Professional Documents
Culture Documents
• Rubra: know the difference between rubra, serosa, alba, and when they are
expected
o Lochia- vaginal discharge after birth.
o Lochia Rubra- red, mostly blood, lasts about 3 days after birth
o Lochia Senosa- pinkish, blood and mucous content, lasts 3-10 days after
birth
o Lochia Alba- mostly mucous, clear and colorless or white, lasts 10-21 days
after birth
• Correct Teaching for Peri Care: includes using ice packs for the first 12-24
hrs. Then heat to aid healing. Sitz bath increases circulation & promotes
healing. Cleanse area with peribottle filled with warm water to squirt over
area after bowel movement/voiding. Place & remove peri pads from front to
back. Topical meds can be used
• What is done if a postpartum woman is not immune to Rubella (when is
vaccine given?): The Rh negative woman is given a dose of RhoGAM within
72 hrs after giving birth to a Rh positive infant. Only mother is given the
shot. Also given is any type of abortion to Rh positive infant.
• Dietary Changes/Recommendations for a Breastfeeding Mother: Mother
needs 500 addt’l cal/day while breastfeeding, 8-10 glasses of water of fluids
to decrease thirst
• When does menstruation return following birth: Menstrual cycles resume
in 6-8 wks if the woman is not breastfeeding—more delayed if she is.
Ovulation can occur at any time.
• When to give RhoGAM, and to whom: RhoGAM is given IM to mother only
when mother is Rh negative and baby is positive
• Correct care of umbilical cord, signs of problems with umbilical cord: Once
the cord is cut, assess artery-vein-artery (AVA) is present & it is clamped off.
Antibiotic ointment given and possible alcohol application at diaper changes
to promote drying of the cord. Cord should become dry & brownish/black.
Clamp is removed in 24 hrs. Cord should fall off in 10-14 days
• Comfort measures/teaching for breasts when woman is not breastfeeding:
Mother should wear a supportive bra. She should avoid stimulating her
nipples, avoid clothing from brushing, & should stay away from sprayer in
shower
• Why after pains worsen with breastfeeding: After pains with breastfeeding
occur because the sucking causes the posterior pituitary gland to release
oxytocin, which contracts the uterus.
• Correct information about bottle-feeding (how much, how often, how to
position bottle, how to warm, when to burp): Formula is digested slower than
breast milk so feeding should be about every 3-4 hrs. Warming is not
Maternity/Pediatrics Study Guide Chapters 8-10, 12-14
necessary. Do not microwave (may cause hot spots), never prop bottle in
baby’s mouth- may cause aspiration, as is associated with cavaties & ear
infections. Infant should be held in cradle position with head slightly elevated
above body. Hold bottle so nipple is always full. Feed slowly & burp after 1-
1.5 ozs. Burp infant by placing on your lap leaning slightly forward, support
head & gently pat back.
• Correct teaching about storing breast milk (freezing): Breast milk can be
stored at room temperature for 4 hrs, stored in fridge for up to 24 hrs and
frozen for 3 mths. Milk can be thawed in fridge for 24 hrs or by running under
lukewarm water.
• 1st Sign of Hypovolemic Shock: Hypovolemic shock occurs when the
volume of blood is depleted & cannot fill the circulatory system. Body
responds by increased heat and respiratory rate. Tachycardia is usually the
first sign. Blood pressure also falls & skin and mucous membranes become
cold, clammy, & pale.
• Signs of Uterine Atony (what is is, symptoms): Uterine Atony is the lack of
normal muscle tone in the uterus, the muscle does not compress allowing
the blood vessels at the placenta to bleed freely & usually massively
o May be caused by uterine over-distention, retained placental
fragments, prolonged labor/use of drugs during labor to relax uterus
• Nursing Priorities When Uterine Atony (Hemorrhage) Happens: uterus is
difficult to feel & is baggy (soft). Fundal height is high above the
umbilicus. Lochia is increased and may contain large clots. Bleeding may
be dramatic or may be prolonged.
o Uterus should be massaged until firm but not excessively as it will
tire and make atony worse. Mother should void.
• Medications used to treat uterine atony (boggy uterus): A dilute oxytocin
IV infusion is most common drug ordered to control uterine atony. Also
methergine may be given or a prostaglandin as carbopost.
• Correct breast care/teaching re:Breastfeeding for a woman who has
Mastitis: Mastitis is an infection of the breast usually occurring 2-3 wks
after birth. It occurs when organisms from the infant’s mouth enter small
cracks in the nipple/areola. Breast enlargement and inadequate milk
emptying is associated. Signs & Symptoms:
Redness & heat in breast
Tenderness
Edema & heaviness in breast
Purulent drainage (may or may not be present)
Fever or chills in woman
o If not treated infected area becomes walled off and an abscess
Maternity/Pediatrics Study Guide Chapters 8-10, 12-14
environment.
• Correct care for circumcised penis:
o Keep area clean, change diaper
o Wash area with warm water, avoid alcohol
o Do not remove yellow crust from penis
o Apply diaper loosely
o Report redness and bleeding
o Observe for at least 6 wet diapers per day
• Symptoms of neonatal abstinence syndrome in newborns: Body tremors
and hyper-irratablity are principle signs of this condition, wakefullness,
diarrhea, poor feeding, sneezing and yawning may also be present
• Symptoms of increasing ICP if infant with hydrocephalus: High pitched
cry, unequal pupil size, or response to light, bulging fontanels, irratability,
or lethargy.