Family Development Unit 4
Differentiate between the hormones prolactin and oxytocin in the physiology of breast milk production
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Know the postpartum assessment
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No the advantages of applying ice or cold pack to the perineum after delivery
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What is a sitz bath, what is the purpose of it, and how often do postpartum women use a sitz bath
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Why is it important to consult with a physician or nurse practitioner before taking any medication while breastfeeding
A fetus is extremely susceptible to drugs ingested by a woman, and the same is true of breastfed infants. Almost any drug may cross in to the acinar cells and be secreted in breast milk. Therefore, the rule a woman followed all during pregnancy, she should take no drug unless prescribed or approved by your primary care provider, continues to apply during lactation.
What is the proportion of head to body length for infants versus an adult
A newborns head usually appears disproportionately large because it is about 1/4 of the total body length compared with an adult, whose head is 1/8 of total height.
What are the advantages of breastfeeding for the mother and the infant
A woman gain several physiologic benefits from breastfeeding, the release of oxytocin from the posterior pituitary gland aids and uterine involution, breastfeeding may serve a protective function in preventing breast cancer and possibly ovarian cancer. A woman may return to improve pregnant weight sooner and, as menstration is delayed, this may serve as a temporary family planning method. Successful breastfeeding can have an empowering the fact because it is a skill only a woman can master. Breastfeeding reduces the cost of feeding and preparation time for the infant feeding. A long term effects may include a decrease risk of hip fractures and osteoporosis in the post menopausal. For the woman. Breastfeeding provides an excellent opportunity to enhance a true symbiotic bond between mother and child. Although this is readily occur with breastfeeding, a woman who hold your baby to formula feed can form this bond as well. Advantages for infants include anti-infective properties, breast milk contains the ideal electrolyte and mineral composition for human infant growth. It is high and lactose, and easily digested sugar that provides reddit glucose for rapid brain growth. The protein and breastmilk is easily digested, and the ratio of cysteine to methionine in breastmilk favors rapid brain growth in the early months. It contains nitrogen in compounds other than protein, so an infant can receive sell building materials from sources other than just protein. Breast milk contains more linoleic acid, and essential fatty acid for skin integrity, and less sodium, potassium, calcium, and phosphorus then do many formulas. Breast milk also has a better balance of trace elements, such as zinc. These levels of nutrients are enough to supply the infant's needs, yet they spare the infant's kidneys from having to produce a high renal solute load of unused nutrients. Yes another advantage of breastfeeding is that breast fed newborns appear to be able to regulate their calcium and phosphorus levels better than infants who are formula fed. In addition, a great deal of discussion about the benefits of breastfeeding his centered on the effects of breastfeeding on the formation of the dental arch, because babies suck differently from a breast then from a bottle.
en does ovulation and menstrual flow return after
A woman who is not breastfeeding can expect your menstrual flow to return in 6 to 10 weeks after birth. If she is breastfeeding, a menstrual flow may not return for 3 or 4 months or, in some women, for the entire lactation period. There is only a slight delay in the return of ovulation and therefore the absence of a menstrual flow does not guarantee that a woman will not conceive during this time, because she may ovulate well before menstration returns.
No the three different maternal concerns and feelings in the post partole., such as abandonment, disappointment and postpartum blues. Know at least one intervention for each of these
Abandonment: only hours before they were the center of attention, with everyone asking about their health and wellbeing. Now suddenly, the baby is everyone's chief interest. You can help a woman move past these feelings by verbalizing the problem example, how things have changed everyones asking about the baby today and not about you, aren't they? These are reassuring words for a woman and help her realize that, although uncomfortable, the feeling she is experiencing is normal Dissapointment: all during pregnancy, they pictured a chubby cheeks, curly hair, smiling girl or boy. They have instead a skinny baby, without any hair, who seems to cry constantly. As an example, handle the child warmly to show you find the infant satisfactory or even special. Comment on the child's good points, such as long fingers lovely eyes and healthy appetite. Postpartum blues: during the post partal period As many as 50% of women experience some feelings of overwhelming sadness or baby blues. For some women it maybe a response to dependence and low self esteem caused by exhaustion, being away from home, physical discomfort, and the tension engendered by assuming a new role especially if a woman is not receiving support from her partner. Give the woman a chance to verbalize her feelings and make as many decisions that she wants to help her gain a sense of control and move past this strange postpartal emotion.
What is acrocyanosis vs central cyanosis
Acrocyanosis is defined as cyanosis of the infant's hands and feet. acrocyanosis is a normal finding at birth through the first 24 to 48 hours after birth. In contrast, central cyanosis, or cyanosis of the trunk, is always a cause for concern. Central cyanosis indicates decrease oxygenation that could be occurring as the result of a temporary respiratory obstruction, and also could reflect a serious underlying respiratory or cardiac disease.
techniques used to promote
Advise mothers to be sure to awaken newborns fully before feeding by handling them, stroking their backs, changing their position, rubbing their arms and chest, or changing their diaper. Gently tickling the bottom of a baby's feet will also wake up baby effectively. Many women are unwilling to cause they're newborns discomfort in these ways. If an infinite not sucking well, a woman can use manual breast expression after a feeding to empty your breast manually.
Know the components of a physical assessment of a newborn
Always complete assessment quickly to prevent exposing a newborn to chilling, yet not so swiftly that the important findings are overlooked. About 20 hours after birth, when the babies systems have had time to stabilize, a more thorough and detailed examination is performed. During the assessment you want to look at the appearance of a newborn skin such as the color, if any birthmarks or present, vernix caseosa, lanugo , desquamation, milia, erhythema toxicum, the presence of forceps marks and skin turgor. Inspect the head, including fontanelles, sutures, molding, any hematoma or swelling. Inspect the eyes, ears, nose, mouth, neck, chest, abdomen, genital area, back, extremities, and perform any pertinent laboratory studies.
discuss abnormal vital signs of a postpartum woman and what do the abnormal results mean
Any woman whose oral temperature rises above 100.4, excluding the first 24-hour period, is considered to have a fever. And high temperature may indicate that a postpartal infection is present. Because a rapid and thready pulse during this time could be a sign of hemorrhage evaluate pulse. Blood pressure should also be monitored carefully during the postpartal period. Because a decrease in this can also indicate bleeding. In contrast, and elevation above 140 systolic or 90 diastolic may indicate the development of postpartal hypertension of pregnancy, and unusual but serious complication of the postpartum period.
Describe the important components to teach parents about bathing the infant
As a rule, bathing should proceed from the cleanest parts of the body to the most soiled areas, that is, from the eyes and face to the trunk and extremities and, left, to the diaper area. Wife in newborns eyes with clear water from the inter to the outer using a clean portion of a washcloth for each eye to prevent the spread of infection.
What is Homans sign, how is it assessed and what is the purpose of the assessment
Assess for thrombophlebitis by dorsiflexion a woman's ankle and asking her if she notices pain and her calf on that motion
is an Apgar score, when is it a test, know how to assess the components of the Apgar score and how they are
At one minute and five minutes after birth, newborns are observed and rated according to an Apgar score. Insert table 18.2 on page 460
What position should newborns be placed for sleeping and why
Baby should be placed on their backs to sleep to prevent sudden infant death syndrome.
Where should you expect to palpate the uterus minutes after birth and where should it be palpated on each post op day
Because uterine contractions begin immediately after placental delivery, the fundus of the uterus is palpable through the abdominal wall, halfway between the umbilicus and the symphysis pubis, within a few minutes after birth. One hour later, it will rise to the level of the umbilicus, where it remains for approximately the next 24 hours. From then on, it decreases by one finger breadth or 1 centimeter per day. For example, on the first postpartal day it will be palpable one centimeter below the umbilicus. In the average woman, by the 9th or 10th day the uterus will have contracted so much that it is withdrawn into the pelvis and can no longer be detected by abdominal palpation.
Describe the circumcision procedure and care and what to teach the
Circumcision is the surgical removal of the foreskin of the penis. The operation is performed on Jewish boys on the 8th day of life as part of a religious rite in a ceremony called a bris. Be certain parents are well informed about the procedure so they can evaluate carefully whether they wish you have a son circumsized. The procedure is best for formed during the first or second day of life, after the baby has synthesize enough vitamin K to reduce the chance of faulty blood coagulation, rather than being done immediately post birth when the level of vitamin K is that a low point. For the procedure, and infant is placed in a supine position and restrain either manually or with a commercial swaddling bored. Application of a local anesthetic is a popular choice. Regional block anesthesia that may also be used if an anesthetist is available. for the actual procedure, a specially designed plastic bell is fitted over the end of the penis. A suture is then tied around the rim of the bell and a circle of the prepuce is cut away, allowing the remaining for skin to be easily retracted and the glans to be fully exposed. The rim of the bell will remain in place for about 1 week then fall off by itself. While in place, the bell helps protect against infection and bleeding because it prevents the healing penis from sticking to a diaper. Circumcision sites of here red but should never have a strong odor or discharge. They film of light yellow mucus often covers the glans by the second day after surgery and should not be washed away because it serves a protective function. Caution parents to keep the area clean from feces and covered with petrolatum for about 3 days or until healing is complete. If they notice any redness or tenderness, or if the baby cries as if in constant pain, they should report it by telephone to their primary care provider because this suggests an infection.
What is colostrum and why is it important
Colostrum is a thin watery yellow fluid composed of protein, sugar, fat, water, minerals, vitamins, and maternal antibodies and is secreted by the acinar breast cells starting in the fourth month of pregnancy. Because it is high in protein and fairly low and sugar and fat, colostrum is easy to digest and capable of providing adequate nutrition for a newborn until it is replaced by transitional breast milk on the 2nd to 4th day.
What are the percentage of protein, carbohydrate, and fat in infant formula and how does that compare to breastmilk
Commercial infant formulas are designed to simulate breast milk and so have the same number of calories per ounce as breast milk. They contain about 9% to 12% of their calories as proteins and 45% to 55% of calories as lactose carbohydrate. The balance 34% to 46% is fat, of which linoleic acid accounts for about 4%.
Know the difference between the types of heat loss, such as convection, conduction, radiation, and evaporation. Know how to prevent each of these.
Convection if the flow of heat from the newborns body surface to cooler surrounding air. Eliminating draft such as air from air conditioners is an important way to reduce convection heat loss. Radiation is the transfer of body heat to a cooler solid objects not in contact with the baby, such as a cold window or air conditioner moving and infant as far from the cold surface as possible helps reduce this type of heat loss. Conduction is the transfer of body heat to a cooler solid object in contact with the baby . for example, a baby placed on the cold base of a warming unit quickly loses heat to the colder metal surface. Covering surfaces with the warm blanket or towel is necessary to help minimize conduction heat loss. Evaporation is loss of heat through conversion of a liquid to a vapor. Newborns are wet when born, so they can lose a great deal of heat as the amniotic fluid on their skin evaporates. To prevent this type of heat loss lay a newborn on the mothers abdomen immediately after birth and cover with a warm blanket for skin to skin contact. In addition, drying the infant, expecially the face and hair, also effectively reduces evaporation evaporation because the head, which is a large surface area in a newborn, can be responsible for a great amount of heat loss. Covering the hair with a cap after drying further reduces the possibility of evaporation cooling.
List reasons that women lose the sensation of knowing she needs to avoid
During a vaginal birth, the fetal head exerts a great deal of pressure on the bladder and urethra as it passes on the bladders underside, this may leave the bladder with a transient loss of tone that, together with the edema surrounding the urethra, decreases a woman's ability to sense when she has to void. A woman who has had epidural anesthesia can feel no sensation in the bladder area until the anesthetic has worn off.
iscuss the importance of a warm relationship between the infant and mother and how this can affect the infant's
During feeding, if hair is close to the infant, & a baby is apt to be particularly sensitive to the parents demonstration of infection or lack of warmth. The feeding experience, therefore, enables an emotional bond between infant and caregiver and helps provide an environment that enhances the psychosocial development of the infant as well as aids physical growth.
Discuss the weight loss experience by newborns during their first few days after birth, as well as the expected day the infant should recapture the same weight as their birth weight by breastfed or bottle fed infants. After this period, how much weight should they gain during their first 6 months of life
During the first few days after birth a newborn loses 5% to 10% of birth weight 6 - 10 ounces this weight loss occurs because a newborn is no longer under the influence of salt and fluid retaining maternal hormones . breast fed newborns have a limited intake until about the third day of life because of the relatively low caloric content and small amount of colostrum they ingest; formula fed newborns need time to establish effective sucking this lack of intake also plays a part in weight loss. After this initial loss of weight, a newborn has about one day of stable weight, then begins to gain weight. The breastfed newborn recaptures birth weight within 10 days. formula fed infant accomplishes this gaine within 7 days. After this, all infants begin to gain about 2 pounds per month 6 - 8 ounces per week for the first 6 months of life
discuss interventions to prevent or relieve engorgement
Empty the breast of milk by having the infant suck more often, or at least continue to suck as much as before. good rest support from a firm fitting bra also helps prevent a pulling, heavy feeling. Warm packs applied to both brass or standing under a warm shower for a few minutes before feeding, combined with massage to begin milk flow, often promote breast softness so an infant can suck. Manual expression or the use of a breast pump to completely empty the breast after the baby has a nurse can help maintain or promote a good milk supply during a period of engorgement.
scribe positions used for
Football hold, laying with a pillow for support, sitting position.
What are expected assessment findings of the umbilical cord? What are unexpected assessment findings of the umbilical cord and what does each of them
For the first hour after birth, the stump of the umbilical cord appears as a white, gelatinous structure marked with the blue and red streaks of the one umbilical vein and the two arteries. Any child with a single umbilical artery needs close observation and assessment until anomalies are ruled out because they are frequently associated with the lack of an umbilical artery. After the first hour of life, the cord will begin to drive, shrink, and turn brown as if it were the dead end of a vine. By the second or third day, it will have turned black. On day 6 to 10, it breaks free, leaving a granulating area a few centimeters wide that will heal during the following week. There should be no bleeding at the base of the cord because this suggests the cord clamp has become loose and where the cord has been dug blues by the friction of bedclothes. In addition, the base of the court should not appear wet. A moist moist or odorous chords suggest infection, a situation that requires immediate antibiotic therapy to prevent the infectious organisms from entering the new borns bloodstream and causing septicemia. Moistness at the base of the court also may indicate a patent urachus, which will drain urine at the cord site until it is surgically repaired. As a last assessment, inspect the base of the cord to be certain no abdominal wall defect such as an umbilical hernia is present. If there is a fashial defect smaller than 2 centimeters in diameter, this will usually close on it's own by school age. If the defect is larger than this, it will probably require surgical correction.
are symptoms and treatments for hypoglycemia in
Hypoglycemia, like anemia, produces few symptoms in newborns, therefore the heel capillary blood sample is necessary to determine if it is present. If the serum glucose reading is found to be less than 40 milligrams per 100 milliliters of blood, hypoglycemia is said to be present. To correct this condition, the infant is prescribed oral glucose or is breastfed immediately because either of these therapies leave elevate the infant's blood sugar to a safe level. It is important to treat hypoglycemia quickly this way because, if brain cells become completely depleted of glucose, brain damage can result. If a newborn exhibit symptoms of hypoglycemia, jitterness, lethargy, seizures, in addition to the low laboratory test results, intravenous glucose probably will be prescribed. A continuous intravenous infusion of glucose may be necessary if the newborn is unable to maintain glucose levels higher than 40 milligrams per 100 milliliters.
Identify the clinical criteria for gestational assessment
Insert table 18.3 on page 462
What is involution and know the two processes
Involution is the process whereby the reproductive organs return to their non-pregnant state. Involution of the uterus involves two processes. First, the area where the placenta was implanted is sealed off to prevent bleeding. Second, the organ is reduced to its approximate pre gestational size.
Is breast feeding an effective contraceptive technique
It can prolong menstration however it does not necessarily stop ovulation so you should still use protection.
Define jaundice and discuss causes of jaundice in breastfed
Jaundice, or yellowing of the skin, occurs in as many as 15% of breastfed infants because pregnanediol, a breakdown product of progesterone, in breastmilk depresses the action of glucuronyl transferase, the enzyme that converts indirect bilirubin which cannot be excreted to the direct form, which is then readily excreted in bile.
What is lochia and be able to differentiate between lochia rubra, lochia serosa, and lochia Alba.
Lochia rubra is red in color and experienced on one two three days after birth its composition is blood, fragments of decidua, and mucus. Lochia serosa is pink in color and experienced on days 3 to 10 postpartum it is composed of blood, mucus, and invading leukocytes. Lochia Alba is white and color and experienced on day 10 to 14 of postpartum and may last up to six weeks it is largely composed of mucus and the leukocyte count is high.
What does it mean if the lochia has an offensive odor or is absent
Lochia should not have an offensive odor as this suggests the uterus has become infected. Immediate intervention is needed to halt postpartal infection. Lochia should never be absent during the first one to three weeks as absence of lochia, like presence of an offensive odor, may indicate postpartal infection. Lochia may be scant in amount after cesarean birth, but it is never altogether absent.
Be able to give clear instructions on perennial care to the post partum
Lochia, if allowed to dry and harden on the vulva and perineum, furnishes a rich bed for bacterial growth, which then can spread to the uterus. To reduce these risks, teach a woman to include perennial care as part of her daily bath or shower and after every voiding or bowel movement. For the woman on bed rest during her first hour after birth, you will need to provide this care for her.
What is the en face position and engrossment
Looking directly at her newborn face, with direct eye contact is termed the en face position. It is a sign a woman is beginning effective attachment. Many fathers can be observed staring at a newborn for long intervals in the same way. Often termed engrossment, this Action Alerts caregivers to how actively the Father, as well as the mother, is beginning bonding.
What are the advantages of the different types of commercial formulas and what criteria should be considered when selecting the appropriate commercial formula
Modified milk-based formulas are used for the average newborn, lactose-free formulas are used for infants with lactose intolerance or galactosemia. Soy formulas were devised for infants who are allergic to cow's milk protein, although such infants may be given casein hydrolysate formulas, which have protein particles too small to be recognized by the immune system. Elemental formulas are used for infants with protein allergies or fat malnutrition. Modified milk based, soy based, and lactose free formulas are all designed to simulate the nutritional content of breast milk, so all contain supplemental vitamins as well as 20 calories per ounce when diluted according to directions. Commercial formulas art supply in four separate form. Powder that is combined with water, condensed liquid that is diluted with an equal amount of water, ready to pour type, which requires no solution, and individually pre packaged and prepare bottles of formula. The powder is the least expensive. A single bottle is easy to prepare by vigorous shaking. The prepackaged time does not need refrigeration or preparation. But it is the most expensive. Cost should not be the only basis for a Parent's Choice, however. Tolerance of the formula by the infant and convenience for the parents also are important.
Why does vitamin K given to newborns? What is the medication route and what is the preferred administration
Most newborns are born with a lower than usual level of vitamin K, leading to a prolonged coagulation or prothrombin time. Because almost all newborns can be predicted to have this diminished blood coagulation ability, vitamin K is usually administered intramuscularly into the lateral anterior thigh, the preferred site for all injections in newborns, immediately after birth.
Describe the important aspects of car seat and what all parents
Newborn should always be transported in rear facing car seats placed in the back seat. When purchasing a car seat, caution parents to look at the brand and style to be certain the seat meets current federal guidelines. Advise parents not to use a sack sleeper or Papoose bunting nor should they wrap the baby in a bulky blanket so the straps will securely fashion the infant into the seat. Caution parents that plastic car seeds grow extremely hot in the summer, so they should test the temperature on the surface before placing their infant into the seat. Stress also that it is a dangerous to not use a car seat as it is to use a car seat improperly.
List important considerations pertaining to fluid intake for
Newborns, because of their metabolic rate being so high, in newborns body surface area is large in relation to body mass. In a newborn, 30% to 35% of body weight is extracellular fluid, in an adult, this proportion is only 20%. Because of all these factors, a newborn needs 150 to 200 milliliters per kilogram of water intake take every 24 hours.
Discuss the differences between breast massage and the nipple rolling techniques
Nipple rolling was advised in the past as a way of making a woman's nipples more protuberant, it is not necessary because few women have inverted or nonprotuberant nipples.
What is witch's milk and what causes it
Occasionally, the breasts of a newborn babies secrete a thin watery fluid popularly termed witchs milk.
For breastfeeding, is the use of supplemental feeding appropriate and if it is how often
Once breastfeeding has been established, after about 6 weeks, missing one feeding will not affect milk production enough to make a difference at the next feeding. There is no need for a mother to express milk manually to safeguard supply while the infant takes a supplemental feeding, although she may prefer to do so to reduce tension and discomfort.
What is a fingerbreadth how do you measure it
One finger breadth is equal to 1 centimeter
What are some causes of and interventions for sore nipples for lactating mothers
Painful nipples result from the strong sucking action of a newborn. This can be worse than by and proper positioning of an infant, forcefully pulling in infant from a breast, allowing an infant to suck too long at a breast after the breast is empty, and permitting a nipple to remain wet from leaking milk. Encourage a mother to position her babies slightly differently for each feeding. Advisor also to expose your nipples you are so the nipple drive by leaving her bra and snaps for 10 to 15 minutes after feeding. Discourage the use of plastic liners that come with nursing bras as these can prevent air from circulating around the breasts. Applying lanolin to nipples after exposure is a way to toughen the nipples and prevent further irritation. Applying a few drops of breastmilk to the nipples after feeding and gently massaging it into the areola can also be recommended. Advise women with sore nipples not to use hand held breast pump because the pressure may cause fissures to worsen.
Describe the technique used to palpate the
Palpate the fundus of the uterus by placing one hand on the base of the uterus, just above the symphysis pubis, and the other at the umbilicus. Press in and downward with the hand at the umbilicus until you bump against the firm globular mass in the abdomen calling the uterine fundus. Ss consistency, location, and height.
patient teaching two parents of a newborn about care for the umbilical
Remind parents to continue to keep the cord dry until it falls off after they return home. Just courage the use of creams, lotions, and oil near the cord because these tend to slow drying of the cord as well as invite infection. Remind them to use sponge baths rather than immerse infant in a tub of water. Some healthcare agencies recommend that parents apply rubbing alcohol to the cord once or twice a day to hasten drying. Others prefer that the cord be strictly left alone, because manipulation of this type could invite infection. After the cord falls off, a small, pink, granulating area about a quarter of an inch in diameter may remain. This should also be left clean and dry until it has healed about 24 to 48 more hours.
Describe Patient teaching about food in calorie intake for breastfeeding mothers
Remind women a good fluid intake is necessary to maintain and adequate milk supply. Recommend a drink at least four eight ounce glasses of fluid a day, many may need to drink 6 glasses. They also need to increase their calorie intake by about 500 calories per day.
List the signs of hunger in a newborn
Restlessness, tense body posture, smacking lips, and tongue thrusting are all signs of hunger. Crying is actually a late sign of newborn hunger.
Know the normal range of vital signs for a newborn
Temperature is 97.6 - 98.6 axillary heart rate 120 to 140 beats per minute respirations 30 to 60 breaths per minute blood pressure 80 / 46
know the difference between the anterior fontanelle and the posterior fontanelle, such as the size, shape, width and length, and when they are expected to close
The anterior fontanel is located at the junction of the two parietal bones and the two fused frontal bones. It is diamond shaped and measures 2 to 3 centimeters in width and 3 to 4 centimeters in length. The posterior fontanelle is located at the junction of the parietal bones and the occipital bone. It is triangular and measures about one to two centimeters in length. The anterior fontanelle can be felt as a soft spot. The anterior fontanelle normally closes at 12 to 18 months of age. In some newborns, the posterior fontanelle is so small that it cannot be palpated readily. It closes by the end of the second month.
Describe the expected characteristics of a newborn's stools
The first stool of a newborn is usually pass within 24 hours after birth. It consists of meconium, a sticky, tarlike, blackish green, odorless material formed from mucus, vernix, lanugo, hormones, and carbohydrates that accumulated in the bowel during intrauterine life. If a newborn does not pass a meconium stool by 24 to 48 hours after birth, the possibility of some factors such as meconium ileus, imperforate anus, or volvulus, which is causing blockage of the bowel, should be suspected. About the 2nd or 3rd day of life, newborn school changes in color and consistency. Termed a transitional school, bowel contents appear both lose and Green and may resemble diarrhea to the untrained eye. By the 4th day of life, breastfed babies past three or four light yellow stools per day. They are sweet smelling. A newborn who received formula usually passes 2 or 3 bright yellow stools a day. These have a slightly more noticeable odor. A newborn placed under phototherapy lights as therapy for jaundice will have bright green stools because of increased bilirubin excretion. Newborns with bile duct obstruction have clay colored or Grace tools, because bile pigments cannot enter the intestinal tract. Blood select Tools usually indicate an anal fissure. Occasionally, a newborn has swallowed some maternal blood during birth and either vomits fresh blood immediately after birth or passes a black tarry stool after two or more days. If mucus is mixed with stool or the stool is watery and loose, a milk allergy, lactose intolerance, or some other condition interfering with digestion or absorption should be suspected.
What is lactation and how many days does it take after giving birth
The formation of breastmilk or lactation begins in a postpartum woman whether or not she plans to breastfeed. On the third day after birth, her breasts become full and feel tense or tender as milk forms with in breast docs and replaces colostrum.
Discuss the use of the latch assessment to evaluate breastfeeding effectiveness
The last score is a useful tool to identify mother-infant pairs who might benefit from additional skilled support to encourage them to continue exclusive breastfeeding. Insert able 19.1 on page 500
Describe the profile of a newborn kidnapper
The profile of someone who might abduct a newborn is a woman who has recently lost a pregnancy or had an infant stillborn and therefore desires and infant very much. She often is someone familiar with hospitals, she may pretend to be a volunteer or an unlicensed healthcare worker and says she needs to take a baby out of the nursery or the mothers room for a procedure.
What is the purpose of using erythromycin ophthalmic
The purpose of ointment is to help prevent gonorrhea and chlamydia conjunctivitis. In the past, I prophylaxis was applied immediately after birth. If it is given, it is better, to allow parents to interact with their infant before the procedure to be certain their newborn can focus on them without blurry vision caused by the ointment.
Be able to describe the weight loss pattern of a postpartum
The rapid diuresis and diaphoresis during the 2nd to 5th days after birth usually result in a weight loss of 5 pounds, in addition to the approximately 12 pounds lost at birth. Lochia flow causes an additional 2 to 3 pound loss, for a total weight loss of about 19 pounds.
Know the different reflexes assassin a newborn. Rooting reflex, sucking reflex, Palmar grasp reflex, plantar grasp reflex, tonic neck reflex, Moro reflex, and the babinski reflex.
The rooting reflex. If a newborn's cheek is brush or stroke near the corner of the mouth, the infant will turn the head in that direction. The rooting reflex disappear that about the 6th week of life. The sucking reflex. When a newborns lips are touched, the baby makes a sucking motion. The second reflex begins to diminish at about 6 months of age. The palmar grasp reflex. Newborns grasp an object placed in their palm by quickly closing their fingers on it. This grasp reflex disappears at about 6 weeks to 3 months of age. The planter grasp reflex. When an object touches the soul of a newborn's but at the base of the toes, the toes grass in the same manner as the fingers. This reflex disappears at about eight to nine months of age in preparation for walking. The tonic neck reflex. When newborns lie on their backs, their heads usually turn to one side or the other. The arm and a leg on the side towards which the head turns extend, and the opposite arm and leg contract. The tonic neck reflex typically disappears between the second and third months of life. The Moro reflex. This can be initiated by startling a new born with a loud noise or by drawing the bassinet. It is strong for the first 8 weeks of life. And then paid by the end of the 4th or 5th month. The Babinski reflex. When the sole of a newborn's foot is stroked in an inverted J curve from the heal upward, a newborn fans the toes. The Babinski reflex remains positive until at least three months of age.
Be able to define sutures, molding, caput succedaneum, cephalohematoma, and craniotables
The skull sutures are the separating lines of the skull. Molding is when the part of the infant's head that engage the cervix molds to fit the cervix contours during labor. Caput succedaneum is edema of the scalp that forms on the presenting part of the head. Cephalohematoma is a collection of blood between the periosteum of a skull bone and the bone itself caused by rupture of periosteum capillary because of the pressure of birth. Craniotabes is a localized softening of the cranial bones probably caused by pressure of the fetal skull against the mother's pelvic bone in utero.
What are the three phases of puerperium
The taking in phase is largely a time of reflection. During this one two three day., a woman is largely passive. She prefers having a nurse attend to her needs and make decisions for her, rather than do these things herself. This dependence results partly from her physical discomfort because of after Payne or hemorrhoids, partly from her uncertainty and caring for her new born, and partly from the exhaustion that follows childbirth. The taking hold phase. After a time of passive dependence, a woman begins to initiate action. She prefers to get her own washcloth or to make her own decisions. Women who give birth without any anesthesia may reach this second phase in a matter of hours after birth. Now, she begins to take a stronger interest in her infant and begins maternal role behaviors. In this third phase, a woman finally redefines her new role. She gives up the fantasized image of her child and accepts the real one. She gives up her old role of being childless where the mother of only one or two. A woman who has reached this phase is well into her new role this is the letting go phase.
is engorgement and when does it happen
This feeling of tension in the breasts on the 3rd or 4th day after birth is termed primary engorgement. It fades as the infant begins effective sucking and empties the breasts of
What can nurses assessed to know if the postpartum woman have a full bladder
To prevent permanent damage to the bladder from overdistention, assess a woman's abdomen frequently in the immediate postpartum period. On palpation, a full bladder is felt as a hard or firm area just above the symphysis pubis. On percussion, a full bladder sounds resonant, in contrast to the dull, thudding sound of non fluid-filled tissue. As the bladder fills, it displaces the uterus. Uterine position and lack of contraction are, therefore, a second good gauge of whether a bladder is full or empty.
Describe proper section techniques used with a bulb syringe
Use a bulb syringe or a soft, small catheter. Never suction vigorously, because this irritates the mucous membrane and could leave a portal of entry for infection. Brisk suctioning also has been associated with bradycardia in newborns because of vagal nerve stimulation. If you use a bulb syringe, decompressed the bulb before inserting it into the infant's mouth or nose, otherwise, the force of decompression of the bulb will push secretions back into the pharynx or bronchi rather than remove them.
No the difference between vernix caseosa, lanugo, milia, and erythema toxicum
Vernix caseosa is the white, cream cheese like substance that serves as a skin lubricant in utero. Lanugo is the fine, Downey hair that covers a term newborn shoulders, back, upper arms, and possibly also the forehead and ears. Milia are sebaceous glands in a newborn that are immature. They appear as pinpoint white that's usually found on cheeks or across the bridge of the nose. Erythema toxicum is a rash that usually appears in the first to fourth day of life, but may appear as late as two weeks of age.
newborn identification
When traditional form of identification used with newborns is a plastic bracelet with a permanent lock that requires cutting to be removed. If an identification band is attached to a newborn's arm or leg, - bands should be used because a newborn's wrist and hand, as well as the ankle and foot, are not very different in width, so bands can slide off easily. A newer form of identification band has a built-in sensor unit that sounds an alarm similar to those attached to clothing in department stores to stop shop lifting, if a baby is transported beyond set hospital boundaries. After identification bands are attached, and infants footprints may be taken and thereafter kept with the babies electronic record for permanent identification.
What criteria are used to know if an infant is getting adequate
Whether the infant seems content between feedings, wetting six to eight diapers within 24 hours, or losing no more than 10% of birth weight. After the first week, weight gain and voiding six to eight times in 24 hours are good criteria to use.
