Proctored RN Maternal Newborn 2016

Berta Abrego Proctored RN Maternal Newborn 2016 1. Infections: Indications for Cesarean Birth- Mothers who are infected with HSV have the possibility of having a miscarriage, preterm labor or ectopic pregnancy. A cesarean section is recommended for all women who have active genital herpes lesions or early outbreak. 2. Infections: Treatment for Gonorrhea- Medications used for patients have gonorrhea includes Ceftriaxone IM and azithromycin PO which are broad spectrum antibiotics. They cause bactericidal action. 3. Expected Physiological Changes During Pregnancy: Patients go through a lot of different physical changes during pregnancy. During the first semester changes will not be so obvious. During the third trimester patient’s abdomen will be enlarged. She will feel back and leg discomfort as well as lethargic. Skin will change as well, stretch marks will become more noticeable and hyperpigmentation will be darker in some areas of the body. 4. Labor and Delivery Process- Caring for a patient who is in second stage of labor, usually the patient will be fully dilated, Intense contractions will be felt every 1 to 2 minutes. Pushing will result in birth during the second stage. 5. Nursing Care and Discharge Teaching: Complications to report. Patients need to be taught that they need to report an infected cord. They cannot bathe a newborn with a circumcision. Teach how to use premoistened towelettes to clean the penis. Teach how to prevent falls, suffocation, strangulation, and burns. Also report any bleedings right away. 6. Therapeutic Procedures to Assist with Labor and Delivery: Indications for Amniofusion-Patients who normally get amniofusion will be patients who have oligohydramnios caused by either uteroplacental insufficiency or premature rupture of membranes. This will be done to supplement the amount of amniotic fluid. 7. Therapeutic Procedures to Assist with Labor and Delivery: Indications for discontinuing oxytocin- Discontinue oxytocin if uterine hyperstimulation occurs. This will be contractions more often than every 2 min or contractions that last 90 seconds. Also if there is no relaxation of uterus between contractions. 8. Expected Physiological Changes During Pregnancy: Quickening means slight fluttering movements of the fetus felt by a woman usually between 16 to 20 weeks of gestation. 9. Newborn assessment: Eliciting Newborn Reflexes- Sucking and rooting reflex is tested by stroking the cheek or the edge of the mouth. Palmar grasp examine finger’s in palm of newborn’s hand. Plantar grasp place nurses finger at base of newborn’s toes, the newborn responds by curling toes. Moro reflex position newborn to fall backward in an angle of at least 30 degrees, the newborn will extend and then abduct his arms. Tonic neck flex newborn turns head to one side then the other while being in a supine position. Babinski reflex performed by stroking outer edge of the foot moving up towards the toes. Toes will eventually fan out. Stepping is done by holding baby in an upright position on a flat surface newborn will respond by stepping. 10. Prenatal Care: Rubella Titer: It determines immunity to rubella. The virus affects the developing organs and the baby may be born with serious disabilities for instance the congenital rubella ............................................continued.......................................................