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NU321 Exam 3 With Complete
Solution
Fourth stage of labor - ANSWER 4 to 6 hours following delivery; necessary to frequently take vitals and to perform fundal exams
involution - ANSWER return of the uterus to a nonpregnant state after birth
two pounds - ANSWER weight of uterus immediately after delivery
one pound - ANSWER weight of uterus one week following delivery
two ounces - ANSWER weight of uterus six weeks following delivery
oxytocin - ANSWER hormone released by the posterior pituitary gland; stimulates let down reflex and afterpains
afterpains - ANSWER cramping after childbirth caused by oxytocin; constricts vessels where placenta separated from uterus to prevent hemorrhage
full bladder (void often!) - ANSWER what afterpains can be impeded by
exfoliation - ANSWER process through which uterus heals itself after placental detachment
autolysis - ANSWER process of "self digestion" that occurs because of withdrawal of estrogen and progesterone in postpartum patients
lochia - ANSWER blood, tissue, and mucous discharge after childbirth
estimated blood loss - ANSWER why it is important to have careful documentation of lochia
rubra - ANSWER bright red discharge that occurs 1 to 2 days following delivery
serosa - ANSWER light pink discharge that occurs 4 to 10 days following delivery
alba - ANSWER white discharge that occurs 10 days to 3 weeks after delivery
activity, clotting, fundal assessments, source documentation - ANSWER pertinent assessments regarding bleeding postpartum
appearance of os - ANSWER how to differentiate between nulligravida and multiparous women
slit like - ANSWER how os appears in women who have had cervix dilated in past (not necessarily L&D, but probably)
edematous, bruised, small tears and partially open - ANSWER appearance of cervix postpartum
six weeks - ANSWER how long the cervix generally takes to heal postpartum
thin, no rugae, dry, tears - ANSWER appearance of vagina postpartum
breastfeeding (delay in estrogen production) - ANSWER what may cause dyspareuia in postpartum women
dyspareuia - ANSWER painful intercourse
edema, bruising, potential episiotomy - ANSWER appearance of perineum postpartum
6 to 8 weeks - ANSWER how long it generally takes the perineum to heal postpartum
3 months - ANSWER period of time where most women who do not breastfeed after birth will menstruate
altered voiding reflex, bladder distention - ANSWER common urinary findings following delivery
constipation, reluctance - ANSWER common GI findings following delivery
colostrum - ANSWER a specialized form of milk that delivers essential nutrients and antibodies in a form that the newborn can digest
hypercoagulability - ANSWER circulatory state in postpartum women that puts them at an elevated risk for clots
neonate - ANSWER birth through 28 days
establishing/maintaining respirations, adjusting to circulatory changes, temperature regulation, retaining nutrients, eliminating waste, regulating weight - ANSWER major physiologic adjustments that neonates must undergo following delivery
self regulation of arousal/sleep states, processing multiple stimuli, forming relationships with caregiver - ANSWER major behavioral adjustments that neonates must undergo following delivery
6 to 8 hours postpartum - ANSWER transition period for neonates
increases lung circulation and perfusion; decreases prostaglandins - ANSWER what clamping cord (and resulting BP hike) does to the respiratory system
fetal hypoxia/hypercarbia - ANSWER chemical changes induced by contractions that stimulate the readying of the respiratory system
change in intrathoracic pressure - ANSWER mechanical changes that stimulate the neonatal respiratory system
skin receptors stimulate respiratory system via medulla upon exposure to extrauterine environment - ANSWER thermal factors that stimulate the neonatal respiratory system
handling, suction, drying, pain lights, sounds, smells, labor process - ANSWER sensory factors that stimulate the neonatal respiratory system
chemical, mechanical, thermal, sensory - ANSWER four components that stimulate the neonatal respiratory system during labor and delivery
surfactant - ANSWER released upon lung expansion at birth; reduces surface tension and allows alveoli to remain open
30 to 60 pauses lasting 15 seconds or last - ANSWER normal respiratory finding for neonate, especially during REM sleep
60 to 80 - ANSWER normal systolic range for neonates
40 to 50 - ANSWER normal diastolic range for neonates
mean BP is less than gestational age - ANSWER indicates neonatal hypotension
mean pressure is greater than 50 to 70 - ANSWER indicates neonatal hypertension
300 mL - ANSWER average amount of blood volume for a neonate at birth
100 ml - ANSWER how much waiting to clamp cord can increase blood volume
increase in heart size, higher systolic BP, increased respers - ANSWER conditions that can be caused by late cord clamping
reduced mean blood volume - ANSWER condition that can be caused by early cord clamping
anemia, hypovolemia, hyperthermia, sepsis - ANSWER what persistent tachycardia can indicate in infants
congenital heart block, hypoxemia - ANSWER what persistent bradycardia can indicate in infants
coarctation of aorta - ANSWER indicated by significant differences between upper and lower extremity blood pressures
anemia, peripheral vasoconstriction - ANSWER what pallor can indicate in neonates
asphyxia, sepsis - ANSWER what peripheral vasoconstriction can indicate in infants
ABO/Rh incompatibility, pathologic jaundice - ANSWER what early jaundice can indicate
pathologic jaundice - ANSWER result of an underlying disease appearing before 24 hours (or persistent after day 7)
conduction - ANSWER loss of heat to cooler surface in direct contact
crying, increased movement - ANSWER how infants generate heat
acrocyanosis - ANSWER temporary cyanotic condition, usually in newborns resulting in a bluish color around the lips, hands and fingernails, feet and toenails; may last for a few hours and disappear with warming; normal finding
brown fat - ANSWER a dark-colored adipose tissue with many blood vessels, involved in the rapid production of heat in hibernating animals and human babies
cold stress - ANSWER loss of heat that causes an increase in respirations and basal metabolic rate, which may lead to anaerobic glyolysis and metabolic acidosis
hyperbilirubinemia - ANSWER what metabolic acidosis increases the incidence of
excessive heat production, overheating - ANSWER causes of hyperthermia in
infants (not super common)
sepsis, decrease in heat loss - ANSWER causes of excessive heat production in infants
too many blankets/bundling - ANSWER causes of overheating in infants
hyperthermic sepsis - ANSWER end result of neonatal hyperthermia; infant appears stressed, has constricted vessels, is pale, and has cold hands and feet
dehydration, heat stroke, death - ANSWER what uncorrected hyperthermia can lead to
98% - ANSWER percent of neonates that void in the first 30 hours of life
longer than 48 hours - ANSWER point where if child hasn't voided, renal impairments are considered
red brick staining - ANSWER normal urinary finding in newborns; caused by the elimination of uric acid crystals
12 months (solid foods!) - ANSWER when sucking calluses should disappear
30 to 90 ml - ANSWER neonatal stomach capacity
meconium - ANSWER first stool formed during fetal life; consists of amniotic fluid, intestinal secretions, and cells
within 24 hours - ANSWER period of time when meconium should be passed
40 to 80 mg/dl - ANSWER normal blood sugar range for infants
jitters, tremors, cyanosis, apnea, weak/high pitched cry, BS less than 35, feeding difficulty, lethargy, seizures, hunger, eye rolling, twitching - ANSWER signs of hypoglycemia
kernicterus - ANSWER bilirubin encephalopathy, a form of brain damage resulting from unconjugated bilirubin entering the brain
lethargy, hypotonic, poor suck, high pitched cry, fever, jaundice - ANSWER s/sx of kernicterus
infection - ANSWER leading cause of neonatal morbidity and mortality
hypo/hyperthermia, lethargy, irritability, poor feeding, vomiting, diarrhea, decreased reflexes, pale/mottled skin, respiratory s/sx - ANSWER s/sx of infection in neonates
vernix caseosa - ANSWER thick, cheesy substance made up of sebum and shed epithelial cells present on neonatal skin to provide hydration
Mongolian spots - ANSWER blue-ish black macules appearing over the buttocks and/or thighs of darker skinned neonates
stork bites - ANSWER "telangiectactic nevi" dark red spots on the eyelids, forehead, or nape of the neck, that usually fade in time
erythema toxicum - ANSWER pink rash that appears suddenly anywhere on the body of a term newborn during the first 3 weeks.
caput succedaneum - ANSWER diffuse edema of the fetal scalp that crosses the suture lines; reabsorbes within 1 to 3 days; commonly seen with vacuum extractions
clamp cord, administer vitamin K, eye prophylaxis - ANSWER therapeutic interventions performed soon after birth
opthallmia neonatorum - ANSWER eye infection from gonorrhea or chlamydia; prevented with prophylactic eye ointment after birth
daily weights, HC, length, chest/abd circumference - ANSWER daily measurements to take on a newborn
large for gestational age - ANSWER above 90th percentile
average for gestational age - ANSWER between 10 and 90th percentiles
small for gestational age - ANSWER below 10th percentile
low birth weight - ANSWER 2500 grams or less
very low birth weight - ANSWER 1500 grams or less
postmature - ANSWER after 42 weeks gestation and showing effects of placental insufficiency
brachial plexus injury - ANSWER skeletal birth injury that impacts movement of shoulder, arm, wrist, or hand
phrenic nerve palsy - ANSWER skeletal birth injury that can affect the hyperextension of the neck and cause facial palsy
PKU, hypothyroidism, galactosemia, CF, MSUD, sickle cell - ANSWER genetic conditions that are routinely caught on newborn genetic screens
HepB, Vitamin K - ANSWER IM injections given to newborns
25 g 5/8 in - ANSWER size of needle for newborns
phototherapy - ANSWER tx of hyperbilirubinemia
hemorrhage, infection, penile injury - ANSWER risks of circumcision
decreased risk UTIs, STIs, CA, HPV, lower cervical CA for partners - ANSWER benefits of circumcision
use of oxygen therapy
germinal matrix hemorrhage - ANSWER typically occurs in infants that are less than 34 weeks old with a history of hypoxia or birth asphyxia
necrotizing enterocolitis - ANSWER can be caused by intestinal ischemia, early enteral feedings, or bacterial colonization in the presence of a compromised immune system
meconium aspiration syndrome - ANSWER abnormal inhalation of meconium produced by a fetus or newborn; more common in postmature infant
persistent pulmonary hypertension of the newborn - ANSWER the result of elevated pulmonary vascular resistance to the point that venous blood is diverted to various degrees through fetal channels (the ductus arteriosus and foramen ovale) into the systemic circulation and bypasses the lungs, resulting in systemic arterial hypoxemia; more common in postmature infants
home care needs, info about specialized infant care, referrals, immunizations, metabolic screening, hearing evals, transportation arrangements - ANSWER components involved in discharge planning for the high risk newborn
adequate lighting, elimination of fire hazards, safety of electrical appliances, adequate ventilation, controlled temp/humidity, placement of crib, exclusion of persons with infectious conditions - ANSWER ways parents can ensure a protective environment at home upon discharge
feeding, elimination, circ care, crying/behaviors, sleeping, signs of illness, community resources, phototherapy - ANSWER potential education topics for parents upon discharge
6 months - ANSWER how long AAUP/WHO/AAFP recommend breastfeeding exclusively
6 to 12 months - ANSWER when solid foods may start to be added to the diet
12 months (cows!) - ANSWER no cow's milk under what age
initiation 80, 6 months 60, one year 30 - ANSWER Healthy People 2020 goal percentages for breast feeding rates
safe, fresh, less infections, fewer allergies, decreased asthma risk, less obesity and diabetes, decreased risk of SIDS, decreased breast CA in mom, save lots of money - ANSWER benefits of breastfeeding
