Ch 27 Mother & NB

________________ refers to the face-to-face position in which a parent's and infant's faces are approximately 20cm apart and on the same plane or level.

en face

Afterbirth pains

Cramping sensations that results from contractions of uterus, usually 1 day postpartum. Usually more common in multigravida and breast feeding moms.

Postpartum Maternal Danger Signs

Fever with or w/o chills. Malodorous vaginal discharge. Excessisve amount of vaginal discharge. Bright red vaginal bleeding after it has changed to pink or rust. Edema; erythematous or painful area on the legs. Pain or burning sensation with urination or an inability to void. Breast changes such as localized pain, heat, edema, or malodorous drainage. Pain in the perineal or pelvic area.

Advantages of breastfeeding

Fewer Infections Lower Risk of Diseases Fewer Allergies and Intolerances Convenience and Cost hormones help contract uterus

Harlequin sign

Harmless color change in a newborn in which the dependent side of the body is a deep color while the other side is pale.

Colostrum

a specialized form of milk that delivers essential nutrients and antibodies in a form that the newborn can digest

Tylenol #3

acetaminophen/codeine pain reliever narcotic S/E drowsey - dizzy - sedation - N - V - C - respiratory depression - urinary retention - allergic reaction - rash - urticaria for c-sections avoid overdosing mother

injuries to the cervix can have

adverse effects on future pregnancies, repair should be immediate

parent-child _______________ is the process by which parent and child come to love and accept each other

attachment

whether or not this is the couple's first

baby, parents appreciate anticipatory guidance in the care of their child

syndactyly

webbed fingers or toes

urinary changes post-partum

with adequate emptying of the bladder & bladder tone is usually restored 5-7 days after childbirth daily urine output up to 3L common

newborn's BP

(70-80)/(40-50) mm Hg

Ibuprofen (Advil, Motrin)

*class*: antipyretics, antirheumatics, nonopioid analgesics, nonsteroidal anti-inflammatory agents (NSAIDS) *Indication* Mild to moderate pain, inflammatory states *Action*: Decreases pain and inflammation by inhibiting prostaglandins *Nursing Considerations*: -may cause GI bleeding, hepatitis, Stevens-Johnson Syndrome - may cause anaphylaxis - monitor for headache, nausea, vomiting, constipation - therapy should be discontinued after first sign of rash - monitor renal and liver labs - patient should avoid using alcohol

blood loss during delivery

- 50% of RBC's made in pregnancy los in delivery -Average vag delivery loss 500-600 ml - C section 1000 ml - Cesarean hysterectomy much more! - POST PARTUM IS THE HIGHEST RISK OF DEVELOPING CLOT

Assessment of Attachment Behaviors

-Careful observation of specific behaviors (Formation of emotional bonds) -Skillful observation and intervening (Enhance parent-infant contact by increasing parent's awareness of infant responses) (Rooming-in: infant stays in the room with the mother)

after delivery the uterine fundus

-is about midway between the umbilicus and the symphysis pubis or slightly higher. -it weighs approx 2# during the first 12 hours after delivery it rises to the level of the umbilicus at midline -24-48 hours uterus begins gradual descent - within one week it is barely palpable and weighs 1# -within 6-8 weeks uterus is again a pelvic organ and 2oz and no longer palpable -called involution

the postpartum patient complains of a persistent headache. which action would the nurse perform first?

1, obtain an order for a mild analgesic, such as acetaminophen 2.reassure that pregnancy - induced headaches will abate 3. check the blood pressure and compare it to baseline measurements 4. check the record for history of epidural or spinal anesthesia

the nurse helps the breast feeding woman to change her newborn's diaper after the baby's first bowel movement. the mother expresses concern because of a large amount of sticky, dark green - almost black- stool. she asks the nurse if something is wrong. what information should be included in the nurse's response?

1, tell the woman not to worry because all breast fed babies have this type of stool 2. explain that this type of stool is called meconium and is expected for the first few bowel movements of all new borns 3. ask the woman what she ate at her last meal before giving birth 4. suggest that the mother ask her pediatrician to explain newborn stool patterns

the nurse is teaching the patient about the signs and symptoms that should be reported to the health care provider. the patient is instructed to notify the health care provider if, after 5days from delivery date, the patient experiences;

1. a temperature of 99F 2. lochia that is light pink-brown in color 3. breast tenderness and redness 4. a fundus that feels like a softball

which treatment related to bowel function would the nurse question for a woman with a fourth-degree laceration of the perineum?

1. administer stool softener for constipation as needed 2. assist with ambulation in hall 3-4 times/day 3. administer enema for constipation as needed 4. encourage fluid intake of at least 3 L/day

the mother report that the new infant is making a weak, high pitched crying sound. she has tried feeding, changing, rocking, and ignoring the baby, but the crying continues. what should the nurse do first?

1. assess the mother-child interaction to see if there are problems with bonding 2. try swaddling or bundling the baby to make him feel secure 3. ask the mother to hold the baby while vital signs are obtained 4. contact the health care provider, because the crying is excessive

when performing a postpartum assessment, what should the nurse so?

1. assist the patient into a lateral position with upper leg flexed forward to facilitate examination of her perineum 2. assist the patient into a supine position with her arms above her head and her legs extended for the examination of her abdomen 3. instruct the patient to avoid urinating just before the examination because a full bladder facilitates funda position 4. wash hands and put on sterile gloves before beginning

the nurse notes that the patient is profusely diaphoretic the first night after delivery. based on the nurses knowledge of what is expected for healthy mother in the immediate postpartum period, which action is the nurse mostly likely to take?

1. assist the patient to change clothes and explain that diaphoresis is normal 2. monitor the patient's temperature, because diaphoresis suggests a fever 3. check the patient's blood sugar to validate that the patient is not hypoglycemic 4. assist to sit upright to facilitate respiratory effort and oxygenation

when teaching parents how to bathe their baby, which point should the nurse stress???

1. avoid immersing the baby in water until after the umbilical cord has fallen off 2. use only mild medicated or scented soap 3. apply baby powder after the bath to keep the skin dry 4. apply baby oil after the bath to keep the skin soft and smooth

the home health nurse is assessing the mother's peripads 6 days after delivery. what is the expected findings?

1. bright red blood with tissue 2. thin pinkish/brown drainage 3. slightly yellow to white drainage 4. small clots with fleshy odor

the womans temperature is slightly elevated12 hours after delivery of the baby. what additional assessment would the nurse perform first?

1. check the appearance and odor of the lochia 2. assess skin turgor and condition of mucous membranes 3. palpate the fundus for height and firmness 4. check a urine specimen for foul odor and cloudiness

a baby boy is 1 hour old when admitted to the newborn nursery. he weighs 7 lb. 3oz.; is 21 in long; has irregular respiration's of 42 breaths/min with adequate chest movement, a heart rate of 145 bpm, and a temperature of 35.6 degrees Celsius, axillary; and is acrocyanotic. what is an appropriate goal for this baby within the next 2 hours, based in these findings?

1. color will remain unchanged 2. respirations will slow 3. temperature will stabilize at 36.5-37 degrees celsius 4. heart rate will decrease to 100 bpm

the patient received an epidural block. in the early recovery stage, what would be considered a normal finding?

1. decreased sensation in both legs 2. altered level of consciousness 3. elevated blood pressure compared to baseline 4. low-grade fever

the woman is interested in returning to her prepregnant weight as soon as possible. she has decided to breastfeed because 'it's better for the baby and it will also help me to lose weight". what information should the nurse give to the mother about nutrition and diet?

1. during breastfeeding, continue the diet recommended during pregnancy 2. for gradual weight loss, follow My Plate suggestions and drink 3L of fluid each day 3. eliminate approximately 300-500Kcal/day for 6-8 weeks for weight loss 4. breastfeeding does require extra calories, so weight loss is expected

when is infant abduction most likely to occur?

1. during visiting hours 2. in the middle of the night 3. during the discharge process 4. upon admission to the nursery

the nurse is explaining to a mother who had an episiotomy how to use peri bottle to clean herself after urination or a bowel movement. which information is correct?

1. first clean perineal area front to back with toilet tissue 2. use the whole peri bottle of water to cleans the perineum 3. fill peri bottles with sterile water warmed to approximately 98 F 4. flush the perineal area twice a day for 20 minutes

the nurse hears in report that a patient who had a cesarean section should receive liquids for the first day with a gradual reintroduction to a regular diet. how does the nurse know when to offer solid foods?

1. follow the protocol or clinical pathway for cesarean section patients 2. give solid food when the dietary kitchen includes it on the meal tray 3. call a health care provider and clarify specific parameters 4. assess the abdomen and auscultate for bowel sounds

the nurse notices that the grandmother seems to be dominating the care of her own daughter and the new infant to the point of excluding the new father. what should the nurse do?

1. gently suggest that the grandmother leave so that the new family can bond 2. refer the family to counseling so that parental roles can be clarified 3. assess the fathers feelings about his role and his knowledge of child care 4. wait til the grandmother leaves and then teach the father how to hold the baby

the nurse identifies that the mother requires additional teaching on the care of the infant's umbilicus if she;

1. gives a tub bath in the first 3 days after delivery 2. uses alcohol on ht stump daily 3. folds the diaper down from the umbilicus 4. reports a foul odor or redness from the stump

after delivery which patient has the greatest risk for life-threatening postpartum hemorrhage?

1. has a vaginal hematoma secondary to forceps-associated delivery 2. has a vulvar hematoma associated with vulvar varicosity 3. has vaginal hematoma related to primigravidity 4. has a retroperitoneal hematoma due to rupture of cesarean scar

the patient has opted to bottle-feed her newborn. the nurse is confident that the patient has understood discharge teaching related to breast engorgement when the patient states;

1. i will most likely not experience breast engorgement if i manually express the milk 2. if i experience engorgement i should use ice to try to get some relief 3. engorgement will most likely occur about 10 days from my delivery date 4. breast engorgement is unlikely since i a, not breastfeeding my baby

on examining a woman who gave birth 5 hours previously, the nurse finds that the woman has saturated a perineal pad within 15 minutes. what action is the nurse's first priority?

1. increase the drip rate of an IV infusion of Ringer lactate solution 2. assess the patient's vital signs 3. call the patients primary health care provider 4. palpate the woman's fundus

the nurse sees that the postpartum patient has an elevation in platelet count. based on this observation, which action will the nurse perform?

1. observe the patient for fatigue, particularly after exertion 2. monitor temperature and watch for signs of infection 3. encourage the patient to get out of bed and walk around 4. watch for signs and symptoms of hemorrhage

the unlicensed assistive personnel tells the nurse that there was a gush of brownish vaginal drainage when the patient got out of bed and stood up. what should the nurse do first?

1. inform the UAP that secretions pool in the supine position and slow is expected 2. ask the UAP to describe the amount and color of the drainage and the patient's response 3. check on the patient and assess for pain, dizziness, or continued vaginal flow 4. tell the patient that there is nothing to worry about and help her clean up

which nursing observation of the newborn's bowel function should be reported to the health care provider?

1. initial stool is black-green with sticky consistancy 2. stool contains strands of lanugo, mucus, and vernix 3. no stool has passed 24 hours after birth 4. newborn appears to be straining when passing stool

the nurse is trying to teach a 15yo mother how to swaddle the baby, but the young mother seems more interested in how her hair and makeup look. she states,"my boyfriend is coming in a little while." how should the nurse respond?

1. let's focus on the swaddling, then you can show him when he gets here 2. you look very pretty. he will be delighted to see you and the baby 3. don't you want to spend some time holding and snuggling your baby? 4. well, you finish with your makeup and i'll take the baby back to the nursery

the nurse finds bright red bleeding on a patient's peripad. the stain is about 6inches long. ehat is the correct description of the character and amount of lochia?

1. lochia rubra, moderate 2. lochia serosa, heavy 3. lochia rubra, heavy 4. lochia serosa, light

the nurse is performing a routine postpartum assessment. which action is indicated before the fundal height is measured?

1. massage the uterus 2. apply pressure to the fundus to check for clots 3. elevate the head of bed 4. ask the patient to empty her bladder

the nurse is discussing sexuality with the new mother. what information should the nurse provide

1. menses usually returns in 3-5 months 2. breastfeeding acts as an effective contraceptive 3. discomfort and bleeding are expected with sexual behavior 4. avoid sexual activity until after the first postpartum office visit

which assessment findings in a new infant should be reported to the health care provider for additional investigation?

1. molding 2. strabismus 3. low-set ears 4. nystagmus

newborns are not able to synthesize vitamin K in the colon until they have adequate intestinal flora. which action would the nurse take?

1. monitor prothrombin levels and observe for bleeding signs 2. administer an injection of vitamin K as ordered (AquaMEPHYTON) 3. administer an injection of Rh (D) immune globulin as ordered (RhoGAM) 4. monitor the color, frequency, and consistancy of bowel movements

the mother reports a mild cramping during the postpartum period. the nurse anticipates that the health care provider will write a PRN order for which medication?

1. morphine 2. acetaminophen 3. aspirin 4. codeine

what is the most important nursing action to perform before assisting the woman to stand up and ambulate for the first time after the delivery of her baby?

1. obtain a wheelchair and place it close to the bedside 2. assist the patient to slowly sit and dangle legs while seated 3. compare the blood pressure to baseline 4. assist the patient to apply a pair of slippers with a nonslip sole

the postpartum patient complains of persistent headaches. which action would a nurse perform first?

1. obtain an order for a mild analgesic, such as acetaminophen 2. reassure that pregnancy-induced headaches will abate 3. check the blood pressure and compare it to the baseline measurements 4. urinary incontinence and perineal lacerations

the newborn infant has a blood glucose level of 40mg/dL. the nurse prepares for which intervention?

1. oral feeding of sterile glucose water 2. helping the mother to start breastfeeding 3. oral feeding of 15-30mL of sterile water 4. administration of intravenous dextrose

Post partum danger signs for parent/newborn relationships

1. passive reaction, either verbal or non-verbal (parents do not touch or hold or examine their baby, or talk in affectionate terms or tones about baby) 2. hostile reaction, either verbal or non-verbal (parents make inappropriate verbalization, glances, physical charactistics) 3. disappointment over gender of baby 4. lack of eye contact 5. non-supportive interaction between parents (if interactions seems questionable, talk to a nurse and physician involved with delivery for further information

the nursse can help a father in his transition to parenthood with what action?

1. pointing out that the infant turned to his voice 2. encouraging him to go home to get some sleep 3. taping the baby's diaper a different way 4. suggesting that he let the baby sleep in the bassinet

the mother has lost a large volume of blood and appears to be in hypovolemic shock following the delivery. the nurse implements an appropriate action by:

1. raising the head of the bed to 80 degrees 2. discontinuing the oxytocic agent in the intravenous infusion 3. massage the fundus firmly and continuously 4. providing oxygen by facemask at 8-10L/min

care of the circumcision includes;

1. removing the yellow crusting right away 2. applying the diaper loosely 3. assessing for bleeding every hour for 4 hours 4. using petroleum gauze under the plastibell

a woman gave birth 48 hours ago to a healthy baby girl. she has decided to bottle feed. during the assessment the nurse notices that both breasts are swollen, warm, and tender on palpation. the patient should be advised that this best treated with which action?

1. running warm water over her breasts during a shower 2. applying ice to the beasts for comfort 3. expressing small amounts of milk from the breasts to relieve pressure 4. wearing a loose-fitting bra to prevent nipple irritation

a baby has a Gomco circumcision. what instruction should the nurse give his parents for care of the circumcised penis?

1. soak the penis in warm water daily 2. cover the glans with a petroleum gauze dressing 3. clean the glans with alcohol to promote healing 4. remove any yellowish exudate that forms within 24 hours

the mother reports to the nurse that the baby doesn't seem to be getting enough breast milk. what should the nurse do first?

1. suggest that the mother supplement with formula feedings 2. teach the mother how to manually pump the breasts 3. assess the axillary region for engorgement of milk supply 4. assess how the mother places the areola in the baby's mouth

a woman asks the nurse how she will know her baby is getting enough milk. the nurses response is based on understanding that which is the best determinant?

1. the baby awakens every 4-6 hours to eat 2. the baby stops nursing when full 3. the baby has 6-10 wet diapers per day 4. the baby cries when hungry

a first-time mother is to be discharged from the hospital tomorrow with her baby girl. which maternal behavior indicates a need for further intervention by the nurse before she can be discharged?

1. the mother leaves the baby on her bed while she takes a shower 2. the mother continues to hold and cuddle her baby after she has feed 3. the mother reads a magazine while her baby sleeps 4. the mother changes her baby's diaper then shows the nurse the contents of the diaper

in evaluating maternal adjustment, which behavior leads the nurse to believe that the patient is still in the taking-in phase?

1. the mother states she is starving and can't wait to eat 2. the majority of the mother's time is spent talking about her delivery experience 3. the mother takes a shower and washes her hair 4. the mother asks the nurse to teach her how to give her baby a bath

the nurse observes several interactions between a postpartum woman and her new son. which behavior if exhibited by this woman does the nurse identify as maladaptive regarding parent-infant attachment?

1. the mother talks and coos to her son 2. the mother seldom makes eye contact with her son 3. the mother cuddles her son close to her 4. the mother tells visitors how well her son is feeding

the nurse notes on assessing the newborn that there is a small tuft of hair at the base of the spine. what is the clinical significance of this finding?

1. this is lanugo that frequently covers the newborns body 2. this is part of the vernix caseosa that is usually left in place for 48 hours 3. different skin colorations and hair patterns are related to genetic factors 4. hair tufts indicate possible abnormalities of spinal column development

in teaching a new mother about breastfeeding the nurse informs her to;

1. use one breast for two consecutive feedings 2. have the baby nurse for 5 minutest each breast 3. put as much of the areolar tissue into the baby's mouth as possible 4. pull the breast straight away from the baby's mouth to break the suction seal

in the postartum period the patient has no urge to void but the nurse notes that the patients bladder is descended. what complications are most associated with bladder distention in postpartum patients?

1. uterine hemorrhage and urinary tract infections 2. rectocele and uterine prolapse 3. kidney dysfunction and painful sexual intercourde 4. urinary incontinence and perineal lacerations

an appropriate technique to teach the new mother about the baby's bath is;

1. vigorously removal of the vernix caseosa 2. use of plain water on the perineal area 3. washing the baby twice daily 4. having the bath water at 100 F

newborn's pulse

120-160 bpm

newborn's average head circumference

13-14 inches

Breast milk can be stored in refrigerator for

24-48 hours

newborn's respirations

30-60/min

the newborn infant weighs 6.6 pounds. how much fluid does this healthy baby need every day?

420-480mL

newborned and mothers health protection act of 1996 requires all health plans to allow the new mother and the newborn to remain in the hospital for a minimum of -__________________ hours after a normal vaginal birth and ___________hours after a ceaea

48 96

crytorchidism

A condition in which the testes fail to descend from the abdominal cavity to the scrotal sac.

latch on reflex

Attachment of the infant to the breast for feeding.

Simethicone (Mylicon)

Antiflatulent. S/E: None. NI: Instruct pt to chew the tablet thoroughly before swallowing; give after meals.

Perineal Lacerations

Are the most common of injuries in the lower genital tract. They usually occur when the fetal head is being born. The extent of the laceration is defined in terms of its depth. First degree, (skin & superficial muscles) Second degree, (through muscles) Third degree, (through sphincter muscle) Fourth degree. (involves anterior rectal wall)

fontanelles

Areas where the infant's skull has not fused together; usually disappear at approximately 18 months of age.

Witch Hazel (Tucks Pads, cream)

Astringent. S/E: Local irritation. NI: Instruct mother that it is external use only. Use for relief of perineal discomfort.

BUBBLE HE assessment

Breasts, Uterus, Bladder, Bowels, Lochia, Episiotomy, Homan's Sign, Emotional Status

Oxytocin (Pitocin)

Monitor for water intoxication (lightheaded, n/v, headache, malaise) which can lead to cerebral edema, seizures, coma, and death. Contraindicated based on late decelerations

to thaw frozen breast milk for use

NEVER microwave (HOT SPOTS) place under warm tap water should be used immediately and not refrozen

Oxytocin (Pitocin)

Oxytocic. Stimulates uterine contractions for the purpose of induction or augmentation of labor. Uses: antepartum for contraction stress test (CST), intrapartum for induction or augmentation of labor, postpartum to promote uterine involution. Precautions/interactions: contraindicated with placental insufficiency, bishop score of 6 and greater when planning induction. Side effects: intense uterine contractions, uterine hyperstimulation (contraction longer than 90 seconds), uterine rupture.

Lochia serosa

Pink, serous, and blood-tinged vaginal discharge that follows lochia rubra and lasts until the 7th to 10th day after birth.

Lochia rubra

Red, distinctly blood-tinged vaginal flow that follows birth and lasts 2 to 4 days

Rhogram

Rh incompatibility (necessary for Rh negative mothers who give birth to an Rh positive baby; prevents hemolytic disease of the newborn) given 72 hours after delivery only to mother in deltoid IM

involution

Shrinking of the uterus (womb) to its normal size after childbirth.

Engorgement

Swelling of the breasts resulting from increased blood flow, edema, and the presence of milk.

Acrocyanosis

Temporary cyanotic condition, usually in newborns resulting in a bluish color around the lips, hands and fingernails, feet and toenails. May last for a few hours and disappear with warming.

pseudomenstruation

Vaginal bleeding in the newborn, resulting from withdrawal of placental hormones.

vernix caseosa

Waxy or "cheesy" white substance found coating the skin of newborn humans

Lochia alba

Whitish/yellowish discharge - lasts 10-14 days, may last 3-6 weeks and remain normal.

in some cultures, including the Chinese, Mexican, Korean, and South East Asia there are certain postpartum rituals for mother and baby. these may include _______________________ , _________________________ , and ___________________ restrictions designed to restire the hot-cold _yinyang) balance

bathing activity dietary

cardiovascular changes in mother postpartum

blood volume is reduced to non-pregnancy levels 2-4 weeks after delivery

________________ refers to the process whereby an infant's behavior and characteristics call forth a corresponding set of maternal behaviors and characteristics.

bonding

postpartum fatigue and depression are

common as a result of hormonal and physiologic changes

cardiovascular changes in mother's body systems after delivery

decrease in cardiac output decrease in blood volume

integumentary changes that occur in the mother's body systems after delivery

decrease in hyperpigmentation increased elasticity

endocrine changes that occur in the mother's body systems after delivery

decreased estrogen decreased progesterone

postpartum fatigue and ____________ are common as a result of hormonal and physiologicchanges

depression

post partum depression

depression suffered by a mother following childbirth, typically arising from the combination of hormonal changes, psychological adjustment to motherhood, and fatigue.

the new mother should avoid

dieting and excessive activity during the early post-partum period

LACHIA

discharge of blood, mucus, and tissue from the uterus during the puerpal period

the tissue of light-skined women , especially those with reddish hair, is not as resily _____________ as that of darker-skinned women, and the healing may be less efficient

distensible

provide demonstration and teaching to

educate the mother about the newborn's hygiene needs

circumcision is an

elective surgical procedure

_______________ is a term applied to a parent's absorption, preoccupation, and interest in his or her infant; the term typically is used to describe the father's intense involvement with his newborn.

engagement

hormonal changes enable the woman to produce

enough milk to meet the nutritional needs of the growing infant, nutritional needs of the lactating woman are similar to those during pregnancy

Polydactyly

extra fingers or toes

Lanugo

fine, downy, unpigmented hair that appears on the fetus in the last 3 months of development

positions of baby for breastfeeding

football hold cradling lying down across the lap

breast milk may be frozen

for 2 weeks

relationship of newborn's head to chest circumference

head circumference is 1 inch larger than the chest

gastrointestinal changes that occur in the mother's body systems after delivery

hemorrhoids constipation

diuresis

increased formation and secretion of urine

urinary changes that occur in the mother's body systems after delivery

initial diuresis possible retention

the decrease in size of the uterus is called ___________

involution

parent-child attachment (bonding)

is the process by which parent and child come to love and accept each other

if breast milk will not be used within 48 hours

it should be frozen immediately after being expressed

motherhood is a

learned skill, the new mother needs extensive teaching and encouragement about parenting skills

motherhood is an _____________________ skill

learning

Dibucaine (Nupercainal)

local anesthetic, amide instruct mother that it is for external use only

newborns exhibit a wife range of

normal variation, verify any questionable observations with another nurse of physician

Homan's sign

pain in *calf upon dorsiflexion* of foot and may indicated thrombophlebitis

Haitian women may request to take the ___________ home to bury or burn

placenta

complications can occur during the

postpartum period, each woman must be assessed carefully

lactation

production of milk

diaphoresis

profuse sweating

in helpinf new families adjust to parenthood,

provide culturally sensitive care following principles that facilitate nursing practice within trans-cultural situations

the ____________lasts about 3-6 weeks, from the time the woman delivers the placenta until the reproductive organs return to the non-pregnant size and position.

puerperium

normal variations in the physical characteristics of the newborn that the parents should not be alarmed in seeing is/are;

select all that apply 1. acroyanosis in an infant that is 5 days old 2. the harlequin sign in a 2-day old infant 3. jaundice during the first 24 hours after delivery 4. epstein's pearls on the hard palate of a 2 week old infant 5. lacy mottling on pale skin immediately at birth

a primigravida has delivered a baby vaginally after 6 hours of labor. she had an uneventful pregnancy and is in food general health. she is transferred from the recovery room to the postpartum unit. what interventions are included in routine postpartum care?

select all that apply 1. assessment of intake and output until the patient is voiding in sufficient quantities 2. insertion of a catheter to assess residual urine after the initial voiding 3. firm massage of the fundus every 15 minutes 4. assessment of the emotional status of the new mother 5. checking of breasts for engorgement and cracking of nipples

when providing education to parents about the care of the umbillical cord, what information should be included?

select all that apply 1. clean the cord with an alcohol swab 2. keeping the diaper folded below the cord 3. applying triple dye to the cord 4. keeping the cord moist to promote healing 5. oiling the cord to facilitate it falling off

the nurse is teaching breast care for the lactating woman. what information should be included?

select all that apply 1. expose the nipple to air for 20 - 30 minutes daily 2. wear a supportive bra 24hours a day for the first few weeks 3. wash breasts and nipples with soap and water before each feeding 4. use plastic liners in bras 5. use ice packs every 4 hours as needed for discomfort associated with engorgement

the nurse is assessing the newborn infant who was just born at 30 weeks gestation. which findings would be considered normal?

select all that apply 1. vernix caseosa 2. lanugo 3. desquamation 4. good skin turgor 5. good tissue elasticity

Autolysis

self-destruction of cells; decomposition of all tissues by enzymes of their own formation without microbial assistance

the newborn has

social and physical needs

Prolactin

stimulates milk production

Circumcision

surgical removal of the foreskin

__________ is the phase of maternal postpartum adjustment characterized by a woman's need to review her labor and birth experiences with the nurse who cared for her while she was in labor. other behaviors exhibited include reliance on others to help her meet needs, excitement , and talkativeness.

taking-in

postpartum maternal teaching report to primary care giver

temp >100.4 F chills changes in lochia (foul odor - return to bright red - excessive amt) calf pain - tenderness - swelling evidence of mastitis (breast tenderness - cracking - redness - feeling of discomfort - uneasiness) urinary urgency - burning - frequency severe incapacitating depression

early discharge necessitates

that the nurse provide essential teaching in a brief period, be careful to document teaching

gynecomastia

the condition of excessive mammary development in the male infant due to residual maternal hormones

meconium

the greenish material that collects in the intestine of a fetus and forms the first stools of a newborn

supplement teaching with written materials so

the new mother has something to refer to when at home

conduct assessment of

the newborn in a head-to -toe format, thoroughly review each body system

before discharge, provide instruction concerning the danger signs of

the postpartum period and verify that the woman know when and how to contact her physician

in preparing the transfer report,

the recovery nurse uses information from the admission record, the birth record, and the recovery record

let-down reflex

the reflex that forces milk to the front of the breast when the infant begins to nurse

during the 6 weeks after delivery

the reproductive organs return to approximately the prepregnant size and location

puerperium

the time from the delivery of the placenta through approximately the first 6 weeks after the delivery

hypothermia and infection are

two major areas of concern in care of the newborn

infant abduction from hospitals in the

united states has been on the increase, parents and nurses must work together to ensure the safety of newborns in the hospital environment