OB - Test 5

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  1. Puerperium?
    1st 6 weeks after birth of an infant
  2. When should the uterus no longer be palpable after birth?
    10th day
  3. Where should uterus be within 24 hrs of birth?
    Umbilicus - should feel firm
  4. How many finger breaths per day should the uterus decrease after birth?
    1 finger breath per day
  5. Postpartum chill?
    Shaking from nervousness - give them a warm blanket
  6. What should you do if someones uterus isn't firm?
    Massage & should become firm
  7. What should you do if you have a boggy uterus?
    Notify MD - assess for clots & hemorrhage - Administer oxytocin
  8. Seperation of the longitudinal muscles of the abdomen during pregnancy
    Diastasis Recti
  9. Normal blood loss for vaginal birth?
    500 ml
  10. Normal blood loss of C-section?
    1000 ml
  11. What is a warning sign for lochia & bleeding?
    If lochia returns to previous state (Ex. Serosa to Rubra or Alba to Serosa)
  12. Rubra, Serosa or Alba?

    Red, day 1-3 blood
  13. Rubra, Serosa or Alba?

    Pinkish/Brownish, day 3-10, blood, mucus, leukocytes
  14. Serosa
    Pinkish or brownish, day 3-10 blood, mucus, leukocytes
  15. Rubra, Serosa or Alba?

    Whitish , day 10-14, largely mucus & leukocytes
  16. If lochia flow increases what should you do?
    Woman should rest more
  17. T/F: Constant trickling of blood or soaking pad every 60 min is more than normal.
  18. 1 gm = how many ml of blood?
    1 ml
  19. What is considered a moderate amount of Lochia?
    4-8 partially/saturated pads/day
  20. How long should you wait before inserting anything into the vagina after birth?
    6 weeks
  21. To inspect the perineum how should the patient lie?
    Sim's position - lift upper buttock and assess
  22. What stage of Lochia is sex considered to be ok?
  23. Reva Rubin:

    Mom wants to talk about her experience of labor & birth, preoccupied with her own needs
    Taking in
  24. Reva Rubin:

    More ready to resume control of her body, baby & taking on mothering role. Needs reassurance if inexperienced.
    Taking hold
  25. Reva Rubin:

    by 5th week, total abandon to NB - mother is worried aboutbaby rather than her own needs
  26. Reva Rubin:

    en face position, engrossement. Encourage through early interaction & breastfeeding
  27. Transient depression in first few days after having a baby?
    Postpartum Blues - weepiness, mood swings, anorexia, difficulty sleeping, feeling of letdown
  28. Depression persisting >2 weeks after having a baby?
    Postpartum Depression - sad feelings, hopeless, worthless, trouble sleeping, unable to concentrate
  29. Postpartum Psychosis?
    Woman may act on harming herself so be aware
  30. Treatment for Superficial Leg Vein Disease?
    • Local heat
    • Elevate limb
    • Bed rest
    • Analgesia
    • Elastic support hose
  31. S/S: tenderness in portion of vein, local heat & redness, normal temperature or low grade fever
    Superficial Leg Vein Disease
  32. S/S: edema of ankle, leg, initial low grade fever then high temp & chills, tenderness & pain, changes in limb color & difference
  33. Treatment of DVT?
    • IV heparin
    • Bed rest
    • Elevation of leg
    • Analgesics
    • warm moist heat
    • antibiotics
  34. When should you suspect infection of a postpartum woman?
    temp > 100.4

    Slight elevation is normal in first 24 hrs due to dehydration
  35. Postpartum - rapid of thready pulse could be a sign of what?
  36. Postpartum women may have orthostatic hypotension r/t blood loss so what should you do ?
    Assist to first trip to bath room

    Instruct pt. to dangle legs and sit first before rising
  37. Breast Assessment:
    • Soft: Day 1-2
    • Filling: Firmer & warmth - day 3
    • Engorged: Firmer, warm and have milk
  38. Mastitis?
    It's unilateral infection of the breast - one tit will be reddened and warm
  39. Breastfeeding or Non-breastfeeding?

    Warm compress & warm shower
  40. Breastfeeding or Non-breastfeeding?

    Cold compress, ice packs, snug bra
    Non-breast feeding
  41. Postpartum Breast care?
    • Wash daily - NO SOAP!
    • Wear 1-2 sizes larger bra with absorbant pads
    • Avoid underwires
  42. 5 signs of respiratory distress?
    • Tachypnea
    • Cyanosis
    • Nasal flaring
    • Expiratory grunting
    • Retractions
  43. Normal weight loss for a newborn?
    5-10% of origanal weight
  44. Normal Head & Chest circumference of a newborn?
    32 - 35 cm
  45. How is first temparature always taken?
  46. How much larger should the head be than the chest?
    2-3 inches
  47. Losing/gaining heat by air?
  48. Laying a baby onto a cold table and the baby loses heat is known what type of heat loss?
  49. Gaining heat by light?
  50. Losing heat after taking a bath is what type of heat loss?
  51. How should the baby sleep to decrease the chance for SIDS?
    Supine position
  52. When can you start adding cereal to an infants diet?
    4-6 months
  53. T/F: Infants should never sleep with parents
  54. How many hours/day will an infant sleep?
    16 out of 24
  55. What color stool will an infant have if they are recieving phototherapy?
    Light green
  56. Startle reflex?
  57. Toes fan reflex
    Babinski reflex
  58. Normal, immature circulatory system. Dependent side red, upper side pale.
    Harlequin sign
  59. Edema on scalp that CROSSES SUTURE LINE?
    Caput Succedaneum
  60. Blood between periosteum of skull bone and bone itself. DOES NOT CROSS SUTURE LINE.
  61. When does posterior fontanelle close on an infant?
    2 months
  62. When does anterior fontanelle close on an infant?
    12 - 18 months
  63. Normal APGAR at 1 minute?
  64. What does the APGAR measure?
    • HR
    • Respiratory effort
    • Muscle tone
    • Reflex irritability
    • Color

    (done at 1, 5 & 10 min)
  65. What type of blood is incompatible with A or B?
    Type O
  66. When is a Direct Combs test advised?
    mom Rh- or Type O
  67. When should you give a rhogam shot?
    if mother is Rh- & father is Rh+
  68. S/S of Endometritis?
    • foul smelling, bloody discharge
    • fever (day 3-4)
    • Uterine tenderness
    • tachycardia
    • chills
    • (elevated temp in 1st 24 hrs & WBCs are normal)
  69. if BS < 40 in an infant what should you do?

    (S/S: jittery, lethargy & seizures)
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OB - Test 5
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