Maternal Newborn VATI Questions and Answers Graded A

Maternal Newborn VATI Questions and Answers Graded A Maternal adaptation to pregnancy and the attainment of the maternal role—whereby the idea of pregnancy is accepted and assimilated into the client's way of life—includes hormonal and psychological aspects. ◯Emotional lability is experienced by many women with unpredictable mood changes and increased irritability, tearfulness, and anger alternating with feelings of joy and cheerfulness. This might result from hormonal changes. ◯A feeling of ambivalence about the pregnancy, which is a normal response, might occur early in the pregnancy and resolve before the third trimester. It consists of conflicting feelings (joy, pleasure, sorrow, hostility) about the pregnancy. These feelings can occur simultaneously, whether the pregnancy was planned or not. signs of gestational hypertension in 2nd and 3rd trimester ●Severe headaches ●Blurred vision ●Edema of face and hands ●Epigastric pain Oligohydramnios is associated with *renal agenesis *premature rupture of the intrauterine membranes *postdate pregnancy polyhydramnios is associated with Gastrointestinal malformations and neurologic disorders are expected findings for a fetus experiencing the effects of polyhydramnios. cause of late decelerations uteroplacental insufficiency Cause of variable decelerations umbilical cord compression teaching for a client who does not want to breastfeed -place ice packs on breasts -do not stand with breasts under hot water in shower -wear a well supporting, perfect fit bra (so breasts dont fill with milk) -drink 2-3 L of fluid a day signs of physical maturity in pre, post, and term babies Skin The skin ranges from translucent and friable in preterm newborns to leathery, cracked, and wrinkled in post-term newborns. Assess the skin for transparency, cracks, veins, peeling, and wrinkles. Lanugo Lanugo is very fine body hair. Extremely premature newborns have none. During the middle of the third trimester, most fetuses have plentiful lanugo. Closer to term, this body hair begins to thin. Terms newborns have very little, and it is nearly absent in post-term newborns. Plantar surface Inspect the plantar surface of the foot for creases. Term newborns have creases over the entire plantar surface, while the creases of a preterm newborn range from absent to faint red markings. Breast Inspect the breast to assess the size of the breast bud in millimeters and the development of the areola. Preterm newborns lack developed breast tissue. Term newborns have a raised to a full areola with breast buds that are 3 to 10 millimeters in diameter. Eye/ear The eye/ear assessment is an analysis of the ear cartilage and shape of the pinna. The pinna is less curved in preterm newborns, while term newborns have a well-curved pinna with firm cartilage. Determine ear recoil by folding the pinna down and assessing how quickly it returns to its previous position. Also, very preterm newborns may have fused eyelids. You'll score the degree of fusion for these newborns. Genitals Observe the genitals for physical maturity. With males, the testes usually descend near term and rugae (ridges or folds) are visible on the scrotum. Palpate the testes to determine if they have descended and note the rugae. With extreme prematurity, the scrotum is flat and smooth. With female newborns at term, the labia majora are larger than the clitoris and the labia minora. Preterm newborns (image on the right) have a prominent clitoris and small labia minora. Base your scores on the degree of development of the labia circumcision care -apply petroleum jelly to the penis for the first 24 hours to keep the diaper from adhering to the circumcision site. With the Plastibell method, petroleum jelly is unnecessary. -Administer acetaminophen (Tylenol) as needed for pain. -Cleanse the penis with warm water and apply the diaper loosely. Demonstrate this for the parents, and make sure they understand that they should not use soap or commercial cleansing wipes until the circumcision has healed (about 5 or 6 days later). -Caution them about the yellow exudate they may see on the glans after 24 hours and for the next 2 to 3 days. They should not remove it, as it is part of the healing process. -Tell them they may control minor bleeding with gentle pressure from a sterile gauze pad. If bleeding continues or if they notice redness, swelling, pus, or a foul odor, they should notify the provider. umbilical cord care -keep clean, dry, clean stump with water, watch swelling/redness/purulent d/c - fold diaper edge down to keep stump dry - will fall of after 10-14 days