Nursing – Flashcard

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question
what does it mean when a fundus is boggy?
answer
Fundus is boggy when it is not firm, may indicate hemorrhage. Indicative of uterine atony (loss of uterine musculature), if not corrected, results in PP hemorrhage. Massage the boggy fundus to stimulate it to become firm again, or give patient Pitocin, or have the patient breastfeed.
question
What're you going to do for hemorrhoids?
answer
Lay on her side. Tighten buttocks when sitting down to reduce contact of the perineum with the seat and avoid prolonged sitting. Maintain high-fiber diet, high fluids. Begin moderate exercise such as walking.
question
How much weight do you expect to lose right after delivery?
answer
10-12 lbs initially- infant, placenta, fluid additional 5 lbs d/t PP diuresis.
question
How do you assess the healing of a placental site? what're you looking for? how can you tell as a nurse if the placental site is healing?
answer
Placental site takes up to 6-7 weeks to completely heal. Heals by a process of exfoliation. Evaluate lochia- type, amount, and consistency- lochia rubra (2-3 days PP) Lochia serosa (3-10 days PP) Lochia alba (1-2 weeks PP) Trend toward a lighter color and bleeding gets lighter
question
What is a Homan's sign?
answer
An indication of incipient or established thrombosis in the leg veins in which slight pain occurs at the back of the knee or calf when, with the knee bent, the ankle is slowly and gently dorsiflexed
question
What does it mean if a fundus is not at midline? know what that is/ what would you do?
answer
Means the patient has a full bladder characteristics: bulging of the lower abdomen, spongy feeling mass between the fundus and pubis, displaced uterus from the midline, usually to the right, increased lochia flow Full bladders may actually cause PP hemorrhage because it prevents the uterus from contracting appropriately Have the patient void
question
What would it mean if there's a steady trickle of blood?
answer
Could mean there's lacerations that still need sutures.
question
Know about rubella vaccines
answer
should receive rubella vaccine early PP, administer right after childbirth.
question
What is RhoGAM?
answer
Vaccine to prevent Rh negative mothers from forming antibodies against their Rh positive babies. All Rh negative mothers with Rh positive babies need to get RhoGAM prior to discharge.
question
Interventions for breastfeeding mothers?
answer
Feeding requirement: 140-160 ml/kg/day Caloric requirement: 100-115 kcal/kg/day Observation of breastfeeding technique weight check maternal assessment infant assessment infant feeding history provide breast pump instructions- collection and storage
question
engorgement, what do you do for that? what do you do if there's redness?
answer
Engorgement is when the breast is not being emptied enough d/t baby not nursing rigorously enough, separation from baby, not nursing enough. Milk builds up and swelling occurs- breasts become hard, skin is taut and shiny- extremely tender and painful, may fun a low-grade fever and become achy. Alveoli can become atrophied and may decrease milk production. Milk ducts can swell shut- leading to mastitis and plugged duct. Apply moist heat, cold compress, wear a supportive bra , may need antibiotics.
question
Contraception for breastfeeding moms/ what would you tell them?
answer
pregnancy can occur before the first menstruation period. Progestin-only hormonal contraceptives are a good idea. No estrogen+ progestin b/c it will decrease milk production. Birth control, implants, and shot of progestin.
question
Normal vitas for newborn?
answer
Resp rate: 30-60 HR: 120-160 Systolic: 70-100 Diastolic: 50-65 Weight in lbs: 4.5-7 Temp: 97.7-98.9
question
Heat loss- what's the most common form of heat loss in babies, how do you avoid it, what're you going to do to prevent it?
answer
radiation: body heat transferred to cooler surfaces- walls of a room, walls of an incubator. Convection: warm body surface to cooler air currents- air conditioned room, unwarmed O2 by mask, removal of infant from a incubator for procedures. Evaporation: loss of heat when water converted to vapor- baths. Conduction: loss of heat to a cooler surface by direct skin contact- chilled hands, cool scales, cold exam tables.
question
hyperbilirubinemia- what is it? what's bilirubin?
answer
accelerated destruction of fetal RBCs. impaired conjugation of bilirubin. increased bili reabsorption from intestines. Bilirubin aids in digestion of fats, green- processed and removed by liver. jaundice will develop when a baby's liver is not efficient enough to remove the bili from the bloodstream- once baby begins to mature and RBCs diminish, jaundice will subside- usually 1-2 weeks after birth
question
know about patient teaching for jaundice? what does it mean?
answer
daylight assists in early recognition- press on abd/ forehead/ nose- check icterus. Nursing care: hydration/ promote feedings/ phototherapy/ possible supplement with formula if BF/ parental support- they'll be upset. six factors: increased amounts of bili delivered to liver, defective uptake of bili from plasma, defective conjugation of the bili, defect in bili excretion, inadequate hepatic circulation, increased reabsorption of bili from intestines.
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