Nursing Bullets: Maternal and Child Health Nursing V
Nursing Bullets: Maternal and Child Health Nursing V
- If a pregnant patient’s test results are negative for glucose but positive for acetone, the nurse should assess the patient’s diet for inadequate caloric intake.
- If a pregnant patient’s test results are negative for glucose but positive for acetone, the nurse should assess the patient’s diet for inadequate caloric intake.
- Rubella infection in a pregnant patient, especially during the first trimester, can lead to spontaneous abortion or stillbirth as well as fetal cardiac and other birth defects.
- A pregnant patient should take an iron supplement to help prevent anemia.
- Direct antiglobulin (direct Coombs’) test is used to detect maternal antibodies attached to red blood cells in the neonate.
- Nausea and vomiting during the first trimester of pregnancy are caused by rising levels of the hormone human chorionic gonadotropin.
- Before discharging a patient who has had an abortion, the nurse should instruct her to report bright red clots, bleeding that lasts longer than 7 days, or signs of infection, such as a temperature of greater than 100° F (37.8° C), foul-smelling vaginal discharge, severe uterine cramping, nausea, or vomiting.
- When informed that a patient’s amniotic membrane has broken, the nurse should check fetal heart tones and then maternal vital signs.
- The duration of pregnancy averages 280 days, 40 weeks, 9 calendar months, or 10 lunar months.
- The initial weight loss for a healthy neonate is 5% to 10% of birth weight.
- The normal hemoglobin value in neonates is 17 to 20 g/dl.
- Crowning is the appearance of the fetus’s head when its largest diameter is encircled by the vulvovaginal ring.
- A multipara is a woman who has had two or more pregnancies that progressed to viability, regardless of whether the offspring were alive at birth.
- In a pregnant patient, preeclampsia may progress to eclampsia, which is characterized by seizures and may lead to coma.
- The Apgar score is used to assess the neonate’s vital functions. It’s obtained at 1 minute and 5 minutes after delivery. The score is based on respiratory effort, heart rate, muscle tone, reflex irritability, and color.
- Because of the anti-insulin effects of placental hormones, insulin requirements increase during the third trimester.
- Gestational age can be estimated by ultrasound measurement of maternal abdominal circumference, fetal femur length, and fetal head size. These measurements are most accurate between 12 and 18 weeks’ gestation.
- Skeletal system abnormalities and ventricular septal defects are the most common disorders of infants who are born to diabetic women. The incidence of congenital malformation is three times higher in these infants than in those born to nondiabetic women.
- Skeletal system abnormalities and ventricular septal defects are the most common disorders of infants who are born to diabetic women. The incidence of congenital malformation is three times higher in these infants than in those born to nondiabetic women.
- The patient with preeclampsia usually has puffiness around the eyes or edema in the hands (for example, “I can’t put my wedding ring on.”).
- Kegel exercises require contraction and relaxation of the perineal muscles. These exercises help strengthen pelvic muscles and improve urine control in postpartum patients.
- Symptoms of postpartum depression range from mild postpartum blues to intense, suicidal, depressive psychosis.
- The preterm neonate may require gavage feedings because of a weak sucking reflex, uncoordinated sucking, or respiratory distress.
- Acrocyanosis (blueness and coolness of the arms and legs) is normal in neonates because of their immature peripheral circulatory system.
- To prevent ophthalmia neonatorum (a severe eye infection caused by maternal gonorrhea), the nurse may administer one of three drugs, as prescribed, in the neonate’s eyes: tetracycline, silver nitrate, or erythromycin.
Neonatal testing for phenylketonuria is mandatory in most states.
- The nurse should place the neonate in a 30-degree Trendelenburg position to facilitate mucus drainage.
- The nurse may suction the neonate’s nose and mouth as needed with a bulb syringe or suction trap.
- To prevent heat loss, the nurse should place the neonate under a radiant warmer during suctioning and initial delivery-room care, and then wrap the neonate in a warmed blanket for transport to the nursery.
- The umbilical cord normally has two arteries and one vein.
- When providing care, the nurse should expose only one part of an infant’s body at a time.
- Lightening is settling of the fetal head into the brim of the pelvis.
- If the neonate is stable, the mother should be allowed to breast-feed within the neonate’s first hour of life.
- The nurse should check the neonate’s temperature every 1 to 2 hours until it’s maintained within normal limits.
At birth, a neonate normally weighs 5 to 9 lb (2 to 4 kg), measures 18″ to 22″ (45.5 to 56 cm) in length, has a head circumference of 13½” to 14″ (34 to 35.5 cm), and has a chest circumference that’s 1″ (2.5 cm) less than the head circumference.
- In the neonate, temperature normally ranges from 98° to 99° F (36.7° to 37.2° C), apical pulse rate averages 120 to 160 beats/minute, and respirations are 40 to 60 breaths/minute.
- The diamond-shaped anterior fontanel usually closes between ages 12 and 18 months. The triangular posterior fontanel usually closes by age 2 months.
- In the neonate, a straight spine is normal. A tuft of hair over the spine is an abnormal finding.
- Prostaglandin gel may be applied to the vagina or cervix to ripen an unfavorable cervix before labor induction with oxytocin (Pitocin).
- Supernumerary nipples are occasionally seen on neonates. They usually appear along a line that runs from each axilla, through the normal nipple area, and to the groin.
- Meconium is a material that collects in the fetus’s intestines and forms the neonate’s first feces, which are black and tarry.
- The presence of meconium in the amniotic fluid during labor indicates possible fetal distress and the need to evaluate the neonate for meconium aspiration.
- To assess a neonate’s rooting reflex, the nurse touches a finger to the cheek or the corner of the mouth. Normally, the neonate turns his head toward the stimulus, opens his mouth, and searches for the stimulus.
- Harlequin sign is present when a neonate who is lying on his side appears red on the dependent side and pale on the upper side.
- Mongolian spots can range from brown to blue. Their color depends on how close melanocytes are to the surface of the skin. They most commonly appear as patches across the sacrum, buttocks, and legs.
- Mongolian spots are common in non-white infants and usually disappear by age 2 to 3 years.
- Vernix caseosa is a cheeselike substance that covers and protects the fetus’s skin in utero. It may be rubbed into the neonate’s skin or washed away in one or two baths.
- Caput succedaneum is edema that develops in and under the fetal scalp during labor and delivery. It resolves spontaneously and presents no danger to the neonate. The edema doesn’t cross the suture line.
- Nevus flammeus, or port-wine stain, is a diffuse pink to dark bluish red lesion on a neonate’s face or neck.
- The Guthrie test (a screening test for phenylketonuria) is most reliable if it’s done between the second and sixth days after birth and is performed after the neonate has ingested protein.
- To assess coordination of sucking and swallowing, the nurse should observe the neonate’s first breast-feeding or sterile water bottle-feeding.
- To establish a milk supply pattern, the mother should breast-feed her infant at least every 4 hours. During the first month, she should breast-feed 8 to 12 times daily (demand feeding).
