NSPN 7100 (Obstetrics Medicine) LATEST
UPDATED STUDY GUIDE COMPLETE AND
VERIFIED RATED A.
A baby will feed most effectively when he/she is in which of the
following states?
Quiet alert
This hormone is responsible for the milk ejection reflex is
Oxytocin
The rate of milk synthesis is influenced by
Regular and thorough emptying of the breasts
Preterm infants who are fed human milk are less likely to develop
Necrotizing enterocolitis
When is the best time to establish the first feed?
In the first hour of life
This is shown to improve both breastfeeding initiation and duration rates
Unrestricted skin to skin contact
A weight loss of up to 8% in the first few days of life is
Acceptable
Most infant formulas are equivalent to breastmilk
False
Formula fed infants should be fed on a schedule versus on demand
False
,An infant who is actively rooting and searching for the breast is
demonstrating
Mid feeding cues
Due to immature sucking and poor milk transfer all late preterm infants
should receive formula supplementation
False
Approximately ______% of Canadian women initiate breastfeeding
90%
What kind of questions could you ask Marnie and Ted to assess their initial
adaptation to parenting?
A good opening question could be "tell me about your labour and birth? Was
it what you expected? Do you have any questions about the experience?" It
can also be helpful to specifically ask Ted, "and how was it for you?" This may
open up the conversation for the couple to express concerns or seek clarity
about why something happened.
In the first 24 hours postpartum, the maternal assessments include:
vital signs
fundus- position and tone
flow- amount, color, consistency
perineum- swelling, pain, stitches
bladder- voiding
bowel- last BM, does she need stool softener?
breasts
pain- perineal pain? Incisional pain post C/S
legs (for thrombosis)
nutrition and hydration
support systems
emotional status
readiness for self-care
,readiness for baby care
(Some nurses like to use the acronym BUBBLES when performing their
assessment. Breast, Uterus, Bowel, Bladder, Lochia, Episiotomy, and Supports.)
Maternal Vital Signs
The physiologic changes of pregnancy, mainly increased blood volume,
enable the woman to deal with the normal blood loss that occurs after birth.
Average blood loss for vaginal birth is 300-500 ml and for caesarean birth it
is 500-1000 ml. Vital signs may have slight variations in the immediate
postpartum period with heart rate elevation in the first hour, transient increase
in blood pressure in first few days' postpartum, and slight increase in
temperature during first 24 hours. These are normal findings that do not
require intervention.
Fundus/flow
Involution, the return of the uterus to pre-pregnant state, is assessed by
palpating the fundus and monitoring the vaginal flow. At the end of the third
stage of labour, the fundus should be approximately 2cm below the umbilicus
and midline. By 12 hours postpartum it can rise to 1cm above the umbilicus
then by 24 hours it should be at or just below the umbilicus. It should descend
by 1-2 cm every 24 hours
When the fundus is above the umbilicus and/or deviated to the right, it may
indicate a full bladder. A full bladder increases the risk of post-partum
hemorrhage (PPH) as the uterus is not able to contract efficiently
Uterine discharge is known as lochia and the amount and color changes
over time.
Lochia rubra: is dark red and lasts for 3-4 days
Lochia serosa: is pink or brown and lasts for 10-14 days
Lochia alba: is yellow to white and may last up to 4-8 weeks
Perineum
When assessing the perineum in the post-partum period, it is important to turn
the woman onto her side so that the entire perineum can be visualized. It may
, be useful to remember this acronym REEDA (Redness, Edema, Ecchymosis,
Discharge, and Approximation) when assessing tears or episiotomies.
Occasionally a woman may develop a pelvic hematoma. A hematoma is a
collection of blood in the connective tissue and it can be vulvar, vaginal, or
retroperitoneal in origin (Lowdermilk et al., 2016). If a woman reports
persistent perineal or rectal pain or a feeling of pressure in the vagina, the
primary care provider should be notified and a careful examination should be
performed. The hematoma may need to be surgically evacuated.
What kind of behaviours would you expect to see that would indicate a
positive attachment process?
Reaching out for the infant, talking to the infant, calling the infant by name,
smiling, kissing, and responding to crying by picking the infant up and
cuddling.
What nursing strategies can you use to support attachment?
Skin to skin care, acknowledging how the infant looks like one parent or the
other, saying things like "look how he/she turns his/her head when you speak.
Look how easily the baby settles in your arms." Encouraging the parents to
provide care such as bathing and changing diapers. Teaching the parents that
attachment is reciprocal; that the infant will want to be held close and
responding immediately to cries or fussiness builds trust and security.
Rubin include the 'taking-in', the 'taking hold', and the 'letting-go phases
of maternal role attainment.
The postpartum phases of psychological adjustment
Average Time Span
Taking In - 2 to 3 days
Taking hold -3-14 days
Letting go -15 days to 6 months
Dependence Continuum
UPDATED STUDY GUIDE COMPLETE AND
VERIFIED RATED A.
A baby will feed most effectively when he/she is in which of the
following states?
Quiet alert
This hormone is responsible for the milk ejection reflex is
Oxytocin
The rate of milk synthesis is influenced by
Regular and thorough emptying of the breasts
Preterm infants who are fed human milk are less likely to develop
Necrotizing enterocolitis
When is the best time to establish the first feed?
In the first hour of life
This is shown to improve both breastfeeding initiation and duration rates
Unrestricted skin to skin contact
A weight loss of up to 8% in the first few days of life is
Acceptable
Most infant formulas are equivalent to breastmilk
False
Formula fed infants should be fed on a schedule versus on demand
False
,An infant who is actively rooting and searching for the breast is
demonstrating
Mid feeding cues
Due to immature sucking and poor milk transfer all late preterm infants
should receive formula supplementation
False
Approximately ______% of Canadian women initiate breastfeeding
90%
What kind of questions could you ask Marnie and Ted to assess their initial
adaptation to parenting?
A good opening question could be "tell me about your labour and birth? Was
it what you expected? Do you have any questions about the experience?" It
can also be helpful to specifically ask Ted, "and how was it for you?" This may
open up the conversation for the couple to express concerns or seek clarity
about why something happened.
In the first 24 hours postpartum, the maternal assessments include:
vital signs
fundus- position and tone
flow- amount, color, consistency
perineum- swelling, pain, stitches
bladder- voiding
bowel- last BM, does she need stool softener?
breasts
pain- perineal pain? Incisional pain post C/S
legs (for thrombosis)
nutrition and hydration
support systems
emotional status
readiness for self-care
,readiness for baby care
(Some nurses like to use the acronym BUBBLES when performing their
assessment. Breast, Uterus, Bowel, Bladder, Lochia, Episiotomy, and Supports.)
Maternal Vital Signs
The physiologic changes of pregnancy, mainly increased blood volume,
enable the woman to deal with the normal blood loss that occurs after birth.
Average blood loss for vaginal birth is 300-500 ml and for caesarean birth it
is 500-1000 ml. Vital signs may have slight variations in the immediate
postpartum period with heart rate elevation in the first hour, transient increase
in blood pressure in first few days' postpartum, and slight increase in
temperature during first 24 hours. These are normal findings that do not
require intervention.
Fundus/flow
Involution, the return of the uterus to pre-pregnant state, is assessed by
palpating the fundus and monitoring the vaginal flow. At the end of the third
stage of labour, the fundus should be approximately 2cm below the umbilicus
and midline. By 12 hours postpartum it can rise to 1cm above the umbilicus
then by 24 hours it should be at or just below the umbilicus. It should descend
by 1-2 cm every 24 hours
When the fundus is above the umbilicus and/or deviated to the right, it may
indicate a full bladder. A full bladder increases the risk of post-partum
hemorrhage (PPH) as the uterus is not able to contract efficiently
Uterine discharge is known as lochia and the amount and color changes
over time.
Lochia rubra: is dark red and lasts for 3-4 days
Lochia serosa: is pink or brown and lasts for 10-14 days
Lochia alba: is yellow to white and may last up to 4-8 weeks
Perineum
When assessing the perineum in the post-partum period, it is important to turn
the woman onto her side so that the entire perineum can be visualized. It may
, be useful to remember this acronym REEDA (Redness, Edema, Ecchymosis,
Discharge, and Approximation) when assessing tears or episiotomies.
Occasionally a woman may develop a pelvic hematoma. A hematoma is a
collection of blood in the connective tissue and it can be vulvar, vaginal, or
retroperitoneal in origin (Lowdermilk et al., 2016). If a woman reports
persistent perineal or rectal pain or a feeling of pressure in the vagina, the
primary care provider should be notified and a careful examination should be
performed. The hematoma may need to be surgically evacuated.
What kind of behaviours would you expect to see that would indicate a
positive attachment process?
Reaching out for the infant, talking to the infant, calling the infant by name,
smiling, kissing, and responding to crying by picking the infant up and
cuddling.
What nursing strategies can you use to support attachment?
Skin to skin care, acknowledging how the infant looks like one parent or the
other, saying things like "look how he/she turns his/her head when you speak.
Look how easily the baby settles in your arms." Encouraging the parents to
provide care such as bathing and changing diapers. Teaching the parents that
attachment is reciprocal; that the infant will want to be held close and
responding immediately to cries or fussiness builds trust and security.
Rubin include the 'taking-in', the 'taking hold', and the 'letting-go phases
of maternal role attainment.
The postpartum phases of psychological adjustment
Average Time Span
Taking In - 2 to 3 days
Taking hold -3-14 days
Letting go -15 days to 6 months
Dependence Continuum
