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Postpartum

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juniperk's version from 2017-12-07 03:54

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Question Answer
Immediatly after delivery what position is the uterus? How far does it descend daily?Immediately after delivery, the uterus is midline between symphysis pubis and umbilicus. Descends 1cm/ day.
What color should the lochia be and when?1. Lochia rubra: blood-tinged discharge, including shreds of tissue and decidua; lochia rubra lasts 2 to 3 days postpartum. 2. Lochia serosa: pale pinkish to brownish discharge lasting 1 week postpartum 3. Lochia alba: thicker, whitish-yellowish discharge with leukocytes and degenerated cells; lochia alba lasts up to 4 weeks postpartum.
What are 8 reasons for slow uterine involution?1. incomplete expulsion of placenta or membranes 2. prolonged labor 3. complicated delivery 4. anesthesia- spinal epidural 5. grand multiparity 6. full bladder 7. infection 8. overdistended uterus - polyhydraminos, twins...
What will the chest XR show for a baby with Meconium aspiration syndrome?atelectasis, consolidation and hyperexpansion.
What are the 6 physical observations on a baby with MAS? What would the lungs sound like?1. barrel-shaped chest with an increased anterior-posterior (AP) chest diameter, 2. prolonged tachypnea, 3. progression from mild to severe respiratory distress, 4. intercostal retractions, 5. end-expiratory grunting, 6. cyanosis. Auscultate the lungs, noting coarse crackles and rhonchi.
What is the tx for MAS?Maintain O2, put on antibiotics, watch, wait, support
What type of shunting will a baby with PPHN have?right to left.
What are the 4 symptoms of PPHN?Observe for marked cyanosis, grunting, respiratory distress with tachypnea (within 12 hours), and retractions.
What is the tx for PPHN?Treat underlying cause, if possible. High freq ventilation. Administer surfactant.
What are 5 things to assess/Monitor with phototherapy?1. Protect genitalia and eyes. 2. Assess for hydration and electrolyte imbalance 3. Change position every 2 hours (Monitor for broken skin) 4. Assess for loose stool 5. Assess temp every 3-4 h
What is vertical infection?In utero by passage of organisms across the placenta or during labor and birth. Greater risk of long term consequences.
What is horizontal infection?After birth form the hosp staff members, contaminated equipment or family members.
What is the intervention for LGA babies from diabetic moms?Check temp, glucose. Assess for birth trauma and glucose immed p delivery and q 30 min until normal then before next feedings
What is the treatment for severely hypoglycemic babies?start IV D10 solution
What are 4 symptoms of hypoglycemia?jitters, tachypnea, low temp, and poor muscle tone
What are 10 behavior characteristics of babies with NAS? 1 CNS hypersensitivity, 2 autonomic dysfunction, 3 respiratory distress 4 temperature instability, 5 hypoglycemia, 6 tremors 7. seizures 8. abnormal cry patterns- shrill high pitch cry 9 feeding difficulties, 10 gastrointestinal disturbances
What are the WITHDRAWAL symptoms of babies with NAS?W = Wakefulness: sleep duration less than 3 hours after feeding I = Irritability T = Temperature variation, tachycardia, tremors H = Hyperactivity, high-pitched persistent cry, hyperreflexia, hypertonus D = Diarrhea, diaphoresis, disorganized suck R = Respiratory distress, rub marks, rhinorrhea A = Apneic attacks, autonomic dysfunction W = Weight loss or failure to gain weight A = Alkalosis (respiratory) L = Lacrimation
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