mother and baby

miscarriage

- 90% occur before 8 wks types of miscarriage threatened : Amount of Bleeding: Spotting; Uterine Cramping: Mild; Passage of Tissue: No; Cervical Dilatation: No; Viability of Pregnancy: Yes Inevitable Amount of Bleeding: Moderate; Uterine Cramping: Mild to severe; Passage of Tissue: No; Cervical Dilatation: Yes; Viability of Pregnancy: No Incomplete Amount of Bleeding: Heavy; Uterine Cramping: Severe; Passage of Tissue: Yes; Cervical Dilatation: Yes visible tissue in cervix; Viability of Pregnancy: No Complete Amount of Bleeding: Slight; Uterine Cramping: Mild; Passage of Tissue: Yes; Cervical Dilatation: No; Viability of Pregnancy: No Missed Amount of Bleeding: Spotting; Uterine Cramping: None; Passage of Tissue: No; Cervical Dilatation: No; Viability of Pregnancy: No

HPV (human papilloma virus)

- DNA tumor virus transmitted through direct skin to skin contact , most often during vaginal or any penetrative sex - cause genital wart, responsible for development of cancer - 3 series vaccine is reconvened at 11-12yo over 6 months period - HPV2 or HPV4 vaccine is for female while HPV4 is used for male

explain the involution process - the process when uterus gradually shrink or return to its original position postpartum

- Involution normally begins immediately after delivery, when the firmly contracted uterus lies midway between the umbilicus and the symphysis pubis. - by the 1st postpartum day, it begins returning to the pelvis. - The average descent rate is 1 cm (or one finger-breadth) daily—slightly slower if the patient had a cesarean birth. - By the 10th postpartum day, the now impalpable uterus lies deep in the pelvis, at or below the symphysis pubis.

fetal alcohol syndrome (FAS)

- a group of alcohol-related birth defects that include physical and mental problems - smallheadcircumference, low birth weight, undeveloped cheekbone

hyperemesis gravid arum

- affect 2% of women can result in hospitalization and affect health of baby - sx: protracted vomiting ( always unable to keep down clear fluid ) retching, severe dehydration, electrolyte imbalances and wt loss - intervention small amount of food 1-2 hrs drink fluid 20-30 mins before or after eating, try not to mix food and drink add protein sources to each meal and snack try salty or tarts food when nauseated eat food @ room temp to decrease aroma avoid brushing tees h after eating b/c it stimulate nausea take ginger up to 1,000g/day try mint, ginger, or orange to decrease morning sickness

how to prepare for procedure in school age

- allow asking question and explain things, why something is done - allow child handle equipment - fear of dark, injury , fear of being alone, death - fear of loss of control - allow choices when possible - special consideration: do procedure on logical, clear process: such as head to toe

ice pack for post vaginal birth

- change freq to promote hygiene - ice pack should be wrapped in disposable covering or clean washcloth, do not apply directly on perineal area - apply ice pack for 20 min only - ice pack should be used for first 24 hrs , not a week after birth

what can 2 yrs old child do?

- child should be able to walk up and down stair w/ steady gait alone, 1 step at a time - run without falling - kicks ball - build woes 6-7 blocks - can turn 1 page at a time ( book) - draw line - know + 300 words - form phases of 2-3 words - state own names - begin parallel play - gain independent from parents

abruption placentae placental abruption

- complication of preeclampsia related to HTN - can be life threatening to pt or fetus - premature detachment of the placenta from uterine wall, resulting in bleeding from uterine blood vessels - common sx: abdominal pain, dark red vaginal bleeding, rigid uterus, abnormal fetal heart rate patterns, uterine tachysystole - once placental abruption occur, fetal distress and maternal hypovolemia can develop quickly -

what happen for mother during 13 to 27 weeks

- constipation is more likely to occur, - skin changes, such as darkening of aerials and nipples, pigmenting of abdominal skin and stretch marks , noted on breast, abdomen and areas of wt gain - colostrum may be expressed from nipples - an altered esophageal spinner and gastric tone often cause heartburn - an increased total volume - stomach displacement occurs - quickening ( fetal movement is felt)

how to prepare for procedure in adolescent

- explain longterm benefit - accept from regression - provide privacy - fear of social incompetence, loss of independence , being different from peers -- don't embarrass them in front of peer - special : provide teaching, expect resistance , point out their strengths

purpose of prenatal screening

- for genetic conditions that are common and for which prenatal dx is available when a pregnancy is id. at increased risk

hepatitis B vaccine

- hepB virus can cause serious infection affect the liver - spread though contact with blood or body fluid, mother - newborn at birth - a sexually transmitted infection --> it is important to verify the immunization status of all adolescent. - vaccination is recommended at birth - within first 12 hour --> then at 1-2 m and 6-18m

Hepatitis A vaccine

- inactivated whole virus vaccine - Hep A virus is spread though close physical contact by eating or drinking contaminated food or water - young children are specifically susceptible to HepA because of close contact with other children, inadequate hand hygiene, tendency to place everything in their mouth - recommenced to all children at age 12 months --> repeat dose in 6-12 months after

how to prepare procedure for newborn

- include parents - mummy restrain : swaddle child - fear of loud noises , sudden movement

what happen for mother during wk 28 to delivery

- increased blood volume may cause functional systolic murmur - engagement ( lightening or dropping ) occur approx 2 wks before delivery - the pulse rate rise 15-20 beats per min lordosis freq occur - uterine enlargement cause diaphragm to rise, reducing space for lung expansion - hemorrhoid may occur

rotavirus

- is most common cause of severe gastroenteritis among young children - virus is shed in stool and easily spread via fecal-oral route - severe, watery a, crampy diarrhea quickly lead to dehydration in infected child

MMR Vaccine (Measles, Mumps, Rubella)

- live attenuated (weaken) virus combo vaccine anaphylactic reaction are believed to be associate with the neomycin or gelatin component rather than the egg component --> egg is no longer a contraindication of measles vaccine - MMR given @ 12-15 months

Meningococcal disease treatment?

- manifest as meningitis , deadly blood infection or bacteremic pneumonia - caused by bacterium Neisseria meningitis - spread though direct contact or by air droplets - develop quickly - usually in healthy children and adolescent --> result in high rate of morbidity and mortality

when to postpone vaccination

- moderate to severe illness - immunosuppression - pregnancy - recently receive blood or antibodies containing products.

how to prepare procedure for infants (6-12 months)

- mummy restraint : swaddle - parental restraint - fear of strangers, and height - get to know child, bring in toys - special consideration: distraction -- turn on TV to help distract form procedure

what happen for mother during first 12 weeks

- nausea and vomiting experienced by more than 50% of women - menses missed hCG can be detected in urine breast tingling and tenderness begin - the uterus can be palpated just above the symphysis pubis - the cervix soften ( Goodell's sign_ and become bluish purple ( Chad's sign) - the uterus become globular, soften and flexes easily over the cervix ( Hegar's sign) - BP may drop because of falling peripheral vascular resistance - the blastocyst implants in the uterus - urinary frequency increase

example of prenatal screening

- neural tube defects --> spina bifida, anencephaly - down syndrome -chromosomal abnormalities - trisomy 18

a new born is have phototherapy. what nurse should do to prevent SE of phototherapy in newborn with hyperbilirubinemia?

- phototherapy can cause loose stools, insensible water loss and altered thermoregulation as SE - nurse should monitor I&O and assess Temp freq

how to prepare for procedure in preschooler

- play with puppets, doll - interactive play, role playing - demonstrate how to use equipment, allow child to play with models of equipment - fear of separation: set up time for parent to be there with child - fear of ghost, scary people -- don't wear scary mask - fear of mutilation - special consideration: let child disrobe themselve

pneumococcal vaccine - PCV13

- pneumococcus pneumonia is most common cause of pneumonia, sepsis meningitis, otitis media in young children - given at 2m, 4m, 6m and 12m (depend on brand) -

a child with sickle cell anemia admitted for vast-occulsive crisis after developing fever and joint pain. which nurse action when caring for this child?

- providing PO or IV fluid - highest priority - because in vaso-occlusive crisis, sickle shaped RBC clumps together and obstruct vessels, cause ischemia and tissue damage - give Ó - warm compress can applied to pain flu joints ormolu comfort - not cold compress because cause vasoconstriction antipyretic meds to reduce fever

Meningococcal vaccine

- recommended for children 2m or older who are at risk due to certain medical condition such as ---------anatomical or functional asplenia ---------complement component deficiency - first year college student living in residence halls who are unvaccinated or incompletely vaccinated

influenza vaccine

- recommended yearly for all person 6m or older - all children 6m to 8yo receiving influenza for the 1s time require 2 dose separated by 4 weeks apart - 1 dose is needed if had receive 2 dose in previous year and at least 1 dose of 2009H1N1 containing vaccine - refer inactivated influenza vaccine (IIV) because can be given to any eligible person aged 6m or older by IM compared to live attenuated influenza vaccine (LAIV) with lots of risk and contraindication

how to prepare for procedure with toddler

- simple explanation - use distraction: book, videos, TV - allow choices - let child participate in procedure - fear of separation from parents, animal, change of routine ( such as way of dressing change etc) - special consideration: don't ask for permission ( never ask can you do something ) - teach parent to expect regression ( ex: toilet training, difficult separation)

6 month old can do?

- sitting w/ support - play peek-a-boo - rolling from back to abdomen

what can 5 yo do

- skips - walk backward - use a jump rope - draw a triangle - ties shoeslace - print letter, numbers or words - count to 10 - speak in full sentences - names coins and days of week - independently dresses and bathes - id. real from pretend

what are the GI changes in newborn after birth

- sterile GI tract, but changes rapidly depending on received feeding - colonization depends on oral intake - environmental, oral, and cutaneous microbes from mom transferred to newborn by sicking, kissing, caressing - human breast milk protect new born GI tract, providing antibodies, leukocytes to prevent harmful bacterial penetration. - stomach begin to stretch 2-3 days after birth to hold more food - on 1st day, feeding may be expelled out - should have small frequent feeding - can hold approx 30-90ml or 1-3oz - newborn will stop sucking if they obtain enough feeding - oral intake needed for production of vitamin K - avoid forcing, overfeeding newborn - GI sphincter is immature -- may regurgitation - most digestive enzyme present at birth, however, low in lipase and amylase -- not digest fat well --> fatty stool - newborn lose 5-10% from birthweight if insufficient caloric intake within 1st wk after birth - Bowel sound can be heart, may be hypoactive on 1st day - first stool passed is meconium - composed of amniotic fluid, shed mucosal cells, intestinal secretion and blood -- greenish, black, has tarry consistency- usually passed w/in 12-24hr of birth - if breast fed-- stool is yellow-gold, light mustard, loose , with seed like particle and sour smelling - if formulae fed-- stool is tan or yellow in color and firmer

what information is included with the nurse's education plan for teaching about iron supplementation?

- take iron with fruit that contain vitamin C such as citrus fruits, tomatoes, melons and strawberries increase absorption of iron --> take @ same time - should not take iron with milk, tea, coffee , oxalates such as spinach and Swiss chard, egg yolk because it decrease iron absorption - heme iron ( found in meats ) such as liver is better absorbed than non-heme source of iron ( veggies ) - take on empty stomach for best absorption - can take iron at bedtime to avoid abdominal discomfort - if miss dose, take asap if w.in 13 hrs of scheduled dose, do not double dose - iron may cause stool to be black or dark green - constipation is common --> eat food high in fiber and lots of fluid.

explain the use of Nitrazine paper to assess presence of amniotic fluid in vaginal secretion

- to aid diagnose rupture of membrane combine with other tests such as ultrasound - result can be affected by contamination of blood, urine, semen, infection or antiseptic agent - The pH of vaginal secretions, which is normally acidic (between 3.8 and 4.2) - if the strip turn blue-green to deep blue , pH of vaginal secretion is alkaline, suggesting membrane has rupture

physiologic jaundice in new born

- very common in new born - yellow of skin, mucous membrane, sera - within the first 3 days of life - manifestation of hyperbilirubinemia ( result from deposition of unconjugated bilirubin pigment in skin and mucous membrane)

what can 4 yo do?

- walk down stairs with alternating feet - balance on 1 foot - catches a ball - draw a square - cuts with scissor - ties a simple knot - name >= 2 colors - like telling stories - begin imaginative / group play - recognize analogies - often focus on self

what can 18 months old do?

- walk up / down stair with help - throws ball overhand - jumps in place - build tower 3-4 blocks - when looking at book, turn 2-3 pages at a time - scribbles - use cups and spoon - know + 10 words - id. common object - has temper tantrums - understand ownership ( mine) - imitate others

what can 3 yr old do

- walk up stair with alternating feet - pedal tricycles - jumps forward with both feet - stand on 1 foot - draw circles - feed self without help - grips crayon with fingers instead of fist - can form sentences of 3-4 words - ask why questions - state own age - begins associative play - is toilet trained, except wiping

birth asphyxia

- when a baby's brain and other organs do not get enough oxygen before, during or right after birth. It can cause temporary or permanent damage. - ass/w meconium stained amniotic fluid -

Rotavirus vaccine

-live vaccine given via oral route in infant - 2 products : Rotarix [ 2m, 4m] and RotaTeg [ 2m,4m, 6m] - contraindicated in children with SCID or hx of intussusception

What can a 1 year old or 12 months old do?

-tripling the birth weight - walk 1st step independently - crawl up stair - use 2 finger pincer grasp - hits 2 object together - say 3-5 words - use nonverbal gesture ( waving good bye) - may have separation anxiety - search for hidden object

Placenta in the lower uterine segment but not covering the internal cervical os Low-lying placenta previa Internal cervical os partially covered by the placenta Partial placenta previa Edge of placenta is about 2.5cm or closer to the internal cervical os Marginal placenta previa Placenta separate as its edge and blood escapes vaginally Marginal placental abruption Placenta separates centrally and blood is trapped Central placental abruption Total placental separation from uterine wall with massive bleeding Complete placental abruption Placenta attaches itself too deeply into the wall of the uterus Placenta accrete/increate/percreta

...

when nuchal translucency testing done

11-14 wks - completed thru ultrasound - test the thickness of fluid build ip at the back of the fetus thicker than normal can indicate genetic disorders.

what is a normal baseline FHR ?

110-160 bpm

when weight blood/ body flooded soaked item ( such as perineal pads during and after birth) to determine blood volume loss, nurse know that 1g of item = ? mL of blood loss

1g of blood soaked item = 1ml of blood loss. Use the equation wet item in grams - dry item in grams = mL of blood within the blood-soaked item

when first ultrasound done during pregnancy

20 wks

when glucose tolerance test done

24-48 wks gestation

when non stress test done

28 wks gestation to birth

when mom with Rh negative should have RhoGAM

A client who is Rh(D)-negative and D-negative and who hasn't already formed Rh antibodies should receive RHO(D) immune globulin at about 28 weeks' gestation and again within 72 hours after birth.

What is placenta previa? and types of placenta previa

Abnormal placental implantation - total: covers all cervical os - incomplete : partially cover part of internal os - low-lying: placenta is in close proximity to os but does not cover it

pt education after giving birth about what to notify provider/nurse

Advise the women after birth to contact her practitioner if she - passes multiple clots the size of a half dollar or larger from the vagina; - soaks more than one perineal pad per hour; - has a malodorous vaginal or perineal discharge; - experiences severe lower abdominal pain, - increased vaginal pain, or pain from the episiotomy; - develops a temperature greater than 100.4° F (38° C); - has no bowel movement within 1 week after delivery; - has pain or urgency with urination; or is unable to urinate.

Hegar sign of pregnancy

Bimanual palpation of a soft uterine isthmus between the cervix below and the uterine body above. Used before modern biochemical pregnancy confirmation became available. softening and compressibility of the lower uterine segment

Category I FHR

Category I FHR characteristics indicate that acid-base balance is normal at the time of observation. No additional interventions are required. Characteristics of FHR tracings in this category are: normal baseline FHR (110 to 160 beats/minute) regular rhythm absence of decreases or decelerations from baseline accelerations from baseline.

how to reduce leg cramps in late pregnancy

Common during late pregnancy, leg cramps cause shortening of the gastrocnemius muscle in the calf. Dorsiflexing or standing on the affected leg extends that muscle and relieves the cramp.

A neonatal nurse teaches students how to recognize gastrointestinal disorders in infants. The nurse tells the students that failure of the newborn to pass meconium in the first 24 hours after birth may indicate what disease? Gastroenteritis Ulcerative colitis (UC) Hirschsprung disease Short bowel syndrome (SBS)

Correct response: Hirschsprung disease Explanation: The nurse should suspect Hirschsprung disease when the newborn does not pass meconium in the first 24 hours after birth, and has bilious vomiting or abdominal distention and feeding intolerance with bilious aspirates and vomiting. Typical signs and symptoms of gastroenteritis include diarrhea, nausea, vomiting, and abdominal pain. The characteristic GI manifestation of UC is bloody diarrhea accompanied by crampy, typically left-sided lower abdominal pain. Clinical manifestations of untreated SBS include profuse watery diarrhea, malabsorption, and failure to thrive.

Which nursing intervention should be included in the care of an unconscious child with Reye's syndrome? Keep the child's arms and legs flexed. Place the child on a sheepskin. Avoid using lotions on his skin. Place the child in a supine position.

Correct response: Place the child on a sheepskin. Explanation: Placing the child with Reye's syndrome on a sheepskin helps to prevent pressure on prominent areas of the body. Rubbing lotion on the extremities stimulates circulation and helps prevent drying of the skin, and therefore shouldn't be avoided. Keeping extremities flexed can lead to contractures. Placing the child supine is contraindicated because of the risk of aspiration and increasing intracranial pressure. The supine position isn't appropriate because it puts pressure on the sacral and occipital areas.

The nurse is caring for a pregnant client who is experiencing morning sickness. The nurse understands that which of the following is responsible for many of the common discomforts of pregnancy? Prolactin FSH Progesterone Estrogen

Correct response: Progesterone Explanation: Progesterone is responsible for many of the common discomforts of pregnancy, such as edema, nausea, constipation, flatulence, and headaches.

a pt is recovering after giving birth to a 6 lb newborn. On assessment, the nurse feels that fundus is firm and is 2 finger breaths bowel the umbilicus. pt did not have a episiotomy but her perineal pads reveal steady trickle of blood. What is the probable cause of this findings? a boggy uterus normal involution a vaginal laceration a clotting problem

Correct response: a vaginal laceration Explanation: A steady trickle of blood on the perineal pad of a client with a well-contracted uterus may indicate a vaginal, cervical, or perineal laceration. A boggy uterus would be palpable above the umbilicus and would be soft and poorly contracted. With normal involution, the perineal pad would show only lochia, not a trickle of blood. A clotting problem causes more than a steady trickle of blood and probably would have been identified earlier during labor.

Assessment of a client in active labor reveals meconium-stained amniotic fluid and fetal heart sounds in the upper right quadrant. What is the most likely cause of this situation? breech position transverse lie occiput posterior position compound presentation

Correct response: breech position Explanation: Fetal heart sounds in the upper right quadrant and meconium-stained amniotic fluid indicate a breech presentation. The staining is usually caused by the squeezing actions of the uterus on a fetus in the breech position, although late decelerations, entrance into the second stage of labor, and multiple gestation may contribute to meconium-stained amniotic fluid.

what kind of vaccine given IM

DTap, DT, Tdap hepatitis A, hepatitis B Hib Influenza Pneumococcal conjugate vaccine (PCV) HPV MCV4 IPV

What would the nurse advise about the average additional kcal/day required during pregnancy?

First trimester: same as pre-pregnancy Second Trimester: an additional 340 kcal/day Third Trimester: an additional 452 kcal/day

how to grade pregnancy Gravida Para

Gravida (G) is the total number of pregnancies she has had, including the present one. Para (P), the outcome of her pregnancies, is further classified by the FPAL system as follows: +) F = Full term: number of babies born at 37 or more weeks of gestation, +) P = Preterm: number of babies born between 20 and 37 weeks of gestation +) A = Abortions: total number of spontaneous and elective abortions +) L = Living children, as of today

HPV vaccine

Human Papilloma Virus (HPV2, HPV4) - -Three doses should be given over a 6 month -interval for females at 11 to 12 years of age (minimum age is 9 years). -The second dose should be administered 2 months after the first dose, and the third dose should be administered 6 months after the first dose. -HPV4 may be given to males starting at age 9 years of age.

what kind of vaccine given subcutaneously

IPV MMR Varicella MPSV4

what should nurse ask pt if membrane ruptured as home ( maternity)

If the patient's membranes have ruptured at home, ask her to describe the color of the vaginal discharge. - A clear vaginal discharge confirms the presence of amniotic fluid, - a green-stained vaginal discharge indicates meconium-stained amniotic fluid, - and cloudy or foul-smelling fluid may indicate infection.

category II FHR

Include any of the following: Baseline rate: - bradycardia not accompanied by recurrent deceleration: < 110 - tachycardia Baseline variability: - minimal baseline - absent baseline - marked baseline Accelerations: - absences of induced accelerations after fetal simulation Period decelerations: - recurrent variable - prolonged - recurrent late with moderate baseline variability - variable decelerations with other characteristics

What is breech presentation?

It is a delivery in which the buttocks come out first. - 4 types: frank , complete breech , single footing breech and double footling breech

Varicella Vaccine

Live attenuated virus (chickenpox) - 1st dose is recommend at 12 months ( not for under 12month) - 2nd dose is recommended at 4-6 y - can be used post-exposure as prophylaxis if administered within 3-5 days

compare parental previa and placenta abruption

PREVIA - bright red bleeding - painless - soft and relaxed uterus - anemia equal to blood loss ABRUPTION - dark venous bleeding ( or may not bleed) - severe steady pain - firm to hard uterus - Anemia greater than apparent blood loss

TCg3 3What is Leopolds maneuver?

Purpose: to determine presentation and position of fetus and aid in location of FHR Method: explain procedure to pt, have woman empty bladder, wash hands, stand beside, facing woman's head in supine position 4 maneuvers - 1st maneuver: - curl finger around fundus --> if fetus in vertex position , buttock feel irregular shaped and firm --> if in breech position, head feels hard, round and movable. - 2nd maneuver: hand on side of abdomen --> if fetus in vertex position, you'll feel smooth , hard surface on 1 side ( back) and lumps and knobs (knees, hands, feet and elbow side) --> if fetus in breech position, may not feel the back at all - 3rd maneuver: - place just above pubis - if fetus in vertex position and has not descended, you'll feel the head --> if in vertex position and has descend, you'll feel less distance mass -4th maneuver: - to determine flexion or extensions of fetus head & neck. - used in late pregnancy - place hands on both side of lower abdomen - apply gentle pressure with fingers as you slide hands down toward pubis --if head is the presenting part, 1 hand will be stoped by cephalic prominence ( the head) and other hand will not be obstructed.

what are the sx of resp distress in neonate

RR> 60 labor respiration grunting nasal flaring generalized cyanosis ( not acrocyanosis, which is normal first day after birth) retraction

Moro reflex

Reflex in which a newborn strectches out the arms and legs , finger fanning out and cries in response to a loud noise or an abrupt change in the environment - disappear after 3-4 months

Chadwick sign

Violet/bluish colour of the vaginal mucosa and cervix as early as the sixth week to 8 wks caused by increased vascularity

Retinopathy of Prematurity (ROP)

a cause of visual disabilities from prematurity where excess oxygen used to help the infant breathe but damages the retina - neonates born before 30 wks gestation or weight 1500g or less at birth also at risk - ensure neonate eaten approx 1hr before procedure - NPO>=2hrs increase neonatal stress and irritability - drop cycloplegia mydriatic agent to promote dilation of pupil for proper exam/ procedure ( peak in 20-60 min) ( apply pressure over tear duct for at least 2 mins after instilling eyes drop - and wipe away excess) ( monitor tachycardia, restlessness or if pupil aren't dilated or only slightly dilated --> notify dr) ( protect from bright light for 4-6hr after pupil dilation) - swaddle and give pain med before procedure because eye exam is painful, neonate will try to reach face, increase risk damaging eyes. -

what can 9 months old baby do?

a pincer grasp - sit unsupported - pull self to standing position - stand while holding on a furniture or someone's hand - response to simple verbal commands such as " no no"

grasp reflex

an infantile reflex in which an infant closes her hand or feet into a fist when touched - palmar grasp disappear after 3months old -plantar grasp lessen by 8 months old

when do posterior fontanelle close?

at 2-3 months old

when should group b streptococci swab done

at 35-37 wks gestation

Haemophilus influenzas type B VACCINE (HiB)

bacteria causing serious illness such as meningitis, epiglottis, septic arthritis have different brand with different dose total 4 doses - 1st dose @ 2 months - 2nd dose @ 4 months - 3rd dose @6 months -4th dose @ 12-15 months old

contraindication of vaccine in children and pregnant women

children who are severely immunocompromised or women who are pregnant should not receive live vaccine [MMR, varicella ) or pertussis immunization (DTP, DTap, Tdap) - encephalopathy without an identified caused within 7 days of the immunization permanently contraindicated further immunization with pertussis containing vaccine.

colostrum

creamy, whitish yellow to orange pre-milk fluid expressed as early as 16 wks gestation

DT Vaccine

diphtheria and tetanus - for children younger than 7yo who have contraindication to pertussis immunization

Quickening

early fetal movement often noted as a fluttering as early as 14 week

when should Rh factor test done?

first prenatal visit

newborn screening

for treatable genetic condition such as - PKU -galactosemia - homocystinuria - biotinidase deficiency congenital hypothyroidism

Babinski reflex

in response to the sole of the foot being stroked, a baby's big toe moves upward or toward the top surface of the foot and the other toes fan out - disappear after 1-2 yr of age

Polio Vaccine (IPV)

inactivated viral vaccine against Polio do not have oral polio vaccine (OPV) because it cause poliomyelitis

Braxton Hicks contractions

intermittent painless uterine contractions that occur with increasing frequency as the pregnancy progresses these painless contractions facilitate uterine blood flow and oxygen to fetus,

how to calculate estimate Date of birth ( EDB)

last menstrual period day + 7 days - 3 months

when not to postpone vaccine

minor respiratory illness or low grade fever

can nurse do vaginal exam with placenta previa?

no! A vaginal examination (speculum or digital) should not be performed in cases of placenta previa because it increases maternal bleeding and can dislodge more of the placenta.

what would the nurse expect as potential problem in neonate if the mother receive magnesium sulfate during labor?

nurse should expect and watch for potential neonatal effect of respiratory depression, hypotonia, and bradycardia , paralysis, (especially when magnesium level reach 15mEq/L) with mother of baby receive magnesium sulfate during labor. - decreased urine output also potential AE, should monitor

how often do nurse/ mother should perform fundus massage after birth?

perform fundal assessments every 15 minutes for the first hour after delivery, - every 30 minutes during the second hour, - and then every 4 hours (or more frequently if complications are present) for 12 to 24 hours

when nurse perform fundus massage , which position should the patient in?

pt should be in supine or trendelenburg when nurse perform fundus massage.

Goodell's sign

softening of the cervical tip caused by increased vascularity , slight hypertrophy and hyperplasia

TdaP vaccine

tetanus, toxoid, reduce diphtheria toxoid and acellular pertussis vaccine for children older than 7yo and adolescent (tetanus booster)

rooting reflex

turn toward object when touch or stroke baby's mouth or cheek open mouth and sucks rhythmically when finger/ nipple inserted into mouth disappear 4-7 months

tonic neck reflex (fencing)

when lying on back with head is turned to the side, arm and leg of that side extend , opposite arm and legs flex - disappear by 3-4 months