Maternal Nursing Bullets

• The narrowest diameter of the pelvic inlet is the anteroposterior (diagonal conjugate).
• The chorion is the outermost extraembryonic membrane that gives rise to the placenta.
• The corpus luteum secretes large quantities of progesterone.
• From the 8th week of gestation through delivery, the developing cells are known as a fetus.
• In an incomplete abortion, the fetus is expelled, but parts of the placenta and membrane remain in the uterus.
• The circumference of a neonate’s head is normally 2 to 3 cm greater than the circumference of the chest.
• After administering magnesium sulfate to a pregnant patient for hypertension or preterm labor, the nurse should monitor the respiratory rate and deep tendon reflexes.
• During the first hour after birth (the period of reactivity), the neonate is alert and awake.
• When a pregnant patient has undiagnosed vaginal bleeding, vaginal examination should be avoided until ultrasonography rules out placenta previa.
• After delivery, the first nursing action is to establish the neonate’s airway.
• Nursing interventions for a patient with placenta previa include positioning the patient on her left side for maximum fetal perfusion, monitoring fetal heart tones, and administering I.V. fluids and oxygen, as ordered.
• The specific gravity of a neonate’s urine is 1.003 to 1.030. A lower specific gravity suggests overhydration; a higher one suggests dehydration.
• The neonatal period extends from birth to day 28. It’s also called the first 4 weeks or first month of life.
• A woman who is breast-feeding should rub a mild emollient cream or a few drops of breast milk (or colostrum) on the nipples after each feeding. She should let the breasts air-dry to prevent them from cracking.
• Breast-feeding mothers should increase their fluid intake to 2½ to 3 qt (2,500 to 3,000 ml) daily.
• After feeding an infant with a cleft lip or palate, the nurse should rinse the infant’s mouth with sterile water.
• The nurse instills erythromycin in a neonate’s eyes primarily to prevent blindness caused by gonorrhea or chlamydia.
• Human immunodeficiency virus (HIV) has been cultured in breast milk and can be transmitted by an HIV-positive mother who breast-feeds her infant.
• A fever in the first 24 hours postpartum is most likely caused by dehydration rather than infection.
• Preterm neonates or neonates who can’t maintain a skin temperature of at least 97.6° F (36.4° C) should receive care in an incubator (Isolette) or a radiant warmer. In a radiant warmer, a heat-sensitive probe taped to the neonate’s skin activates the heater unit automatically to maintain the desired temperature.
• During labor, the resting phase between contractions is at least 30 seconds.
• Lochia rubra is the vaginal discharge of almost pure blood that occurs during the first few days after childbirth.
• Lochia serosa is the serous vaginal discharge that occurs 4 to 7 days after childbirth.
• Lochia alba is the vaginal discharge of decreased blood and increased leukocytes that’s the final stage of lochia. It occurs 7 to 10 days after childbirth.
• Colostrum, the precursor of milk, is the first secretion from the breasts after delivery.
• The length of the uterus increases from 2½” (6.3 cm) before pregnancy to 12½” (32 cm) at term.
• To estimate the true conjugate (the smallest inlet measurement of the pelvis), deduct 1.5 cm from the diagonal conjugate (usually 12 cm). A true conjugate of 10.5 cm enables the fetal head (usually 10 cm) to pass.
• The smallest outlet measurement of the pelvis is the intertuberous diameter, which is the transverse diameter between the ischial tuberosities.
• Electronic fetal monitoring is used to assess fetal well-being during labor. If compromised fetal status is suspected, fetal blood pH may be evaluated by obtaining a scalp sample.
• In an emergency delivery, enough pressure should be applied to the emerging fetus’s head to guide the descent and prevent a rapid change in pressure within the molded fetal skull.
• After delivery, a multiparous woman is more susceptible to bleeding than a primiparous woman because her uterine muscles may be overstretched and may not contract efficiently.
• Neonates who are delivered by cesarean birth have a higher incidence of respiratory distress syndrome.
• The nurse should suggest ambulation to a postpartum patient who has gas pain and flatulence.
• Massaging the uterus helps to stimulate contractions after the placenta is delivered.
• When providing phototherapy to a neonate, the nurse should cover the neonate’s eyes and genital area.
• The narcotic antagonist naloxone (Narcan) may be given to a neonate to correct respiratory depression caused by narcotic administration to the mother during labor.
• In a neonate, symptoms of respiratory distress syndrome include expiratory grunting or whining, sandpaper breath sounds, and seesaw retractions.
• Cerebral palsy presents as asymmetrical movement, irritability, and excessive, feeble crying in a long, thin infant.
• The nurse should assess a breech-birth neonate for hydrocephalus, hematomas, fractures, and other anomalies caused by birth trauma.
• When a patient is admitted to the unit in active labor, the nurse’s first action is to listen for fetal heart tones.
• In a neonate, long, brittle fingernails are a sign of postmaturity.
• Desquamation (skin peeling) is common in postmature neonates.
• A mother should allow her infant to breast-feed until the infant is satisfied. The time may vary from 5 to 20 minutes.
• Nitrazine paper is used to test the pH of vaginal discharge to determine the presence of amniotic fluid.
• A pregnant patient normally gains 2 to 5 lb (1 to 2.5 kg) during the first trimester and slightly less than 1 lb (0.5 kg) per week during the last two trimesters.
• Neonatal jaundice in the first 24 hours after birth is known as pathological jaundice and is a sign of erythroblastosis fetalis.
• A classic difference between abruptio placentae and placenta previa is the degree of pain. Abruptio placentae causes pain, whereas placenta previa causes painless bleeding.
• Because a major role of the placenta is to function as a fetal lung, any condition that interrupts normal blood flow to or from the placenta increases fetal partial pressure of arterial carbon dioxide and decreases fetal pH.
• Precipitate labor lasts for approximately 3 hours and ends with delivery of the neonate
• Methylergonovine (Methergine) is an oxytocic agent used to prevent and treat postpartum hemorrhage caused by uterine atony or subinvolution.
• As emergency treatment for excessive uterine bleeding, 0.2 mg of methylergonovine (Methergine) is injected I.V. over 1 minute while the patient’s blood pressure and uterine contractions are monitored.

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