| Pain Management | Discharge Planning/Teaching | Post-Partum Assessment | Pregnancy Complications | Newborn Assessment |
|---|---|---|---|---|
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Naproxen and Tylenol
These are the two most common PO analgesics given on the MBU for discomfort post vaginal delivery
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Health links and public health
Your patient is concerned about who she can call if she has a question after they are discharged: what are two resources you can refer your patient to if they have any questions
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Swelling and tenderness to perineum, sutures intact
Your patient delivered vaginally 24 hours ago with a second degree tear. What findings can you expect when assessing her perineum?
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Glucose tolerance test
What test is conducted between 24-28 weeks gestation to assess for gestational diabetes
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Birth, hr 1, hr 2, hr 3, PRN
Your newborn patient was safely delivered at term with no complications in pregnancy or delivery. How frequently should you be assessing vitals on this baby?
|
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Fentanyl and Bupivacaine
What are the two primary medications used in an epidural during labour?
|
Carseat
Your patient is ready for discharge! What is the one piece of equipment your patient is required to have to bring home her baby?
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Reassurance: clots the size of a plum or larger may need intervention. Ensure clots are blood and not tissue
Your 24 hour post vaginal delivery patient calls you to her bathroom because she has passed two toonie sized clots and she is very concerned: what do you do?
|
Placenta previa: risk for significant bleeding if cervix dilates. ++ emergency if patient with placenta previa presents in labour. *no prenatal care risk
Name the term for a placenta that has implanted close to or over the cervix and why a c-section is necessary for these patients
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frontal and posterior are soft and level
How would you describe a normal newborn’s fontanelles?
|
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hydrotherapy, heat, movement/position changes, massage, aromatherapy, TENS
Name a non-pharmacological technique that can be used for pain management during labour
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Alone in crib or bassinet, flat surface with tight fitted sheet, no blankets or stuffed animals
You are discussing with your patient her plan for safe sleep for her newborn at home. What sleeping set up would your patient describe to demonstrate understanding of safe sleep.
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Foley catheter insitu. 12-24 hours post op foley comes out, patient due to void 6 hours post removal
You receive a new admission who had a c-section delivery with no complications. What urinary device can you expect to find, and what are your elimination goals for this patient?
|
KEEP YOUR HAND IN and hold head of baby off cord. Call for help immediately. Prepare for c-section
Your patient describes increased pressure in her perineum. You check her cervix and feel the umbilical cord protruding through the cervix: what is your next step?
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Sclera, mucus membranes, torso when skin blanched
What areas of the body is jaundice most noticeable in a newborn?
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risk for constipation, narcotic presence in breastmilk, drowsiness from narcotics
A patient is prescribed T3s post c-section for pain management: name two important patient teaching points
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Transcutaneous bilirubinometer (TCB)
What non-invasive test is performed on newborns to ensure the baby is not experiencing jaundice
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Assess for effective latch when breast feeding. Can provide lanolin, cool compresses
Your patient is describing discomfort to her nipples, you notice they are significantly reddened and have tiny blisters. What should you assess and what comfort measures can you provide
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Dark stools and constipation are normal while on iron supplements: expected finding for this patient
Your patient was diagnosed with anemia during pregnancy and has been complaining of dark stools and constipation. What do you tell this patient?
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Explain to parents this is a normal finding in a newborn (acrocyanosis) and will resolve as the infant's circulation develops
You are performing your newborn patient’s first bath and notice a blueish tinge to her hands and feet and around her lips, however not to her mucus membranes. What do you do?
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Nitrous oxide or fentanyl
A patient has declined analgesia throughout labour, however when she reaches 9cms dilation begins requesting pain meds. What is the best option for pain management for this patient?
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<8-10%
What is the acceptable percentage of weight loss for a newborn for safe discharge?
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Baby blues vs PPD. Assess for supports in the community. ? social work involvement or prioritize public health referral
You notice your patient is frequently tearful, asking a significant number of questions/looking for + frequent reassurance, and has been alone for her entire hospital stay. What concerns might you have for this patient?
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Blood pressure and presence of protein in urine. Concerned for Preeclampsia
A patient presents to women’s triage who is 32 weeks gestation with complaints of headache, dizziness, and new onset swelling to lower extremities. What do you assess first and what are you concerned about?
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Weight gain, appropriate urine output. For high risk babies, they can be weighed pre and post feeds (1 gram weight increase=1mL breastmilk consumed)
A breast-feeding Mom is wondering how she knows her baby is getting enough breastmilk- name two indicators that the baby is receiving adequate nutrition
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