OB test 3

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mel26704
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236518
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OB test 3
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2013-09-23 21:24:57
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OB test 3
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  1. Blue coloring of the hands and feet:
    acrocyanosis
  2. __________ is present for several __________ until the pulmonary changes have stabilized and oxygenated blood has reached the hands and feet.
    • acrocyanosis
    • hours
  3. Cyanosis around the lips or face is NOT normal and is a sign of:
    respiratory distress
  4. Caput succedaneum is __________ of the newborn's scalp that is present at __________ that disappears __ to __ days.
    It does not need __________.
    • edema
    • birth
    • 2-3 days
    • tx
  5. Caput succedaneum may cross __________ lines and is caused by:
    • suture lines
    • caused by head compression against the cervix
  6. Cephalohematoma is a collection of blood between the __________ and the __________.
    periosteum and the skull
  7. Cephalohematoma appears several __________ to a day after birth.
    hours
  8. What is caused by a rupturing of the periosteal bridging veins because of the friction and pressure during L&D?
    cephalohematoma
  9. A cephalohematoma is largest on the __ day and reabsorbs in __ to __ weeks.
    • 2nd day
    • 3-6 weeks
  10. The surgical removal of the foreskin that covers the glans penis:
    circumcision
  11. Circumcision is considered an __________ procedure and parents must give written consent.
    elective
  12. Reasons for and against circumcision:
    • For:
    • religious reasons
    • prevent the need for procedure later in life
    • may reduce UTI, penile cancer, and STD's
    • Against:
    • painful procedure
    • possibility of hemorrhage
    • infection
    • adhesions
  13. What is the procedure for circumcision?
    • infant is placed on circumcision board
    • pain relief
    • physician makes a slit in the foreskin and either uses Gomco clamp or Plastibell to control bleeding of foreskin as it is cut off
    • Vaseline gauze is placed on penis to prevent the diaper from sticking to the site
    • New ointment is applied at each diaper change for at least 24-48 hrs
  14. What are the nursing responsibilities during a circumcision?
    • set up equipment/supplies
    • secures infant
    • keep bulb syringe close by
    • comfort baby
    • keep infant warm
    • afterwards, check hourly for 12 hrs for bleeding and to assure infant is voiding
    • ensure the parents know how to care for the circumcision
  15. Most infants are not fed __ to __ hrs before circumcision to prevent __________.
    • 2-4
    • regurgitation
  16. What causes cold stress?
    decreased oxygen --> metabolic rate can't increase --> results in not maintaining temp
  17. Four ways to lose heat:
    • conduction
    • convection
    • evaporation
    • radiation
  18. The loss of heat by direct contact with a cooler object is:

    Examples:
    • conduction
    • cold hands, cold stethoscope, cold scale
  19. The loss of heat by movement of air:

    Examples:
    • convection
    • air current from open doors, air conditioning, people moving around
  20. The loss of heat when water is changed to vapor:

    Examples:
    • evaporation
    • when wet body dries, during a bath or wet from amniotic fluid or from we diapers
  21. The loss of heat by transfer to cooler objects nearby, but not enough for direct contact:

    Examples:
    • radiation
    • infant near a cold window, cold walls of an incubator
  22. __________ is placement of the urinary meatus on the underside of the penis.
    hypospadias
  23. __________ is placement of the urinary meatus on top of the penis.
    epispadias
  24. Small whitish-yellow epithelial cysts are called:
    Epstein's pearls
  25. Epstein's pearls are found on the __________, disappear in a few __________, and may be confused with thrush.
    • hard palate
    • few weeks
  26. What happens if an infants temp is not raised by non-shivering thermogenesis?
    metabolism of brown fat begins
  27. Brown fat is only found in __________.
    newborns
  28. Brown fat appears at about __ to __ weeks of gestation and increases until about __ to __ weeks of age (unless depleted by cold stress).
    • 26-36
    • 2-3
  29. Where is brown fat located?
    • back of neck
    • between scapula
    • around kidneys
    • axilla
    • around heart and abdominal aorta
  30. What happens once all an infants brown fat is metabolized?
    they do not have a method of heat production
  31. Eye infection that occurs at birth or during the first month:
    opthalmia neonatum
  32. What is the most common cause of opthalmia neonatum?
    gonorrhea or chlamydia
  33. If left untreated, opthalmia neonatum can result in:
    severe vision impairment
  34. __________ ointment is a prophylactic that is instilled into each eye soon after birth.
    erythromycin
  35. Management of opthalmia neonatum depends on the __________ organism, but __________ and __________ are commonly used.
    • causative
    • Rocephin and Penicillin
  36. Blood tinged mucous discharge from the vagina of an infant:

    Caused by:
    • pseudomenstruation
    • withdrawal of maternal hormones
  37. A white, creamy substance called __________ may cover the skin, but usually disappears by term.  It may remain found in __________.
    • vernix
    • creases
  38. An infant's nipples may secrete a whitish fluid called:
    witch's milk
  39. What is the first priority of infant care after delivery?
    ABCs!
  40. The first and most important care given is to clear the __________ and then the __________ of the mucous and amniotic fluid to open the airway.
    • mouth
    • nose
  41. __________ scoring assesses the infant's cardiopulmonary adaptations to extrauterine life. The scale is from 0-10, worst to best.
    Apgar
  42. APGAR stands for:
    • appearance
    • pulse
    • grimace
    • activity
    • respirations
  43. Apgar scoring should be performed on every baby at __ min and at __ min.  If the scores are low, do them again at __ min and __ min.
    • 1 and 5
    • 10 and 15
  44. High levels of bilirubin in the blood causes __________ and is caused by an increase in the destruction of RBCs.  Tx is __________, the babies are placed under the bili lights or bili blankets (breaks down bilirubin).
    • jaundice
    • phototherapy
  45. Fine, downy hair, __________, is most abundant between __ to __ weeks gestation and disappears as the gestational age increases.
    lanugo
  46. The earliest stools of an infant is called:
    meconium
  47. White, pinhead-sized, distended sebaceous glands on the cheeks, nose, chin, and ocacasionally the trunk are called:
    millia
  48. The shaping of the fetal head to adapt to the mother's pelvis during labor is called:
    molding
  49. In __ to __ days, the cranial bones typically return to their proper placement after molding.
    2-3 days
  50. Deep blue areas of coloration, usually in the sacral region, at birth are called:
    mongolian spots
  51. An environment in which the newborn can maintain internal body temp with minimal oxygen consumption and metabolism is called __________.

    In this environment, the newborn's body can focus more on __________ and __________.
    • neutral thermal environment
    • growth and development
  52. When a newborn produces heat, it is called:
    thermogenesis
  53. Thermogenesis can be done through:
    • metabolism
    • muscular activity
    • non-shivering thermogenesis
  54. If shivering is seen in an infant, this indicates:
    metabolic rate has already doubled
  55. When in a cool environment, the infants metabolic rate __________ and the newborn may cry and have muscular activity in order to produce heat.
    increases
  56. Things to assess on a newborn:
    • respirations
    • crying
    • reflexes
    • irritatbility
    • pulse
    • skin color
    • muscle tone
  57. The __________ reflex is also known as the "startle reflex".
    Moro
  58. The moro reflex is checked by:
    • hold infant in semiseated position, allowing head to fall backward to 30 degree angle
    • or having infant lie on flat surface and hitting the surface to startle them

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