Maternity 2
The nurse notices while holding him upright that a day-old newborn has a significantly indented anterior fontanelle. She immediately brings it to the attention of the physician. What does this finding most likely indicate?
Dehydration The anterior fontanelle can be felt as a soft spot. It should not appear indented (a sign of dehydration) or bulging (a sign of increased intracranial pressure) when the infant is held upright. Vernix caseosa is the white, cream cheese-like substance that serves as a skin lubricant in utero. Some of it is invariably noticeable on a term newborn's skin, at least in the skin folds, at birth. Cyanosis is a condition of decreased oxygenation that results in the skin having a blue hue
The woman with DM is at increased risk for pregnancy-related
Hypertension In the third trimester, the physician will likely recommend weekly blood pressure and urinary protein measurement
It takes oxygen to produce heat. If the newborn becomes cold stressed, he or she will eventually
develop respiratory distress. This is one important reason to protect the newborn from heat loss.
An 20-year-old primipara is getting ready to go home. She had a second-degree episiotomy with repair. She confides in the nurse that she is afraid to go to her postpartum checkup because she is afraid to have the stitches removed. Which reply by the nurse is best?
"Many women have that fear after having an episiotomy. The stitches do not need to be removed because the suture will be gradually absorbed." The episiotomy is approximated and repaired using suture that is gradually absorbed by the body.
The nurse is caring for a newborn with fetal alcohol syndrome. The nurse knows that the newborn will demonstrate:
Hyperactivity. Explanation: Newborns with fetal alcohol syndrome exhibit hyperactivity, a small height and head circumference, hypoglycemia, and irritability.
What should the nurse expect for a full-term newborn's weight during the first few days of life?
Loss of 5% to 10% of birth weight in formula-fed and breastfed newborns The nurse should expect the newborn who is breastfed or formula-fed to lose 5% to 10% of birth weight in the first few days of life.
The nurse is caring for an infant born to a mother who abused cocaine during her pregnancy. Which of the following characteristics would the nurse likely see in this infant?
The infant cries when touched. Developmental delays occur in young children of substance abusers. Infants of cocaine abusers do not liked to be touched or held and avoid the caregiver's gaze, which contributes to bonding delays. Infants of cocaine abusers are often restless and below average weight when bo
Administer betamethasone as ordered to
increase fetal lung maturity in the event delivery must occur before term.
The woman with diabetes is at increased risk for UTI because of elevated blood sugar levels. Review with the woman the signs of a UTI include
increased frequency, voiding small amounts, burning with urination, and cloudy urine. Teach her to drink eight to 10 glasses of noncaffeinated beverages every day to help prevent UTI and to wipe from front to back after using the restroom.
Any unusual stress that increases demands upon the cardiovascular system can precipitate heart failure. Examples include
infection, anemia, dehydration, underlying medical disorders, and excessive emotional or physical stress.
Ectopic pregnancy
is a pregnancy that occurs outside of the uterus. The fertilized ovum implants in another location other than the uterus. The common term for this condition is "tubal" pregnancy.
The most effective medication to prevent and treat eclamptic seizures
is magnesium sulfate, usually administered intravenously
For asthma
. Inhaled medications, such as albuterol and corticosteroids are the frontline treatment agents. 1st - Albuterol- betaagonis 2nd- corticosteroid if albuterol doesnt work
new mother asks the nurse how she could determine if her 2-week old son is getting enough breast milk. Which response by the nurse would be most appropriate?
"He should wet about 6 to 8 diapers a day." By 4 to 7 days of life, a newborn should have 6 to 8 voids in a 24 hour period indicating adequate fluid intake and a sign of successful feeding. Typically the breast fed infant has yellow, seedy, very soft or liquid stools and stool at least 3 to 4 times a day, possibly as often as after every feeding. Stools of infants fed iron-fortified formula are green in color. Falling asleep while eating is not an indicator of adequate intake
After teaching a pregnant woman with iron deficiency anemia about her prescribed iron supplement, which statement indicates successful teaching?
"I need to eat foods high in fiber." Iron supplements can lead to constipation, so the woman needs to increase her intake of fluids and high-fiber foods. Milk inhibits absorption and should be discouraged. Vitamin C-containing fluids such as orange juice are encouraged because they promote absorption. Ideally the woman should take the iron on an empty stomach to improve absorption, but many women cannot tolerate the gastrointestinal discomfort it causes. In such cases, the woman should take it with meals. Iron typically causes the stool to become black and tarry; there is no need for the woman to notify her doctor
The nursing instructor is reviewing with students ways to assess if the infant is getting enough at each feeding. Which of the following statements by a student demonstrates an understanding of these concepts?
"Assess the infant's voiding, growth, and alertness." The best confirmation of whether an infant is receiving adequate nutrition is to assess whether the newborn is voiding, growing, and alert.
A 26-year-old new mother says to her nurse, "I am so disappointed. I gained 25 pounds with my baby. Just what the doctor said I should gain. But after I had my baby I only lost 12 pounds." What is the best response by the nurse?
"It is normal to lose between 12 and 14 pounds after the baby delivers. You should be back to your pre-pregnancy weight by the time your baby is about 6 months old." Immediately after delivery approximately 12 to 14 pounds are lost with expulsion of the fetus, placenta, and amniotic fluid.
A new mother is concerned because it is 24 hours after childbirth and her breasts have still not become engorged with breast milk. How should the nurse respond to this concern?
"It takes about 3 days after birth for milk to begin forming." The formation of breast milk (lactation) begins in a postpartal woman regardless of her plans for feeding. For the first 2 days after birth, an average woman notices little change in her breasts from the way they were during pregnancy as, since midway through pregnancy, she has been secreting colostrum, a thin, watery, prelactation secretion. On the third day post birth, her breasts become full and feel tense or tender as milk forms within breast ducts and replaces colostrum. There is no need to recommend formula feeding to the mother. Mastitis is inflammation of the lactiferous (milk-producing) glands of the breast; there is no indication that the client has this condition. Lactational amenorrhea is the absence of menstrual flow that occurs in many women during the lactation period.
Ophthalmia neonatorum is contracted when a mother has which sexually transmitted infection(s)?
Colonization of chlamydia and gonorrhea in the vaginal tract can lead to ophthalmia neonatorum in the newborn.
You are a graduate LVN/LPN seeing your first cesarean delivery. An infant girl is born and as the nurse assesses the infant she asks you what you would carefully assess in this infant. You respond "Respiratory status." The assessing nurse asks you "Why?" What would be your best response?
"There is more fluid is present in the lungs at birth after a cesarean delivery than after a vaginal delivery." The process of labor stimulates surfactant production, and much of the fetal lung fluid is squeezed out as the fetus moves down the birth canal. This so-called vaginal squeeze is an important way nature helps to clear the airway in preparation for the first breath. The vaginal squeeze also plays a role in stimulating lung expansion. The pressure of the birth canal on the fetal chest releases immediately when the infant is born. The lowered pressure from chest expansion draws air into the lungs
S.H.I.F.T.T.L.E. ACRONYM for Fetal Alcohol syndrome
-Small height an head circumference -Hyperactivity -Irritability -Flattened Nasal Bridge -Tremors or Seizures -Trouble Sleeping -Low Birth Weight LBW -Eyelid folds (short palpebral fissures)
S.C.U.T.E.N. is an acronym for Respiratory depression in Newborns
-Sternal retractions-Intercostal or xiphoid retractions -Central cyanosis -Unequal movements of the chest and abdomen during breathing efforts -Tachypnea (sustained respiratory rate greater than 60 breaths per minute) -Expiratory Grunting (noted by stethoscope or audible to the ear) -Nasal Flaring
The normal weight range for a full-term newborn is between
5 lb 8 oz and 8 lb 13 oz (2,500 and 4,000 g).
Pelvic hematoma
A hematoma also can form deep in the pelvis where it is much more difficult to identify. The primary symptom is deep pain unrelieved by comfort measures or medication and accompanied by vital sign instability
Which type of breast milk is highest in antibodies?
Colostrum Colostrum is the first milk that is expressed postpartum. It is thick, yellow milk and is higher in antibodies than any other type of milk.
Nursing care for the newborn that is withdrawing from alcohol includes the supportive interventions of swaddling, decreasing sensory stimulation, and ensuring adequate nutrition. Keep the newborn's environment quiet and dark during the first few days of withdrawal. Administer benzodiazepine or other anticonvulsants, as ordered, to prevent or treat seizure activity.
Adequate nutrition is key to supporting weight gain. The newborn's sucking reflex may be weak, and he or she may be too irritable to feed. Give small amounts of formula or breast milk frequently. Monitor the newborn's daily weight, intake, and output. Encourage the parents to feed the newborn. This measure also helps promote bonding.
Signs of Hypoglycemia
Anxiety Shakiness Confusion Headache Tingling sensations around the mouth Hunger Sudden behavior change Pale skin Cold, clammy skin Increased pulse Seizure Unresponsiveness
Which intervention would be helpful to a bottle-feeding client who's experiencing hard or engorged breasts?
Applying ice Ice promotes comfort by decreasing blood flow (vasoconstriction), numbing the area, and discouraging further letdown of milk. Restricting fluids doesn't reduce engorgement and shouldn't be encouraged. Warm compresses will promote blood flow and hence, milk production, worsening the problem of engorgement. Bromocriptine has been removed from the market for lactation suppression
Which of the following assessments would lead you to believe a postpartal woman is developing a urinary complication?
At 8 hours postdelivery she has voided a total of 100 mL in four small voidings. Postpartal women who void in small amounts may be experiencing bladder overflow from retention.
Hemoglobin levels less than 10 g/dL
define anemia during pregnancy
A newer method of treating a small, unruptured ectopic pregnancy is intramuscular injections of methotrexate, an antineoplastic (anticancer) drug.
Because the cells of the zygote are rapidly multiplying, methotrexate targets the pregnancy for destruction. Because surgery on a fallopian tube is a risk factor for ectopic pregnancy, treating an ectopic pregnancy with the anticancer drug methotrexate instead of with surgery can help prevent future ectopic pregnancies.
Vaginal birth is preferred if possible. Benefits of vaginal versus cesarean birth include decreased oxygen demands, minimal blood loss, less chance of postoperative complications, such as infection and pulmonary issues like pneumonia.
Cesarean delivery may be recommended in some situations, including cephalopelvic disproportion or the presence of an aneurysm, where the risk to the fetus or mother is greater than the risk of surgery.
The nurse places a warmed blanket on the scale when weighing a newborn to minimize heat loss via which mechanism?
Conduction Using a warmed cloth diaper or blanket to cover any cold surface, such as a scale, that touches a newborn directly helps to prevent heat loss through conduction. Drying a newborn and promptly changing wet linens, clothes, or diapers help reduce heat loss via evaporation. Keeping the newborn out of a direct cool draft, working inside an isolette as much as possible, and minimizing the opening of portholes help prevent heat loss via convection. Keeping cribs and isolettes away from outside walls, cold windows, and air conditioners and using radiant warmers while transporting newborns and performing procedures will help reduce heat loss via radiation.
Coughing and a respiratory rate above 50
Coughing and sneezing are normal reflexes present in newborns. The expected respiratory rate of newborn is 30 to 60 breaths per minute.
AN elevated hematocrit is associated with
Dehydration
Pain relieve
Fentanyl or butorphanol are the pain relievers of choice during labor because they do not cause histamine release, which could lead to bronchospasm. Epidural analgesia is the ideal method of pain control for the laboring woman with asthma (
The therapeutic level of magnesium sulfate is 4 to 8 mg/dL. This level is effective to prevent seizures without causing toxicity. Magnesium toxicity begins when serum magnesium levels approach 9 mg/dL. First, the reflexes disappear, then as the levels increase, respiratory depression and cardiac arrest can follow.
For this reason, monitor the reflexes and respiratory rate of the woman receiving magnesium sulfate at frequent intervals. Draw serum magnesium levels at prescribed intervals. Calcium gluconate is the antidote to magnesium sulfate. The RN gives this medication by IV push to treat magnesium overdose.
Which of the following best describes the time between fertilization of the egg and birth?
Gestational age
Hypoglycemia can be deadly. The woman needs a ready source of glucose (e.g., a candy bar or glass of milk) closeby. A family member must administer WHAT if the woman loses consciousness.
Glucagon
When asked by a father to compare the feeding habits of formula-fed and breastfed infants, which of the following is the correct response from the nurse about breastfed infants?
Go approximately 3 hours between feedings. Formula is harder than breast milk to digest. Therefore, breastfed babies typically feed more frequently than formula-fed babies (ie, every 3 hours instead of every 4 hours).
When planning the care for a client during the first 24 hours postpartum, the nurse expects to monitor the client's pulse and blood pressure frequently based on the understanding that the client is at risk for which of the following?
Hemorrhage The nurse should monitor the pulse and blood pressure frequently in the first 24 hours postpartum because the client is at greatest risk of hemorrhage. Hemorrhoids cause discomfort and contribute to constipation; this does not call for monitoring of pulse and blood pressure frequently. Increased coagulability causes increased risk of thromboembolism in the puerperium. Precipitous labor or instrument-assisted births pose an increased risk for cervical laceration. None of these conditions require monitoring of pulse and blood pressure
The nurse is caring for a newborn whose mother tested positive for hepatitis B surface antigen (HBsAg). Which does the nurse expect the newborn to receive because of this result
Hepatitis B vaccination • Hepatitis B immune globulin When a mother has a positive test for hepatitis B surface antigen (HBsAg), the newborn is given hepatitis B vaccine and hepatitis B immune globulin. Hepatitis A and C vaccines are given at a later date in the child's schedule for immunizations
H.I.S.H. ACRONYM for signs and symptoms of Fetal alcohol syndrome
Hyperactivity Irritability Small height & head circumference Hypoglycemia
After uterine evacuation in spontaneous abortion, the primary care provider often orders
IV oxytocin (Pitocin) or oral methylergonovine maleate (Methergine) to help prevent bleeding.
Which of the following instructions should a nurse give to a lactating client about how to break suction during a feeding?
Insert a finger into the corner of the baby's mouth between the gums The nurse should instruct the client to insert her finger into the corner of the baby's mouth between the gums to break the suction. The mother should not tug at the nipple, as this might damage the infant's unexposed teeth. Pressing both the cheeks of the infant simultaneously or shifting the infant to the football hold from the cross-cradle hold will not help break the suction.
Occipital posterior position back of baby's head is to the mothers back
It is a vertex presentation where the occiput is placed posteriorly over the sacro-iliac joint or directly over the sacrum is called an occipito-posterior position.
The nurse is preparing a teaching plan for new parents about why newborns experience heat loss. Which of the following would the nurse include?
Limited voluntary muscle activity Explanation: Newborns have limited voluntary muscle activity or movement to produce heat. They have thin skin with blood vessels close to the surface. They cannot shiver to generate heat. They have limited stores of metabolic substances such as glucose and glycogen
You assess a postpartum woman's perineum and notice that her lochial discharge is moderate in amount and red. You would record this as what type of lochia?
Lochia rubra Lochia rubra is red; it lasts for the first few days of the postpartal period.
Care of the newborn experiencing substance withdrawal focuses on providing physical and emotional support.
Medications such as chlorpromazine, clonidine, diazepam, methadone, morphine, paregoric, or phenobarbital may ease the withdrawal and prevent complications, such as seizures.
Administer oxytocin as ordered to control uterine atony.
Methylergonovine maleate or carboprost tromethamine (Hemabate) are other medications that may be ordered to stimulate the uterine muscle to contract.
`A new mother asks the nurse why her newborn must get a vitamin K injection. Which response made by the nurse is best?
Newborns need vitamin K to prevent hemorrhage. They cannot produce it themselves right after birth because of the lack of normal flora in their intestines." Vitamin K is essential for clot formation and hemorrhage prevention. It is synthesized in the gut by normal flora. The newborn's gastrointestinal system is sterile at birth; therefore, the newborn cannot synthesize vitamin K. Vitamin K is not an immunization, nor does it prevent infection
A 26-year-old primigravida has brought her doula to the birthing center for support during her labor and delivery. The doula has been helping her through the past 16 hours of labor. The laboring woman is now 6 cm. dilated. She continues to report severe pain in her back with each contraction. The patient finds it comforting when her doula uses the ball of her hand to put counterpressure on her lower back. What is the likely cause of the woman's back pain?
Occiput posterior position A labor complicated by occiput posterior position is usually prolonged and characterized by maternal perception of increased intensity of back discomfort. The lay term for this type of labor is "back labor
Treatment for chlymidia & Gonorhea
One intramuscular dose of ceftriaxone, a cephalosporin, along with either oral azithromycin or doxycycline 100 mg orally is the recommended treatment
What is Preclampsia & eclampsia?
Pre-eclampsia or preeclampsia is a disorder of pregnancy characterized by high blood pressure and large amounts of protein in the urine. Eclampsia is the onset of seizures in a woman with pre-eclampsia.
A nurse is teaching newborn care to students. The nurse correctly identifies which of the following as the predominant form of heat loss in the newborn?
Radiation, convection, and conduction. Heat loss in the newborn occurs primarily through radiation, convection, and conduction because of the newborn's large ratio of body surface to weight, and because of the marked difference between core and skin temperatures. Nonshivering thermogenesis is a mechanism of heat production in the newborn. Lack of brown adipose tissue contributes to heat loss, particularly in premature infants, but it is not the predominant form of heat loss. Peripheral vasoconstriction is a method to increase heat production
Just after delivery, a newborn's axillary temperature is 94°F (34.4°C). What action would be most appropriate?
Rewarm the newborn gradually. A newborn's temperature is typically maintained at 97.7°F to 99.7°F (36.5°C to 37.5°C). Since this newborn's temperature is significantly lower, the nurse should institute measures to rewarm the newborn gradually. Assessment of gestational age is completed regardless of the newborn's temperature. Observation would be inappropriate because lack of action may lead to a further lowering of the temperature. The nurse should notify the physician of the newborn's current temperature since it is outside normal parameters
Scarf sign.
Scarf sign is accomplished by gently pulling the newborn's arm in front of and across the top portion of the body until resistance is met as a measure of neuromuscular maturity. Popliteal angle and posture do not require manipulation of the arm. Square window and arm recoil do not require the nurse to move the arm across the chest.
Ginger is a herbal remedy commonly used to treat nausea.
Some cultures consider ginger to be a "hot" herb that treats "cold" conditions. Although there is no information regarding possible adverse fetal effects during pregnancy, recent research demonstrates that ginger can reduce nausea significantly.
Which 2 Specialist can help manage Diabetes in pregnant women?
Sometimes the obstetrician consults with an endocrinologist who then manages the woman's DM throughout her pregnancy. At other times, the obstetrician consults with the perinatologist, or the perinatologist manages the woman with DM during her pregnancy.
Which of the following would alert the nurse to the possibility of respiratory distress in a newborn?
Sternal retractions Sternal retractions, cyanosis, tachypnea, expiratory grunting, and nasal flaring are signs of respiratory distress in a newborn. Symmetrical chest movements and a respiratory rate between 30 to 60 breaths/minute are typical newborn findings. Some newborns may demonstrate periodic breathing (cessation of breathing lasting 5 to 10 seconds without changes in color or heart rate) in the first few days of life
Dietary needs change from pregnancy to lactation. What should breastfeeding mothers be advised?
That even if a mother has adequate fat stores, calorie intake should increase Women use approximately 500 calories above their normal total daily calorie needs to produce breast milk. Thirst is usually a reliable indicator of need; caffeine should be restricted because it does enter breast milk; and breast milk will not be deficient of calcium even if the woman does not consume enough calcium
The woman who is at risk for endocarditis needs antibiotic prophylaxis.
The antibiotic therapy begins when labor begins. Administration continues through the first postpartum day.
complication seen in the newborn of the woman with DM
The fetus is also at risk for delayed lung maturity and other complications seen in the newborn of the woman with DM Children who were born to mothers with DM have an increased risk for health risks later on in life including hypertension, impaired glucose tolerance, and obesity
Common times for checking blood sugars include upon awakening, after breakfast, before and after lunch, before and after dinner, and before bedtime.
The goal is to maintain fasting blood glucose levels of less than 95 mg/dL, and to not exceed 120 mg/dL two hours after meals
For the average newborn, this physiologic weight loss amounts to a total loss of 6 to 10 oz, and the cause is a loss of excess fluid combined with a low fluid intake during the first few days of life.
The newborn should regain the weight within seven to 10 days, after which he or she begins to gain approximately 2 lb every month until 6 months of age.
The nurse is assessing an infant's reflexes. While eliciting a rooting reflex, the infants strongly sucks on the nurse's finger. How does the nurse interpret this finding?
The rooting reflex was tested incorrectly. Explanation: Gently stroking the newborn's cheek brings out the rooting reflex. The newborn would demonstrate this reflex by turning toward the touch with an open mouth. This infant demonstrates a positive suck reflex but does not display the rooting reflex because the test was performed incorrectly
Signs & Symptoms of Heart disease
The woman may complain of the following: Dyspnea Orthopnea Nocturnal cough Dizziness Fainting Chest pain Cyanosis Clubbing of the fingers Neck vein distention Tachycardia Heart murmurs Edema
Iron rich food
These include animal protein, dried beans, fortified grains and cereals, dried fruits, and any food cooked in cast iron cookware.
The newborn that is withdrawing from alcohol is typically hyperactive, irritable, has trouble sleeping, and may have tremors or seizures. Characteristics of FAS include LBW, small height and head circumference, short palpebral fissures (eyelid folds), reduced ocular growth, and a flattened nasal bridge.
This newborn is prone to respiratory difficulties, hypoglycemia, hypocalcemia, and hyperbilirubinemia. Growth during infancy and childhood continues to fall below average growth rates. Unfortunately, the brain damage that occurs during fetal development is permanent, resulting in intellectual disability.
A fundal massage is sometimes performed on a postpartum woman. Which of the following is a reason for performing a fundal massage?
Uterine atony Fundal massage is performed for uterine atony, which is failure of the uterus to contract and retract after birth. The nurse would place the gloved dominant hand on the fundus and the gloved nondominant hand on the area just above the symphysis pubis. Using a circular motion, the nurse massages the fundus with the dominant hand. Then the nurse checks for firmness and, if firm, applies gentle downward pressure to express clots that may have accumulated. Finally the nurse assists the woman with perineal care and applying a new perineal pad.
Tests to evaluate the woman's heart include
a 12-lead electrocardiogram, echocardiogram, and Doppler study.
Surfacant
a substance found in the lungs of mature fetuses, keeps the alveoli from collapsing after they first expand. The work of breathing increases greatly when the lungs lack surfactant
Tachycardia that lasts for more than several minutes accompanied by dizziness or light-headedness suggests
a tachyarrhythmia and requires further investigation.
primapara means
a woman who is giving birth for the first time.
A woman experiences an amniotic fluid embolism as the placenta is delivered. Your first action would be to
administer oxygen by mask. An amniotic embolism quickly becomes a pulmonary embolism. The woman needs oxygen to compensate for the sudden blockage of blood flow through her lungs.
If a woman is Rho(D)-negative, she should receive Rho(D) immunoglobulin (RhoGAM)
any time a pregnancy is terminated for any reason. The length or type of pregnancy does not change this need.
The woman's breast does not produce milk until
approximately three to five days after birth
IV magnesium sulfate is the drug of choice to treat eclamptic seizures, but other anticonvulsants, such
as phenytoin (Dilantin) or diazepam (Valium), are sometimes ordered.
The average length is 20 in with the range
between 19 and 21 in (48 and 53 cm
However, poorly controlled DM, particularly in the early weeks of pregnancy, is likely to have complications including
birth defects, stillbirth, hypertensive disorders, polyhydramnios (excess levels of amniotic fluid), preterm delivery, and shoulder dystocia
Postpartum hemorrhage, anemia, infection, and thromboembolism are complications that greatly increase the risk
cardiac decompensation
The greatest risk for the fetus of the woman with GDM is
excessive growth, resulting in macrosomia (birth weight over 4,000 g [8.8 lb] or higher than the 90th percentile for gestational age) and birth trauma including shoulder dystocia.
primigravida means
first time pregnant
Foods high in folic acid include
fortified grains, dried beans, and leafy green vegetables.
Signs of preeclampsia include
headache, visual disturbances, epigastric pain, generalized edema, urinary protein, and elevated blood pressure. Call physician if symptoms
atony
lack of normal tone or strength; flaccidity.
Respiratory distress and cold stress are also two stressors that often lead to
neonatal hypoglycemia. Respiratory distress, apnea, seizures, and coma are late signs of hypoglycemia,
Misoprostol (Cytotec)
orally to induce contractions
The earliest warning sign of cardiac decompensation is
persistent rales in the bases of the lungs -a nocturnal cough. A sudden decrease in the ability to perform normal duties, exertional dyspnea, & attacks of coughing with a smothering feeling are serious signs of heart failure. Upon physical examination, tachycardia, edema, and hemoptysis may be noted
Wernicke's encephalopathy refers to
the presence of neurological symptoms caused by biochemical lesions of the central nervous system after exhaustion of B-vitamin reserves, in particular thiamine
Newborn withdrawal symptoms from drug abusing mother are
tremors, restlessness, hyperactivity, disorganized or hyperactive reflexes, increased muscle tone, sneezing, tachypnea, vomiting, diarrhea, disturbed sleep patterns, and a shrill high-pitched cry.. Ineffective sucking and swallowing reflexes create feeding problems, and regurgitation and vomiting occur often after feeding.
The woman can usually continue to take her cardiac medications during pregnancy, with the exception of
warfarin (Coumadin), angiotensin-converting enzyme inhibitors, and angiotensin II receptor blockers. HEPARIN would be given
