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472 critical component intramuscular injections

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**Durham, p.472 critical component: Intramuscular injectionsPromoting parent-infant interaction**Durham, p.469 critical component: promoting parent-infant attachmentHepatitis B immunization before discharge
Physiologic JaundiceNormal processTherapy for hyperbilirubinemia**Hyperbilirubinemia is a condition that there is a high level of unconjugated bilirubin in the neonate’s bl r/t the immature liver function, high RBC countDue to:↑ hemolysis d/t the shorter life span of fetal RBCs (60-90 days)Slower uptake of bilirubin by the liverLack of intestinal bacteria: bilirubin is converted to urobilin by gut bacteriaPoorly established hydrationTotal bilirubin levels peak around 4−5 days after birthYellowish coloring of the skin and sclera d/t the deposit of bilirubin in tissuesPhototherapy: serum bilirubin levels by biliary excretion of unconjugated bilirubinFrom 2 Hours After BirthUntil Discharge: Common Problems
Phototherapy. Bilateral eye patches are always used during photo light therapy to protect the baby’s eyes.
Phototherapy: Nursing CareNursing InterventionRationaleRemove clothing except diaperMaximize skin exposureApply eye coveringsProtect infant's eyesAssess serum bilirubin levelsDetermine effectiveness of therapyMeasure irradiance levelsMaintain desired irradiance levelReposition infant every 2 hoursExpose different areas, preventpressure areas, vary infant stimulationMaintain adequate nutrition/hydrationPrevent dehydrationExamine skinDetect pressure areas, bronzing, rash,and changes in jaundiceAllow parents to hold childPrevent anxiety
From 2 Hours After BirthUntil Discharge: Common ProblemsHypoglycemiaPlasma glucose concentration less than 40 mg/dLRisk factorsPreterm/postterm infants, infant of diabetic mother, SGA/LGA infant, respiratory distress, hypothermiaClinical manifestationsLethargy, Poor feeding/ sucking, Pallor/ cyanosis, Hypothermia, Respiratory distress, Tremors, seizure activity, High-pitched cryRoutine screening for all at-risk infantsEarly feedings5% or 10% dextrose by oral or IV**Durham, p.447-448 critical component: hypoglycemia
From 2 Hours After BirthUntil Discharge: Common ProblemsCircumcisionRecommendationsParental decisionsCare of the newly circumcised infantCleanse the penis gently with water and put petroleum jelly around the glans after each diaper change**Durham, p.474 Box 15-3: ASPMN position statement: Male infant circumcision pain management
NCLEX review question #1Signs of bladder distention during the first 12 hours postpartum include which of the following? Select all that apply.A. Firm uterusB. Uterus displaced to right of umbilicus C. Increased lochiaD. Fundus located at 2 cm below the umbilicus
NCLEX review question #1: AnswerB and C
NCLEX review question #2Your patient is a 22-year-old woman who gave birth to her first child 12 hours ago. You would expect her fundus to be located ______.

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Term
Fall
Professor
WASHINGTON
Tags
Obstetrics, Oxytocin, Hemorrhoids, Estrogen

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