• MERTENITY GUIDE WEEK 6 EXAM
• Why would we suggest a new mom do skin-to-skin with her newborn?
• Skin-to-Skin
• Cardiopulmonary Stability
• Body Temperature (Prevents Cold Stress, Thermal Stability)
• Promote Bonding [Golden Hour – First Hour After Birth]
• What medications can we give a patient for postpartum hemorrhage, and
what would contraindicate their use?
• Postpartum Hemorrhage (Medications)
• Oxytocin (Pitocin)
• Misoprostol (Cytotec)
• Hemabate (IM) [CONTRAINDICATION: Asthma]
• Methergine (IM) [CONTRAINDICATION: Hypertension]
• What are the differences between postpartum blues, depression and psychosis?
• Postpartum Blues [“Baby Blues”]
• Peaks around the 5th day (Subsides by 10th Day)
• Emotionally Labile; Cries Easily, Sadness
• Anxiety, Insomnia, Fatigue
• Does NOT Impair Functioning
• Postpartum Depression [PPD]
• Lasts More than 2 Weeks (Rarely Disappears without Help)
• Intense/Pervasive Sadness
• Difficulty Sleeping, Loss of Appetite
• Feeling of Detachment/Lack of Interest Towards Newborn
• Thoughts of Self-Harm
• Gradually Improves Over 6 Months (with Treatment)
• Postpartum Psychosis
• PPD with Psychotic Features
• Rapid Onset
• Bizarre Behavior, Hallucinations, Paranoid Delusions
• Impulsivity with Risk of Suicide or Infanticide
• How do we know if a patient is experiencing subinvolution?
• Subinvolution
• Failure of the Uterus to Return to a Nonpregnant State
• Signs and Symptoms
• Prolonged Lochia or Bleeding
• Enlarged Uterus
• Signs and symptoms to watch for in association with hypovolemic shock
• Hypovolemic Shock (Occurs with 30% - 40% of Volume Loss)
• Signs/Symptoms
, • Pale, Cool, Clammy Skin
• Hypotension
• Weak/Rapid Pulses
• What is idiopathic thrombocytopenic purpura (ITP) and why is it a
problem? What symptoms would we see and how would it need to be
treated?
• Idiopathic Thrombocytopenic Purpura [ITP]
• Autoimmune Disorder
• Antiplatelet Antibodies Decrease Life Span of the Platelets
• ITP Signs and Symptoms
• Thrombocytopenia
• Increased Bleeding Times
• Severe Hemorrhage After C-Section/Vaginal Lacerations
• Treatment: Corticosteroids in Pregnancy
• What is mastitis and what are the treatment/comfort measures we can suggest for
the patient? (pg 629)
• Mastitis (Inflammation of the Breast)
• Treatment/Comfort Measures
• Antibiotics; Analgesics
• Frequent Pumping; Warm Compresses (Improves Milk Flow)
• What is endometritis. What are the symptoms associated with this
problem, and how would it need to be treated? (pg 516)
• Endometritis (Infection of the Lining of the Uterus)
• Sign/Symptoms
• Fever [100.4oF]; Increased Pulses
• Chills; Anorexia; Nausea; Fatigue; Lethargy
• Pelvic Pain; Uterine Tenderness
• Foul-Smelling, Profuse Lochia
• Treatment
• Prophylactic Antibiotics with C-Section (Reduces Incidence)
• What is chorioamnionitis? What are the symptoms we would possibly see?
What causes this condition, and how would it need to be treated?
• Chorioamnionitis (Bacterial Infection in the Amniotic Cavity)
• Signs/Symptoms
• Maternal Fever
• Maternal/Fetal Tachycardia
• Uterine Pain
• Purulent, Foul-Smelling Amniotic Fluid
• Treatment
• Administer Antibiotics
• Why do we use vitamin K in the newborn?
• Vitamin K Prophylaxis
, • Promotes Blood Clotting (Increases Synthesis of Prothrombin by the
Liver)
• Stimulates Production of RBC (Prevents Hemorrhagic Complications)
• There are many different integumentary conditions that we may assess
on a newborn. What are they and what do they look like?
• Integumentary Conditions (Newborn)(ALL NORMAL SKIN CONDITIONS)
• Vernix Caseosa
• Cheese-Like Protective Covering
• Antimicrobial; Prevents Fluid Loss
• Acrocyanosis
• Blueish Discoloration of Hands/Feet
• Considered Normal for First 24hrs
• Milia
• White Pinpoint Papules
• Sweat Glands on Nose; Infants Do NOT Sweat for First 24hrs
• Desquamation
• Peeling After a Few Days After Birth
• Presentation at Birth Indicates Post-Maturity
• Nevus Simplex [“Angel’s Kiss”]
• Salmon Patches, Stork Bites
• Pink Spots on Nape of Neck (Blanches Easily)
• Occurs on 80% of Newborns
• Mongolian Spots
• Bluish Black Pigmentation (Fades Over Time)
• Most Common on Back/Buttocks (More Common on Dark
Skin)
• Erythema Toxicum
• Newborn Rash
• Appears in First 24hrs (Can Last Up to 3 Weeks)
• Red Macules/Papules; Small Vesicles
• No Treatment Required
• Lanugo
• Fine Hairs on Body
• Often Disappear During First Week of Life
• More Commonly Found on Preterm Infants
• What are conditions that we may see on the genitalia of a newborn male, that
would need further evaluation/treatment?
• Genitalia Conditions (Newborn Male)
• Cryptorchidism (Undescended Testicles)
• Torsion (Bluish Discoloration of Scrotum)
• Hydrocele (Accumulation of Fluid Around Testicles)
• When there is swelling of the tissue on the head of a newborn, what are
the possible names of that swelling? What would it look like on
assessment? What complications could the swelling possibly cause?
• Head Swelling Conditions
, • Molding (NORMAL)
• Distorted Shape Due to Overlapping to Facilitate Delivery
• Caput Succedaneum (NORMAL)(“Like a Cap”)
• Edematous Area Over the Scalp
• Crosses Suture Lines
• Disappears in 3 – 4 Days
• Cephalhematoma
• Collection of Blood
• Does NOT Cross Suture Lines
• Hemolysis (Increases Risk of Hyperbilirubinemia)
• Fontanelles
• Depressed/Indented with Dehydration
• Bulging with Increased Cranial Pressure
• What would we assess in a newborn who is experiencing dehydration?
• Dehydration Assessment (Newborn)
• LOC; Skin (Cold/Clammy)
• O2 Saturation; Breath Sounds
• Pulses; Tissue Perfusion
• What problems might a newborn experience if they are born to a diabetic
mother who did not have glycemic control during her pregnancy?
• Issues with Poor Glycemic Control During Pregnancy
• Macrosomia (Enlarged Baby)
• Increased Risk for Birth Injuries
• More Susceptible to Hyperbilirubinemia and Hypoglycemia
• Higher Risk for Respiratory Distress Syndrome
• Excess Glucose in Utero Increased Insulin Production in Infant
• Decreases Amount of Surfactant for Lung Development
• When thinking through feeding a newborn, what aspects of feeding and
nutrition do we need to consider?
• Newborn Feeding/Nutrition
• Feeding Behaviors
• Responsive to Feeding Cues
• Suck, Breathe, Swallow
• Intestinal Microbiome
• Flora Established with First Week to Synthesize Vitamin K
• Breastfeeding Helps Develop
• Gastroesophageal Reflux [GER]
• Spitting Up
• Stools (pg 537, Box 22.1)
• Meconium (First Stool After Birth)
• Transitional
• Milk Stool (Appears by the 4th Day)
• Yellow Seedy with Breastfeeding
• We need to watch for intake and output with newborns. What are we
• Why would we suggest a new mom do skin-to-skin with her newborn?
• Skin-to-Skin
• Cardiopulmonary Stability
• Body Temperature (Prevents Cold Stress, Thermal Stability)
• Promote Bonding [Golden Hour – First Hour After Birth]
• What medications can we give a patient for postpartum hemorrhage, and
what would contraindicate their use?
• Postpartum Hemorrhage (Medications)
• Oxytocin (Pitocin)
• Misoprostol (Cytotec)
• Hemabate (IM) [CONTRAINDICATION: Asthma]
• Methergine (IM) [CONTRAINDICATION: Hypertension]
• What are the differences between postpartum blues, depression and psychosis?
• Postpartum Blues [“Baby Blues”]
• Peaks around the 5th day (Subsides by 10th Day)
• Emotionally Labile; Cries Easily, Sadness
• Anxiety, Insomnia, Fatigue
• Does NOT Impair Functioning
• Postpartum Depression [PPD]
• Lasts More than 2 Weeks (Rarely Disappears without Help)
• Intense/Pervasive Sadness
• Difficulty Sleeping, Loss of Appetite
• Feeling of Detachment/Lack of Interest Towards Newborn
• Thoughts of Self-Harm
• Gradually Improves Over 6 Months (with Treatment)
• Postpartum Psychosis
• PPD with Psychotic Features
• Rapid Onset
• Bizarre Behavior, Hallucinations, Paranoid Delusions
• Impulsivity with Risk of Suicide or Infanticide
• How do we know if a patient is experiencing subinvolution?
• Subinvolution
• Failure of the Uterus to Return to a Nonpregnant State
• Signs and Symptoms
• Prolonged Lochia or Bleeding
• Enlarged Uterus
• Signs and symptoms to watch for in association with hypovolemic shock
• Hypovolemic Shock (Occurs with 30% - 40% of Volume Loss)
• Signs/Symptoms
, • Pale, Cool, Clammy Skin
• Hypotension
• Weak/Rapid Pulses
• What is idiopathic thrombocytopenic purpura (ITP) and why is it a
problem? What symptoms would we see and how would it need to be
treated?
• Idiopathic Thrombocytopenic Purpura [ITP]
• Autoimmune Disorder
• Antiplatelet Antibodies Decrease Life Span of the Platelets
• ITP Signs and Symptoms
• Thrombocytopenia
• Increased Bleeding Times
• Severe Hemorrhage After C-Section/Vaginal Lacerations
• Treatment: Corticosteroids in Pregnancy
• What is mastitis and what are the treatment/comfort measures we can suggest for
the patient? (pg 629)
• Mastitis (Inflammation of the Breast)
• Treatment/Comfort Measures
• Antibiotics; Analgesics
• Frequent Pumping; Warm Compresses (Improves Milk Flow)
• What is endometritis. What are the symptoms associated with this
problem, and how would it need to be treated? (pg 516)
• Endometritis (Infection of the Lining of the Uterus)
• Sign/Symptoms
• Fever [100.4oF]; Increased Pulses
• Chills; Anorexia; Nausea; Fatigue; Lethargy
• Pelvic Pain; Uterine Tenderness
• Foul-Smelling, Profuse Lochia
• Treatment
• Prophylactic Antibiotics with C-Section (Reduces Incidence)
• What is chorioamnionitis? What are the symptoms we would possibly see?
What causes this condition, and how would it need to be treated?
• Chorioamnionitis (Bacterial Infection in the Amniotic Cavity)
• Signs/Symptoms
• Maternal Fever
• Maternal/Fetal Tachycardia
• Uterine Pain
• Purulent, Foul-Smelling Amniotic Fluid
• Treatment
• Administer Antibiotics
• Why do we use vitamin K in the newborn?
• Vitamin K Prophylaxis
, • Promotes Blood Clotting (Increases Synthesis of Prothrombin by the
Liver)
• Stimulates Production of RBC (Prevents Hemorrhagic Complications)
• There are many different integumentary conditions that we may assess
on a newborn. What are they and what do they look like?
• Integumentary Conditions (Newborn)(ALL NORMAL SKIN CONDITIONS)
• Vernix Caseosa
• Cheese-Like Protective Covering
• Antimicrobial; Prevents Fluid Loss
• Acrocyanosis
• Blueish Discoloration of Hands/Feet
• Considered Normal for First 24hrs
• Milia
• White Pinpoint Papules
• Sweat Glands on Nose; Infants Do NOT Sweat for First 24hrs
• Desquamation
• Peeling After a Few Days After Birth
• Presentation at Birth Indicates Post-Maturity
• Nevus Simplex [“Angel’s Kiss”]
• Salmon Patches, Stork Bites
• Pink Spots on Nape of Neck (Blanches Easily)
• Occurs on 80% of Newborns
• Mongolian Spots
• Bluish Black Pigmentation (Fades Over Time)
• Most Common on Back/Buttocks (More Common on Dark
Skin)
• Erythema Toxicum
• Newborn Rash
• Appears in First 24hrs (Can Last Up to 3 Weeks)
• Red Macules/Papules; Small Vesicles
• No Treatment Required
• Lanugo
• Fine Hairs on Body
• Often Disappear During First Week of Life
• More Commonly Found on Preterm Infants
• What are conditions that we may see on the genitalia of a newborn male, that
would need further evaluation/treatment?
• Genitalia Conditions (Newborn Male)
• Cryptorchidism (Undescended Testicles)
• Torsion (Bluish Discoloration of Scrotum)
• Hydrocele (Accumulation of Fluid Around Testicles)
• When there is swelling of the tissue on the head of a newborn, what are
the possible names of that swelling? What would it look like on
assessment? What complications could the swelling possibly cause?
• Head Swelling Conditions
, • Molding (NORMAL)
• Distorted Shape Due to Overlapping to Facilitate Delivery
• Caput Succedaneum (NORMAL)(“Like a Cap”)
• Edematous Area Over the Scalp
• Crosses Suture Lines
• Disappears in 3 – 4 Days
• Cephalhematoma
• Collection of Blood
• Does NOT Cross Suture Lines
• Hemolysis (Increases Risk of Hyperbilirubinemia)
• Fontanelles
• Depressed/Indented with Dehydration
• Bulging with Increased Cranial Pressure
• What would we assess in a newborn who is experiencing dehydration?
• Dehydration Assessment (Newborn)
• LOC; Skin (Cold/Clammy)
• O2 Saturation; Breath Sounds
• Pulses; Tissue Perfusion
• What problems might a newborn experience if they are born to a diabetic
mother who did not have glycemic control during her pregnancy?
• Issues with Poor Glycemic Control During Pregnancy
• Macrosomia (Enlarged Baby)
• Increased Risk for Birth Injuries
• More Susceptible to Hyperbilirubinemia and Hypoglycemia
• Higher Risk for Respiratory Distress Syndrome
• Excess Glucose in Utero Increased Insulin Production in Infant
• Decreases Amount of Surfactant for Lung Development
• When thinking through feeding a newborn, what aspects of feeding and
nutrition do we need to consider?
• Newborn Feeding/Nutrition
• Feeding Behaviors
• Responsive to Feeding Cues
• Suck, Breathe, Swallow
• Intestinal Microbiome
• Flora Established with First Week to Synthesize Vitamin K
• Breastfeeding Helps Develop
• Gastroesophageal Reflux [GER]
• Spitting Up
• Stools (pg 537, Box 22.1)
• Meconium (First Stool After Birth)
• Transitional
• Milk Stool (Appears by the 4th Day)
• Yellow Seedy with Breastfeeding
• We need to watch for intake and output with newborns. What are we
