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Newborn Care and Postpartum Management, Exams of Nursing

Harvard UniversityNursing

A wide range of topics related to newborn care and postpartum management, including apgar score assessment, common newborn medications, priority interventions for immediate newborn care, normal newborn assessments and vital signs, umbilical cord care, newborn reflexes, effects of vacuum-assisted delivery, gestational age assessment, signs and symptoms of postpartum complications (mastitis, deep vein thrombosis, postpartum hemorrhage, endometritis), and patient education on various topics like exercise for diabetic mothers, natural family planning methods, and breastfeeding management. Detailed and comprehensive information that could be useful for healthcare professionals, particularly nurses and midwives, in their practice of caring for newborns and postpartum mothers.

Typology: Exams

2023/2024

Available from 08/26/2024

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Exam 2 NR 327 Complete Course Final
Questions and Correct solutions
Know how to determine the newborn APGAR score based on the assessment
information provided. (review table 15.4 on page 425 of your required textbook) -
CORRECT ANSWER-0
A (Activity) limp
P (pulse) absent
G (Grimace/Reflex) no response
A (apperance/color) pallor or cyanosis
R (Respiration) . No spontaneous
Apgar score 2 reveals - CORRECT ANSWER--Greater than 100 hr
-spontaneous lust, strong cry
-Flexed body posture
-responds promptly
-pink (white)
-cyanosis (black)
-pink mucous membranes.
Common medication administered to newborns at delivery and how to administer them -
CORRECT ANSWER-1) Vitamin K Phytonadione- intramuscular- vastus lateralis
muscle.
2) Erythromycin Ophthalmic Ointment- From inner to outer canthus
3)Hepatitis B immunization- the schedule is at birth, 1 month, and 6 months. different
site than vit k.
What is the treatment for newborn born to mother who is Hep B positive - CORRECT
ANSWER-hepatitis B immunoglobulin and the hepatitis B vaccine is given within 12 hr
of birth. (dif sites)
Know priority interventions for immediate newborn care - CORRECT ANSWER-1)
Stabilize infant. cough reflex, then suction mouth then nose.
2) 2 identification
3) warm infant
Know normal newborn assessments (review table 20.2 on pages 555-559 of your
required textbook) - CORRECT ANSWER-Vitals
length (19-21 inches)
Head circumference (13-15 in)
chest (12-14in) 2 less than head
APGAR
3 vessels in cord
pf3
pf4
pf5
pf8

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Download Newborn Care and Postpartum Management and more Exams Nursing in PDF only on Docsity!

Exam 2 NR 327 Complete Course Final

Questions and Correct solutions

Know how to determine the newborn APGAR score based on the assessment information provided. (review table 15.4 on page 425 of your required textbook) - CORRECT ANSWER- 0 A (Activity) limp P (pulse) absent G (Grimace/Reflex) no response A (apperance/color) pallor or cyanosis R (Respiration). No spontaneous Apgar score 2 reveals - CORRECT ANSWER--Greater than 100 hr

  • spontaneous lust, strong cry
  • Flexed body posture
  • responds promptly
  • pink (white)
  • cyanosis (black)
  • pink mucous membranes. Common medication administered to newborns at delivery and how to administer them - CORRECT ANSWER-1) Vitamin K Phytonadione- intramuscular- vastus lateralis muscle.
  1. Erythromycin Ophthalmic Ointment- From inner to outer canthus 3)Hepatitis B immunization- the schedule is at birth, 1 month, and 6 months. different site than vit k. What is the treatment for newborn born to mother who is Hep B positive - CORRECT ANSWER-hepatitis B immunoglobulin and the hepatitis B vaccine is given within 12 hr of birth. (dif sites) Know priority interventions for immediate newborn care - CORRECT ANSWER-1) Stabilize infant. cough reflex, then suction mouth then nose.
  2. 2 identification
  3. warm infant Know normal newborn assessments (review table 20.2 on pages 555-559 of your required textbook) - CORRECT ANSWER-Vitals length (19-21 inches) Head circumference (13-15 in) chest (12-14in) 2 less than head APGAR 3 vessels in cord

Know normal newborn vital signs range - CORRECT ANSWER-Temp: 97.7-99.5 F HR: 120- 160 RR: 30- 60 BP- 65/ Know care of the newborn umbilical cord stump and parent teaching - CORRECT ANSWER-Make sure it is clamped. 24-48 hours- comes off when they go home. Use only water look for erythema, edema, and drainage with each diaper change. cord falls off 10-14 days Keep diaper folded down. do not submerge in water. Know normal versus abnormal healing of the circumcised penis - CORRECT ANSWER- Normal

  • Yellowish scab or crust
  • should be healed within 10 days Abnormal
  • fever, drainage, pus, bad smell. Know the requirements of the newborn car seat - CORRECT ANSWER-rear-facing car seat in the back seat, preferably in the middle (away from air bags and side impact), to transport the newborn. Keep infants in rear-facing car seats until age 2 Know how to perform the different newborn measurements (see page 543 in required textbook) - CORRECT ANSWER-Head- measure around the fullest part of the head. Place around occiput and just above the eyebrows. Chest-Put tape at the level of the nipples. Length- from top of the head to the heel.- put one hand on babys head and stretch out legs. Know different methods of newborn heat loss and how to prevent them (review pages 520 - 523 of your required textbook) - CORRECT ANSWER-Radiation- Transfer of heat to cooler object like keeping baby by the window. Evaporation- Air drying of the skin that results in cooling. Dry infant from head to toe as quickly as possible. Conduction- Direct contact with something cold. Use skin to skin. Convection- Drafts, air, open doors. Know how to elicit newborn reflexes and the importance of them - CORRECT ANSWER-โ— sucking and rooting: turns head to side that is touched and begins to suck when cheek or edge of mouth is stroked. โ— Palmar grasp: Grasps object when placed in palm. โ— Plantar grasp: toes curl downward when sole of the foot is touched. โ— moro reflex: Arms and legs symmetrically extend and then abduct

Education to reduce perineal infection for a vaginal delivery - CORRECT ANSWER- Cleanse the perineal area from front to back with warm water after each voiding and bowel movement. โ— Blot perineal area from front to back. โ— Remove and apply perineal pads from front to back Know s/s of mastitis - CORRECT ANSWER--Initial symptoms may be flulike with fatigue and aching muscles.

  • fever 102.
  • chills, malaise, headache
  • redness, heat
  • a sore nipple that has cracks and fissures fissure or crack in the nipple and progresses to chills and fever, plus localized pain, swelling, and redness. S/S of DVT, prevention, and non-pharmacological treatment - CORRECT ANSWER-s/s: Leg pain and swelling, Unilateral area of swelling, warmth, and redness โ— Hardened vein over the thrombosis โ— Calf tenderness Prevention- fluids, evevate legs, walk treatment: Bed rest is prescribed for the woman with deep vein thrombosis to decrease swelling and to promote venous return from the leg. What are the signs and symptoms pf placenta previa? Placenta abruption? What are the key differentiating signs and symptoms? Nursing care and considerations - CORRECT ANSWER-PLACENTA PREVIA: Painless vaginal bleeding Assess for bleeding, leakage, or contractions. โ— Assess fundal height. โ— Perform Leopold maneuvers (fetal position and presentation). โ— Refrain from performing vaginal exams (can exacerbate bleeding). โ— Administer IV fluids, blood products, and medications as prescribed. Corticosteroids, such as betamethasone, promote fetal lung maturation if early delivery is anticipated (cesarean birth). โ— Have oxygen equipment available in case of fetal distress. ABRUPTIO PLACENTAE: Vaginal bleeding, sharp abdominal pain, and tender rigid uterus Palpate the uterus for tenderness and tone. โ— Assess FHR pattern. โ— Immediate birth is the management โ—ฏ Administer IV fluids, blood products, and medications as prescribed. โ—ฏ Administer oxygen 8 to 10 L/min via face mask.

โ—ฏ Monitor maternal vital signs, observing for declining hemodynamic status. โ—ฏ Continuous fetal monitoring โ—ฏ Assess urinary output and monitor fluid balance. Know how to recognize normal versus abnormal postpartum assessments - CORRECT ANSWER-Normal: Fever of 100.4 only for 24 hours. A sustained rapid pulse can indicate hemorrhage. Know the expected levels of fundal assessment at different time periods; 12 hrs, 24 hrs, etc - CORRECT ANSWER-At 12 hours after delivery, the fundus is typically 1 cm above the umbilicus About a week after delivery, the fundus should be halfway between the umbilicus and the symphysis pubis. Every 24 hr, the fundus should descend approximately 1 to 2 cm. It should be halfway between the symphysis pubis and the umbilicus by the sixth postpartum day. โ— After 2 weeks, the uterus should lie within the true pelvis and should not be palpable. Know signs and symptoms of hydatidiform mole (gestational trophoblastic disease) - CORRECT ANSWER-dark brown vaginal bleeding in the second trimester that is not accompanied by abdominal pain. increased fundal height that is inconsistent with the week of gestation, and excessive nausea and vomiting due to elevated hcg levels. Know S/S of preeclampsia - CORRECT ANSWER-Occurring after 20 wk of pregnancy BP โ‰ฅ140 mm Hg systolic or โ‰ฅ90 mm Hg diastolic or higher Proteinuria 0.3 g protein or higher in a 24-hour urine specimen or โ‰ฅ +1 per dipstick or P/C ratio โ‰ฅ0.3 mg/dL . Know the s/s of magnesium toxicity, treatment, and priority nursing assessment - CORRECT ANSWER-s/s: Respiratory depression, with a rate of fewer than 12 breaths per minute

  • Chest pain
  • Decreasing maternal pulse oximeter values:
  • Less than 95% during pregnancy
  • Less than 92% during postpartum phase
  • Absence of DTRs
  • Blurred vision
  • Altered sensorium (confused, lethargic, slurred speech, drowsy, disoriented)
  • Oliguria
  • Hypotension
  • Serum magnesium value greater than 8 mg/dL
  • Respiratory/cardiac arrest 3.5- 7 Treatment:

โ—ฏ Large for gestational age newborn โ—ฏ Malpresentation โ—ฏ Cephalopelvic disproportion โ—ฏ Previous classical vertical uterine incision Know patient teaching instructions for natural family planning methods - CORRECT ANSWER-Calandar: Accurately record the number of days in each cycle counting from the first day of menses for a period of at least six cycles. โ— The start of the fertile period is figured by subtracting 18 days from the number of days in the woman's shortest cycle. โ— The end of the fertile period is established by subtracting 11 days from the number of days of the longest cycle. Diaphram: change every 2 years or 20% weight gain or loss. 6 hr b4 and after sex. wash with soap and water after. empty bladder b4 insertion. Know s/s of ectopic pregnancy and signs of rupture - CORRECT ANSWER-abrupt unilateral lower-quadrant abdominal pain with or without vaginal bleeding Know treatment for chlamydia - CORRECT ANSWER-Azithromycin or amoxicillin Know treatment for managing engorgement a breastfeeding mother - CORRECT ANSWER-Cold compress after feeding. Warm shower before: Completely empty breast at each feeding. nurse on demand. let feed 8-12 times in 24 hour period. Know phase of maternal postpartum adjustment expected findings - CORRECT ANSWER-Dependent: Taking in phase- 24 - 48 hr- all about mom and birth experience. Dependent-independent- taking hold phase: 2-3 days after focus on baby interdependent- letting go phase: focus on family as a unit Know s/s of DIC - CORRECT ANSWER-DIC allows excess bleeding to occur from any vulnerable area such as IV sites, incisions, gums, or the nose and from expected sites such as the site of placental attachment during the postpartum period. Know patient education for diabetic regarding exercise - CORRECT ANSWER-They should Know s/s of endometritis - CORRECT ANSWER-a tender uterus and foul-smelling lochia.

Continued flow of lochia serosa or alba beyond the normal length of time can indicate endometritis, especially if it is accompanied by fever, pain, or abdominal tenderness Pelvic pain โ— Chills โ— Fatigue โ— Loss of appetite Know non-pharmacological care of sore nipples - CORRECT ANSWER-Apply breast milk and air dry. after breast feeding. Use various positions Fundus becomes soft and uncontracted when massage is stopped. What to do... - CORRECT ANSWER-Still support lower uterine segment. Massage fundus until firm; then apply pressure to express clots. Notify health care provider, and begin oxytocin or other drug administration, as prescribed, to maintain a firm fundus. Fundus is above umbilicus and/or displaced from midline. What to do... - CORRECT ANSWER-Assess bladder elimination. Assist mother in urinating, or catheterize, if necessary, to empty bladder. Recheck the position and consistency of fundus after bladder is empty.