OB test 3
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Blue coloring of the hands and feet:
__________ is present for several __________ until the pulmonary changes have stabilized and oxygenated blood has reached the hands and feet.
Cyanosis around the lips or face is NOT normal and is a sign of:
Caput succedaneum is __________ of the newborn's scalp that is present at __________ that disappears __ to __ days.
It does not need __________.
Caput succedaneum may cross __________ lines and is caused by:
- suture lines
- caused by head compression against the cervix
Cephalohematoma is a collection of blood between the __________ and the __________.
periosteum and the skull
Cephalohematoma appears several __________ to a day after birth.
What is caused by a rupturing of the periosteal bridging veins because of the friction and pressure during L&D?
A cephalohematoma is largest on the __ day and reabsorbs in __ to __ weeks.
The surgical removal of the foreskin that covers the glans penis:
Circumcision is considered an __________ procedure and parents must give written consent.
Reasons for and against circumcision:
- religious reasons
- prevent the need for procedure later in life
- may reduce UTI, penile cancer, and STD's
- painful procedure
- possibility of hemorrhage
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
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
Most infants are not fed __ to __ hrs before circumcision to prevent __________.
What causes cold stress?
decreased oxygen --> metabolic rate can't increase --> results in not maintaining temp
Four ways to lose heat:
The loss of heat by direct contact with a cooler object is:
- cold hands, cold stethoscope, cold scale
The loss of heat by movement of air:
- air current from open doors, air conditioning, people moving around
The loss of heat when water is changed to vapor:
- when wet body dries, during a bath or wet from amniotic fluid or from we diapers
The loss of heat by transfer to cooler objects nearby, but not enough for direct contact:
- infant near a cold window, cold walls of an incubator
__________ is placement of the urinary meatus on the underside of the penis.
__________ is placement of the urinary meatus on top of the penis.
Small whitish-yellow epithelial cysts are called:
Epstein's pearls are found on the __________, disappear in a few __________, and may be confused with thrush.
What happens if an infants temp is not raised by non-shivering thermogenesis?
metabolism of brown fat begins
Brown fat is only found in __________.
Brown fat appears at about __ to __ weeks of gestation and increases until about __ to __ weeks of age (unless depleted by cold stress).
Where is brown fat located?
- back of neck
- between scapula
- around kidneys
- around heart and abdominal aorta
What happens once all an infants brown fat is metabolized?
they do not have a method of heat production
Eye infection that occurs at birth or during the first month:
What is the most common cause of opthalmia neonatum?
gonorrhea or chlamydia
If left untreated, opthalmia neonatum can result in:
severe vision impairment
__________ ointment is a prophylactic that is instilled into each eye soon after birth.
Management of opthalmia neonatum depends on the __________ organism, but __________ and __________ are commonly used.
- Rocephin and Penicillin
Blood tinged mucous discharge from the vagina of an infant:
- withdrawal of maternal hormones
A white, creamy substance called __________ may cover the skin, but usually disappears by term. It may remain found in __________.
An infant's nipples may secrete a whitish fluid called:
What is the first priority of infant care after delivery?
The first and most important care given is to clear the __________ and then the __________ of the mucous and amniotic fluid to open the airway.
__________ scoring assesses the infant's cardiopulmonary adaptations to extrauterine life. The scale is from 0-10, worst to best.
APGAR stands for:
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.
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).
Fine, downy hair, __________, is most abundant between __ to __ weeks gestation and disappears as the gestational age increases.
The earliest stools of an infant is called:
White, pinhead-sized, distended sebaceous glands on the cheeks, nose, chin, and ocacasionally the trunk are called:
The shaping of the fetal head to adapt to the mother's pelvis during labor is called:
In __ to __ days, the cranial bones typically return to their proper placement after molding.
Deep blue areas of coloration, usually in the sacral region, at birth are called:
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
When a newborn produces heat, it is called:
Thermogenesis can be done through:
- muscular activity
- non-shivering thermogenesis
If shivering is seen in an infant, this indicates:
metabolic rate has already doubled
When in a cool environment, the infants metabolic rate __________ and the newborn may cry and have muscular activity in order to produce heat.
Things to assess on a newborn:
- skin color
- muscle tone
The __________ reflex is also known as the "startle reflex".
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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