TEST BANK For Olds' Maternal-Newborn Nursing &
Women's Health Across the Lifespan 12th Edition by
Davidson & Ladewig
Physiologic hyperbilirubinemia - ANSWER: caused by a mild elevation of bilirubin and
is not usually harmful to infants. It affects nearly all newborns, develops between 72
and 96 hours after birth, and usually goes away by one to two weeks after birth.
Infants who are born at 35 to 37 weeks of gestation, or who are Asian, may require
more time to resolve.
Hemolytic hyperbilirubinemia - ANSWER: Caused by blood/antigen incompatibility,
with onset in the first 24 hours. Rarely requires any treatment but phototherapy
Breastfeeding associated jaundice - ANSWER: hyperbilirubinemia that begins at 2 to
5 days of life; associated with insufficient breastfeeding and infrequent stooling
breastmilk jaundice - ANSWER: begins 4-7 days after birth
peaks 10-14 days after birth
glucuronidase present in breast milk converts conjugates bili to unconjugated bili
can persist for up to 12 weeks
rarely does bili levels reach concerning levels
Phototherapy and exchange transfusion - ANSWER: treatment of hyperbilirubinemia
Neonatal hypoglycemia - ANSWER: is low blood sugar of 30 or less during the first
day after birth or below 45 thereafter, and is often related to preterm birth, SGA, or
LGA
Occurs in 1-3 out of every 1,000 births
Half of hypoglycemic neonates develop brain damage
Suspect hypoglycemia in these circumstances - ANSWER: -Elevated insulin levels in
the infant with a brittle diabetic mother
-septic shock
-hyperthyroidism
-inadequate glucose store in malnourished infants and poor feeders
-hypoxemia or ischemia
-ingestion of alcohol, beta blockers or salicylates
-hyperinsulinism
Treatment for hyperinsulinism - ANSWER: 5 - 15mg/kg/day of oral diazoxide if
ineffective partial pancreatectomy is required
,Multiple birth complications
Fetal/neonatal - ANSWER: -increase incidence of spontaneous abortion and neonatal
death
-risk of cerebral palsy correlating with decreased gestational age
-increased risk of IUGR
-increased incidence of respiratory distress syndrome, necrotizing enterocolitis,
intraventricular hemorrhage, retinopathy of prematurity, and patent ductus
arteriosus
Multiple birth complications
Maternal - ANSWER: -Severe HTN/ Preeclampsia
-Anemia
-Preterm Delivery
-Increased risk of C-section
Supplementary or Complementary Feeding - ANSWER: usually discouraged if
breastfeeding is not well established, introduce by week four. Breastfeeding vs bottle
feeding the latch is different. Breastfeeding the tongue moves front to back and
bottle feeding the tongue moves up and down squeezing the nipple.
nipple shield - ANSWER: silicone cover for the nipple that may help with
breastfeeding issues. Should not be used for nipple soreness if tolerable. Should only
be used for short term use, wean from shield. Nipple will usually elongate during this
time
Supplemental nursing system - ANSWER: allow the mother to provide supplemental
nutrients or medication to the infant while breastfeeding. Typical system has a
container for the liquid supplement and a tubing system with a tubing clamp
Breastmilk storage guidelines - ANSWER: •Discard partial feeding after 1-2 hours
•On the counter for 4 hours
•In the fridge for 4 days
•In the freezer for 3-6 months
•In the deep freezer up to 12 months
bottle feeding - ANSWER: May be a needed supplement for preterm babies
Special-needs formulas available
Can be high quality
Allows more paternal participation
Calories
Vitamins
Proteins
Iron Supplementation
Infant Formulaa - ANSWER: Cow milk based formulas- Enfamil, Similac, Good Start
, Soy Based- Isomil, Soyalac, ProSobee, Nursoy
Therapeutic- Nutramigen, Pregestimil
Formula required for neonates - ANSWER: Approximately 2.5 ounces of formula for
each pound of weight within each 24 hour period
Pros of Soy Formula - ANSWER: galactosemia
lactase deficiency
IgE-mediated allergy to cows milk protein
Temporary lactase deficiency that may occur after infectious gastroenteritis
Parents seeking vegetarian diet
Cons of Soy Formula - ANSWER: Less weight gain
Less linear growth
Increased risk for osteoporosis
elevated levels of alkaline phosphate
elevated levels of aluminum
Five stages of grief - ANSWER: denial, anger, bargaining, depression, acceptance
Maternal complications
Hemorrhage - ANSWER: Vaginal delivery >500mL
C-section delivery >1000mL
increased pulse, decreased BP, and decreased urine output
>10 point drop in HCT
Early hemorrhage more risk of mortality than late hemorrhage
Causes of postpartum hemorrhage (Early) - ANSWER: Most common uterine atony
(multiple gestations, prolonged labor, labor induction, anesthesia, preeclampsia and
placental previa)
Genital Lacerations/Episiotomy
Uterine inversion
Rupture of uterus
Coagulation disorders
Hematomas of the vulva, vagina, or subperitoneal areas
Causes of postpartum hemorrhage (Late) - ANSWER: Subinvolution of placental
implantation site- leaves open tissue that may bleed
Retained placental tissue- bleeding occurs when it sloughs from implantation site
thrombophlebitis - ANSWER: Clot formation occurs in the vessel walls, leading to
occlusion and inflammation
Femoral thrombophlebitis - ANSWER: s/sx: malaise, chills and fever,diminished
peripheral pulses, shiny white skin over affected area, and pain, stiffness, and
swelling of affected leg
Women's Health Across the Lifespan 12th Edition by
Davidson & Ladewig
Physiologic hyperbilirubinemia - ANSWER: caused by a mild elevation of bilirubin and
is not usually harmful to infants. It affects nearly all newborns, develops between 72
and 96 hours after birth, and usually goes away by one to two weeks after birth.
Infants who are born at 35 to 37 weeks of gestation, or who are Asian, may require
more time to resolve.
Hemolytic hyperbilirubinemia - ANSWER: Caused by blood/antigen incompatibility,
with onset in the first 24 hours. Rarely requires any treatment but phototherapy
Breastfeeding associated jaundice - ANSWER: hyperbilirubinemia that begins at 2 to
5 days of life; associated with insufficient breastfeeding and infrequent stooling
breastmilk jaundice - ANSWER: begins 4-7 days after birth
peaks 10-14 days after birth
glucuronidase present in breast milk converts conjugates bili to unconjugated bili
can persist for up to 12 weeks
rarely does bili levels reach concerning levels
Phototherapy and exchange transfusion - ANSWER: treatment of hyperbilirubinemia
Neonatal hypoglycemia - ANSWER: is low blood sugar of 30 or less during the first
day after birth or below 45 thereafter, and is often related to preterm birth, SGA, or
LGA
Occurs in 1-3 out of every 1,000 births
Half of hypoglycemic neonates develop brain damage
Suspect hypoglycemia in these circumstances - ANSWER: -Elevated insulin levels in
the infant with a brittle diabetic mother
-septic shock
-hyperthyroidism
-inadequate glucose store in malnourished infants and poor feeders
-hypoxemia or ischemia
-ingestion of alcohol, beta blockers or salicylates
-hyperinsulinism
Treatment for hyperinsulinism - ANSWER: 5 - 15mg/kg/day of oral diazoxide if
ineffective partial pancreatectomy is required
,Multiple birth complications
Fetal/neonatal - ANSWER: -increase incidence of spontaneous abortion and neonatal
death
-risk of cerebral palsy correlating with decreased gestational age
-increased risk of IUGR
-increased incidence of respiratory distress syndrome, necrotizing enterocolitis,
intraventricular hemorrhage, retinopathy of prematurity, and patent ductus
arteriosus
Multiple birth complications
Maternal - ANSWER: -Severe HTN/ Preeclampsia
-Anemia
-Preterm Delivery
-Increased risk of C-section
Supplementary or Complementary Feeding - ANSWER: usually discouraged if
breastfeeding is not well established, introduce by week four. Breastfeeding vs bottle
feeding the latch is different. Breastfeeding the tongue moves front to back and
bottle feeding the tongue moves up and down squeezing the nipple.
nipple shield - ANSWER: silicone cover for the nipple that may help with
breastfeeding issues. Should not be used for nipple soreness if tolerable. Should only
be used for short term use, wean from shield. Nipple will usually elongate during this
time
Supplemental nursing system - ANSWER: allow the mother to provide supplemental
nutrients or medication to the infant while breastfeeding. Typical system has a
container for the liquid supplement and a tubing system with a tubing clamp
Breastmilk storage guidelines - ANSWER: •Discard partial feeding after 1-2 hours
•On the counter for 4 hours
•In the fridge for 4 days
•In the freezer for 3-6 months
•In the deep freezer up to 12 months
bottle feeding - ANSWER: May be a needed supplement for preterm babies
Special-needs formulas available
Can be high quality
Allows more paternal participation
Calories
Vitamins
Proteins
Iron Supplementation
Infant Formulaa - ANSWER: Cow milk based formulas- Enfamil, Similac, Good Start
, Soy Based- Isomil, Soyalac, ProSobee, Nursoy
Therapeutic- Nutramigen, Pregestimil
Formula required for neonates - ANSWER: Approximately 2.5 ounces of formula for
each pound of weight within each 24 hour period
Pros of Soy Formula - ANSWER: galactosemia
lactase deficiency
IgE-mediated allergy to cows milk protein
Temporary lactase deficiency that may occur after infectious gastroenteritis
Parents seeking vegetarian diet
Cons of Soy Formula - ANSWER: Less weight gain
Less linear growth
Increased risk for osteoporosis
elevated levels of alkaline phosphate
elevated levels of aluminum
Five stages of grief - ANSWER: denial, anger, bargaining, depression, acceptance
Maternal complications
Hemorrhage - ANSWER: Vaginal delivery >500mL
C-section delivery >1000mL
increased pulse, decreased BP, and decreased urine output
>10 point drop in HCT
Early hemorrhage more risk of mortality than late hemorrhage
Causes of postpartum hemorrhage (Early) - ANSWER: Most common uterine atony
(multiple gestations, prolonged labor, labor induction, anesthesia, preeclampsia and
placental previa)
Genital Lacerations/Episiotomy
Uterine inversion
Rupture of uterus
Coagulation disorders
Hematomas of the vulva, vagina, or subperitoneal areas
Causes of postpartum hemorrhage (Late) - ANSWER: Subinvolution of placental
implantation site- leaves open tissue that may bleed
Retained placental tissue- bleeding occurs when it sloughs from implantation site
thrombophlebitis - ANSWER: Clot formation occurs in the vessel walls, leading to
occlusion and inflammation
Femoral thrombophlebitis - ANSWER: s/sx: malaise, chills and fever,diminished
peripheral pulses, shiny white skin over affected area, and pain, stiffness, and
swelling of affected leg
