peripheral tissue resistance to insulin that occurs during pregnancy. The secretion of pregnancy hormones (HPL, somatotropin) drive an increase in insulin resistance in maternal peripheral tissues which increases in the second half of pregnancy.

PU- When conducting a health history with a couple who are experiencing subfertility, the nurse will include which of the following? Select all that apply. General health Medication history Sexual history Surgical history School history

The nurse will need to gather a thorough health history that will include information related to general health, medications, past sexual history, and surgical history.

The common denominator that exists in abruptio placenta and preeclampsia/eclampsia that is most harmful is: The potential for postpartum hemorrhage. maternal hemodynamic instability. The potential loss of function of the placenta resulting in decreased fetal oxygenation. The potential for preterm labor.

The potential loss of function of the placenta resulting in decreased fetal oxygenation. Abruptio placentae results in abrupt loss of function of the placenta due to tearing away of the placenta from the uterine wall. In preeclampsia/eclampsia there is vasoconstriction of the placental vessels due to hypertension. Both will result in decreased placental perfusion and thus decreased fetal oxygenation.

*Describe the risks, benefits and side effects of LARC methods(Long acting reversible contraceptive= IUD'S*

Trend is increasing IUD's are maintenance free and long-lasting and reduce the risk of unintended pregnancy. Pain in abdomen, length of string, infection, late period, ectopic pregnancy

*Explain the statistics and social issues surrounding unintended pregnancy rates in the U.S*

Unintended pregnancy rates rose among low-income women, while rates among higher-income women declined women with the least amount of resources have the most amount of unintended pregnancy Most affected group of unintended pregnancies is 15-19 years old

episotomies

Usually heal within 2-3 weeks

Rooting reflex

a baby's tendency, when touched on the cheek, to turn toward the touch, open the mouth, and search for the nipple

*Define menstrual interval*

day 1 of period to day 1 of the next period

marginal placenta previa with external hemorrhage

edge of the placenta is at the margin of the internal os

The nurse is assessing the health history of a male partner. Which data is most likely to be related to an infertility problem?

employment as a taxi driver Excessive testicular heat, which can occur from long periods of sitting, can limit sperm production and mobility.

Which definition best explains the term "subfertility/infertility"?

failure to achieve pregnancy after 1 year of unprotected intercourse Infertility is the failure to achieve conception after 1 year of unprotected intercourse. Because most couples have the potential to conceive but are just less able to conceive without additional help, the term subfertility is more often used today.

The first half of the menstrual cycle is called: luteal phase follicular phase ovarian phase

follicular phase

postpartal diuresis

increased production of urine that occurs in the pospartum period to rid the body of fluid retained during pregnancy

Symptoms of PMS occur in which phase of the menstrual cycle? ovulatory phase luteal phase follicular phase

luteal phase

A young woman is newly married and is seeking advice on contraception. She is in a monogamous relationship and would like a temporary contraceptive, as she plans to have children in the future. Her husband dislikes the feel of condoms. Also, she mentions that she typically experiences dysmenorrhea and has a history of recurrent urinary tract infections. Which method should the nurse recommend?

oral contraceptive pills (OCPs) Oral contraceptive pills would be the best choice of those listed for this client, as it is a temporary contraceptive that also can help relieve dysmenorrhea. Postcoital douching is ineffective as a contraceptive measure as sperm may be present in cervical mucus as quickly as 90 seconds after ejaculation. Diaphragms are contraindicated for women with a history of recurrent urinary tract infections. Vasectomy is a permanent measure and thus inappropriate in this situation.

dysmenorrhea*

painful menstruation - prostaglandin release. Can be mild to severe.

partial previa

placenta covers a portion of internal os

A couple in their mid-30s are at their primary care provider's office because they have been unable to conceive for 3 years. They already have one child who is 4 years of age. The care provider explains to them that they are dealing with what kind of infertility?

secondary infertility There are two main types of infertility: primary and secondary. A couple who has never been able to conceive has primary infertility, whereas a couple who has been able to conceive in the past but is currently unable to do so has secondary infertility.

low lying placenta previa

the placenta is implanted in the lower uterine segment and is near the internal os but does not reach it

A client desires protection from unwanted pregnancies. However, the client does not enjoy sex when her partner wears a male condom. Also, the client experiences breast tenderness, headache, and nausea after taking oral contraceptive pills (OCPs). Which method would be the most likely choice for the couple to help them enhance their sexual experience as well as prevent any side effects?

transdermal contraceptive Application of transdermal contraceptive patches to the skin would most likely be the option for this couple. These patches will not hamper the sexual experience nor cause side effects such as those caused by oral contraceptive pills (OCPs). Natural membrane and polyurethane condoms are forms of male condoms, which the client does not like. Ethinyl estradiol is an oral contraceptive pill, which would most likely cause the client to experience breast tenderness, headache, and nausea.

What is a boggy uterus?

uterus is a uterus that feels soft and "squishy" when palpated. Risk for bleeding

PU - A nurse is instructing a client on birth control methods. The client asks about the cervical mucus method. When should the nurse tell the client she is fertile in relation to her mucus?

when it is thin, watery, and copious The cervical mucus method relies on the changes that occur naturally with ovulation. Before ovulation, cervical mucus is thick and does not stretch when pulled. With ovulation, the mucus becomes thin, copious, watery, transparent, and stretchy.

Describe important nursing interventions in management of shoulder dystocia

-McRoberts Manuever -Episiotomy -Elective claviculcar fracture of newborn

*Recognize the most important components of sexual history taking*

-Open-ended, understandable, nonjudgmental questions. -"I am going to ask you a few questions about your sexual health and practices" -"I ask these questions of all my patients" -"This information is kept in strict confidence" The 5 Ps Partners practice(oral, anal, or vaginal) Protection(from STD's) Past history Prevention (of pregnancy)

Describe the mechanism of action and the rationale for the medications given in preterm labor and in severe preeclampsia and eclampsia

-Preeclampsia and eclampsia= Labetalol or hydralazine to control hypertension and magnesium sulfate to prevent seizures -cure= give birth Preterm labor= corticosteroids(lung development), tocolytics(slow contractions), Magnesium sulfate (assessing deep tendon reflexes)

Describe important elements of nursing care of mother/infant in the immediate postpartum period

-Skin to skin contact and breastfeeding is important

Describe the rationale for giving Rhogam to Rh negative postpartum patients

-giving Rhogam is important because it can help prevent the mother from developing antibodies in future pregnancy

Identify common maternal and fetal scenarios which would require c-section

-placental previa, abnormal presentation, previous uterine surgery, non-reassuring fetal status, active herpes infection

Explain causes of early pregnancy bleeding and potential nursing interventions

1. Spontaneous abortion 2. Ectopic Pregnancy - rupture 3. Implantation 4. Cervical, vaginal or uterine pathology Nursing interventions= looking at vital signs, RH status, Surgical intervention, Lab values (Serial B-HCG),

Normal menstration returns after —- weeks for those who are not breastfeeding

12 weeks.

What are the changes seen in AUB (abnormal uterine bleeding)

AUB= anovulatory cycles: unpredictable dysynchronous pattern of bleeding. Ovulation does not occur. This has a prolonged estrogen stimulation so the endometrial tissue stays in the proliferation phase causing an irregular pattern of bleeding. There is no LH surge, no ovulation, no corpus leutum, no progesterone. without progesterone the lining is unorganized so there is excessive proliferation and excess bleeding. Most prominent - perimenaupause Causes: coagulation disorders, thyroid issues, medications. Always treat the underlying cause

*Three most common causes of vaginitis*

All 3 can change the pH and disrupt vaginal flora Bacterial Vaginosis= thin white discharge that evenly coats the vaginal wall with stale fish odor Candidiasis= yeast/fungal infection that is not considered STI and is normal. Itchyness, soreness, painful intercourse (dyspareunia) Trichomoniasis= frothy yellow green discharge with PH>4.5. Protozoa tails will whip things up. Buring, bleeding, painful intercourse

The estrogen content in the contraceptive pill performs which action? A) decreases the permeability of cervical mucus B) increases the level of luteinizing hormone (LH) C) interferes with endometrial proliferation D) suppresses follicle-stimulating hormone (FSH)

D) suppresses follicle-stimulating hormone (FSH)

*Differentiate between the follicular and luteal phases of the menstrual cycle*

Follicular= under control of FSH, follicles in ovary are growing and form a mature egg. Estrogen levels rise. Once they reach a peak there is a surge of Luteinizing hormone (LH) which promotes ovulation. Luteal= Begins at ovulation and lasts until the menstrual phase. Progesterone hormone excreted by corpus lutuem to raise internal temperature.

A couple who has not conceived after 6 years of not using birth control are being seen in the infertility clinic. In assessing the client's psychosocial response to infertility, which might the nurse expect to find? Select all that apply. Excitement at the possibility of conceiving Sexual stimulation and excitement Guilt related to the lack of conception Anger toward others who have conceived Fear of the possible outcome of the testing

Guilt related to the lack of conception Anger toward others who have conceived Fear of the possible outcome of the testing Couples who have experienced infertility may experience guilt related to the lack of conception, anger toward others, and fear of the outcome. The nurse should be prepared to visit with the couple regarding these feelings, and should view these feelings as a normal process.

The two most common STDs in the young adult (15-24yo) population in the US are? SELECT ALL THAT APPLY HPV HSV Gonorrhea Chlamydia

HPV Chlamydia

Identify and describe the key nursing interventions and expected findings for the mother in the postpartum period including: lochia type and amount, fundal involution and time frame, appropriate perineal care (ice vs. sitz bath), need for Rhogam(part of normal postpartum care if mom is RH- at 28 weeks and again after 72 hours) and psychological adjustments

Lochia Rubra= dark red up to 4 days Lochia Serosa= old blood up to 4-10 days Lochia Alba= whitish yellow outside of hospital Fundal Involution= return of uterus to non-pregnant state following birth, 12 hours returns to appx umbilicus, 2 weeks after childbirth returns in true pelvis Perineal Care= Ice within first 24 hours, then sitz bath or heat after 24 hours, also peribottle to clean the perineal area Rhogam= If mom is Rh- and newborn is Rh+ (28 weeks for RHO Ghan and 72 hours after delivery) Psychological Adjustments= can she care for the baby and herself? Does she have family members who can help care for the baby?

Describe the hormonal changes that occur at menopause and the associated symptoms

Menopause = 1 year without menses. Perimenopausal: Fluctuations in estradiol levels -hot flashes (vasomotor instability) most prominent symptom. theromoregulartory segment in hypothalamus is triggered. -greatest in 1st 6 months- 2 years and can last up to 10 years. Has profound impact on quality of life (fatigue, nighttime waking, mood issues (similar to PMS) estrogen has positive effect on BONES- after menopause osteoclast production overtakes and osteoporosis can set in.

Describe the characteristics of the normal menstrual cycle

Normal menstrual cycle- -Average age= 8-16 -Cycle intervals= 21-35 days -Flow=25-60 ml (variable) -Length= 3-5 days

What are the changes seen in Polycystic ovary syndrome

PCOS= Think excess androgens (testosterone) that lead to a constellation of sings and symptoms characterized by irregular menstrual periods and excess facial and body hair with acne, possible male pattern baldness. PCOS risk= 50% are obese. increased type 2 diabetes, impaired glucose tolerance metabolic syndrome. often before age 40. Triad of consequences: Infertility, an-ovulation, irregular menses.

*What can disrupt the vaginal flora?*

Phase of menstrual cycle STDs Contraceptive choices Antibiotics - reducing lactobacilli and leading to overgrowth of fungal elements Sexual activity - semen is alkaline Use of hygienic products Moisture retention

Central with concealed hemorrhage placenta previa

The blood has no where to go and can invade the myometrium and cause hypoxia because no O2 is reaching the placenta

PU - A client prescribed oral contraceptive pills (OCPs) has presented for a routine visit. Which finding, if reported by the client upon assessment, should the nurse prioritize?

abdominal pain The warning signs to report for a client on OCPs are severe abdominal or chest pain, dyspnea, headache, weakness, numbness, blurred or double vision, speech disturbances, or severe leg pain and edema. Light bleeding, light flow, and cramping are all normal.

A sexually active client comes to the clinic requesting some form of birth control but is concerned about the bad side effects she has heard are caused by oral contraceptive pills (OCPs). Which information should the nurse point out about the positive aspects of this type of contraceptive? Select all that apply. decreased incidence of dysmenorrhea decreased acne improved cycle regularity increased menstrual flow decreased acute pelvic inflammatory disease

decreased incidence of dysmenorrhea decreased acne improved cycle regularity decreased acute pelvic inflammatory disease Although oral contraceptive pills (OCPs) have many side effects—and some of them serious—they also have non-contraceptive benefits, such as increased menstrual cycle improvements, decreased incidences of the following: dysmenorrhea, premenstrual dysphoric syndrome, acne, iron-deficiency anemia, and acute PID (and resulting tubal scarring from PID).

The nurse should carefully screen a client who insists on using only oral contraceptive pills (OCPs) for which contraindication?

deep vein thrombosis

Describe important nursing interventions in umbilical cord prolapse

-reposition the mom knees-chest promotes gravity to shift fetus out of pelvis -gloved hand into vagina to pushes the fetus upward away from the cord -trendleburg position

Cephalohematoma

Collection of blood that does NOT cross suture lines Shows up after day 2 or 3 Associated with hyperbilrubinemia (becasuse of RBC) firm to touch (feels like water balloon)

diastasis recti

Separation of the longitudinal muscles of the abdomen (rectus abdominis) during pregnancy.

Caput fetal head

Swelling that appears right away Caused from prolonged birth goes away within 3 days crosses the suture lines can have ecchymosis and petechiae