Maternity HESI Review
Watch a newborn APGAR test and find out what the scores mean.
Activity (muscle tone)
0 — Limp; no movement
1 — Some flexion of arms and legs
2 — Active motion
Pulse (heart rate)
0 — No heart rate
1 — Fewer than 100 beats per minute
2 — At least 100 beats per minute
Grimace (reflex response)
0 — No response to airways being suctioned
1 — Grimace during suctioning
2 — Grimace and pull away, cough,
or sneeze during suctioning
Appearance (color)
0 — The baby's whole body is completely bluish-gray or pale
1 — Good color in body with bluish hands or feet
2 — Good color all over
Respiration (breathing)
,0 — Not breathing
1 — Weak cry; may sound like whimpering, slow or irregular breathing
2 — Good, strong cry; normal rate and effort of breathing
CEPHALAHEMATOMA
A cephalohematoma is a collection of blood under the periosteum. It is almost always a complication
of childbirth. It most commonly occurs when the fetal head is forced through the birth canal; the head
is propelled forward while the cervix grips the scalp tenaciously. This sliding, tearing force can tear
tiny veins that nourish the periosteum from the bone side. This tearing of vessles causes bleeding
(hemorrhage) under the tough covering of each bony plate (the periosteum), and a tense pocket of
blood collects. This is apparently a painless process.
The course of a newborn's uncomplicated cephalohematoma in itself is benign. The trapped blood
cells break down and the component parts are reabsorbed into the system for recycling or disposal
EYE PROPHYLAXIS
Eye drops or ointment containing an antibiotic medication are placed in a newborn's eyes after birth.
This is required by law to protect the baby from an unknown gonorrhea infection in the mother's body.
Antibiotics are used in most hospitals. Another preparation, called silver nitrate, is sometimes used.
The ointment or drops may cause a baby's eyes to appear cloudy and some newborns' eyes may become
very irritated with redness or swelling. This is a temporary condition and the medication should not be
washed or cleaned out of the eyes.
NEW BORN THERMOREGULATION
neonates produce body hat by non shivering thermogenesis, this process requires increased oxygen and
,glucose consumption to burn brown fat, subcutaneous fat acts as an insulator and helps conserve body
heat. A flexed position decreases exposed surface area and conserves body heat.
Gestational age assessment BALLARD SCALE
An assessment that evaluates six neuromuscular and six physical characteristic performed during the
first few hours of birth.
A score of 1 to 5 is assigned to each characteristic and the total score correlates to a gestational age,
term babies get a score of 3 for each characteristic scores an 18 for the musculature assessment and a
18 for the physical characteristics: the total [points is 36 points coordinates to 38+ week gestation.
PRETERM BIRTH
born prior to 37 weeks and 7 days.
ATTACHMENT/BONDING
The process by which a parent comes to love and accept a child and a child comes to love a parent is
referred to attachment. VERY important for mother and baby to bond after birth.
Four Stages of Labor:
First Stage – Effacement and dilation of cervix
- Latent Phase – Cervical dilation is 1 to 4 cm. Uterine contractions occur every 15 to 30 min, are 15 to
30 sec in duration (mild intensity). Mother is talkative and eager to be in labor. Changes position
without reminder.
- Active Phase – Cervical dilation is 4 to 7 cm. Uterine contractions occur every 3 to 5 min.; are 30 to
, 60 seconds in duration (moderate intensity). Mother becomes restless and anxious as contractions
become stronger. Mother is usually serious, intense, has a need for increased concentration, will answer
in short phrases only. May need reminders to change positions.
- Transition phase – Cervical dilation is 8 to 10 cm. Uterine contractions occur every 2 to 3 min, are 45
to 90 seconds in duration. (Strong intensity) Mother is working hard with intense concentration and
will give one-word answers to questions only between contractions; anxiety increases, fears loss of
control and abandonment, senses helplessness and may state “I can’t do this anymore”.
Interventions: Monitor maternal VS. Monitor FHR via ultrasound Doppler, fetoscope,
or electronic fetal monitor. Assess FHR before, during, and after a contraction (normal is 120 to 160
beats/min. Monitor uterine contractions by palpation or monitor, determining frequency, duration, and
intensity. Assess status of cervical dilation and effacement. Assess fetal station presentation and
position by Leopold’s maneuver. Assist with pelvic examination and prepare for a fern test. Assess the
color of the amniotic fluid if the membranes have ruptured (meconium-stained fluid can indicate fetal
distress.
Second Stage – Expulsion of the fetus. Pushing stage. Extends from complete dilatation to
Delivery. Cardinal movements- adaptations that the fetus undertakes to maneuver through the pelvis
during labor and birth. Every darn fool in Rotterdam eats rotten egg rolls everyday.
Engagement of the presenting part occurs
Descent of the fetus into the pelvis
Flexion of the fetal head; (descent and flexion often occur simultaneously)
Watch a newborn APGAR test and find out what the scores mean.
Activity (muscle tone)
0 — Limp; no movement
1 — Some flexion of arms and legs
2 — Active motion
Pulse (heart rate)
0 — No heart rate
1 — Fewer than 100 beats per minute
2 — At least 100 beats per minute
Grimace (reflex response)
0 — No response to airways being suctioned
1 — Grimace during suctioning
2 — Grimace and pull away, cough,
or sneeze during suctioning
Appearance (color)
0 — The baby's whole body is completely bluish-gray or pale
1 — Good color in body with bluish hands or feet
2 — Good color all over
Respiration (breathing)
,0 — Not breathing
1 — Weak cry; may sound like whimpering, slow or irregular breathing
2 — Good, strong cry; normal rate and effort of breathing
CEPHALAHEMATOMA
A cephalohematoma is a collection of blood under the periosteum. It is almost always a complication
of childbirth. It most commonly occurs when the fetal head is forced through the birth canal; the head
is propelled forward while the cervix grips the scalp tenaciously. This sliding, tearing force can tear
tiny veins that nourish the periosteum from the bone side. This tearing of vessles causes bleeding
(hemorrhage) under the tough covering of each bony plate (the periosteum), and a tense pocket of
blood collects. This is apparently a painless process.
The course of a newborn's uncomplicated cephalohematoma in itself is benign. The trapped blood
cells break down and the component parts are reabsorbed into the system for recycling or disposal
EYE PROPHYLAXIS
Eye drops or ointment containing an antibiotic medication are placed in a newborn's eyes after birth.
This is required by law to protect the baby from an unknown gonorrhea infection in the mother's body.
Antibiotics are used in most hospitals. Another preparation, called silver nitrate, is sometimes used.
The ointment or drops may cause a baby's eyes to appear cloudy and some newborns' eyes may become
very irritated with redness or swelling. This is a temporary condition and the medication should not be
washed or cleaned out of the eyes.
NEW BORN THERMOREGULATION
neonates produce body hat by non shivering thermogenesis, this process requires increased oxygen and
,glucose consumption to burn brown fat, subcutaneous fat acts as an insulator and helps conserve body
heat. A flexed position decreases exposed surface area and conserves body heat.
Gestational age assessment BALLARD SCALE
An assessment that evaluates six neuromuscular and six physical characteristic performed during the
first few hours of birth.
A score of 1 to 5 is assigned to each characteristic and the total score correlates to a gestational age,
term babies get a score of 3 for each characteristic scores an 18 for the musculature assessment and a
18 for the physical characteristics: the total [points is 36 points coordinates to 38+ week gestation.
PRETERM BIRTH
born prior to 37 weeks and 7 days.
ATTACHMENT/BONDING
The process by which a parent comes to love and accept a child and a child comes to love a parent is
referred to attachment. VERY important for mother and baby to bond after birth.
Four Stages of Labor:
First Stage – Effacement and dilation of cervix
- Latent Phase – Cervical dilation is 1 to 4 cm. Uterine contractions occur every 15 to 30 min, are 15 to
30 sec in duration (mild intensity). Mother is talkative and eager to be in labor. Changes position
without reminder.
- Active Phase – Cervical dilation is 4 to 7 cm. Uterine contractions occur every 3 to 5 min.; are 30 to
, 60 seconds in duration (moderate intensity). Mother becomes restless and anxious as contractions
become stronger. Mother is usually serious, intense, has a need for increased concentration, will answer
in short phrases only. May need reminders to change positions.
- Transition phase – Cervical dilation is 8 to 10 cm. Uterine contractions occur every 2 to 3 min, are 45
to 90 seconds in duration. (Strong intensity) Mother is working hard with intense concentration and
will give one-word answers to questions only between contractions; anxiety increases, fears loss of
control and abandonment, senses helplessness and may state “I can’t do this anymore”.
Interventions: Monitor maternal VS. Monitor FHR via ultrasound Doppler, fetoscope,
or electronic fetal monitor. Assess FHR before, during, and after a contraction (normal is 120 to 160
beats/min. Monitor uterine contractions by palpation or monitor, determining frequency, duration, and
intensity. Assess status of cervical dilation and effacement. Assess fetal station presentation and
position by Leopold’s maneuver. Assist with pelvic examination and prepare for a fern test. Assess the
color of the amniotic fluid if the membranes have ruptured (meconium-stained fluid can indicate fetal
distress.
Second Stage – Expulsion of the fetus. Pushing stage. Extends from complete dilatation to
Delivery. Cardinal movements- adaptations that the fetus undertakes to maneuver through the pelvis
during labor and birth. Every darn fool in Rotterdam eats rotten egg rolls everyday.
Engagement of the presenting part occurs
Descent of the fetus into the pelvis
Flexion of the fetal head; (descent and flexion often occur simultaneously)
