PEDS: 4-22-09 ch 9

-a slow constant trickle of blood indicated a cervical /vaginal bleeding, not lochia

-emotionaly readiness is important when have intercourse for the first time

-bradycardia is usually gone after 48 hours of birth

-uterine atony- mean uterine tone-uterine bleeding

-if MOM is RH – and baby is RH - there is NO problem

- if MOM is RH - and baby is RH+, MOM needs to receive Rhogam within 72 hours of birth.

How it works- when giving birth, or other traumas or procedures such as amniocenteses, tear of placenta, transplant organs, corianic villi sampling, bleeding related to placenta, the babies blood can go into mothers circulation causing the mother to form antibodies that fight the baby’s blood type (rh +). If this happens when the baby is still in the mothers body, it can cause erythro blastosis fetalis which is fetus RBC breakdown and even miscarriage. If the crossover of blood occurs at the time of birth, the mother will receive the vaccine so her blood does not form antibodies against that blood type, so it will not affect subsequent pregnancies.

-at 28 wks gestation the coombs testing can be done to detect mother antibodies and baby

RUBELLA- can mess with hearing, visions, and brain. Need to isolate mother that is pregnant if there is an outbreak. After birth, give rubella right away, it does not go into breast milk.

TAKING IN- mother is focused more on self and is not worried about the baby. Knows that baby is being taken care of.

TAKING HOLD- mom takes charge of baby and bonds

LETTING GO- lets go of freedom, previous fantasies of perfect baby and focuses on reality.

MENTAL HEALTH (GROUPS)

Self help- some examples in hospitals- groups where people cope with emotional impact of disease/illness, diabetes, Alzheimer’s.

Groups size- up t0 12 can be okay, depends on how the group interacts.

Open ended membership- participation may vary

Close- no people coming and going

Initial orientation phase- key point is promoting trust by making rules and norms

-conflict in healthy for groups if resolved

AUTOCRATIC – leadership is kind of like military, rigid and authoritarian. Low morale and high productivity

DEMOCRATIC- focus on group members and gets needs met. Low productivity, high morale

LAISSEZ FAIRE- low productivity, low morale. Bad kind of group

LPN FUNTIONS IN IN MENTAL HEALTH- variable according to locations and customs. Meds primarily.

TEST REVIEW-

Lots of questions on defense mechanisms, coping, basic communication.

Blocks to communication- the word why? If it begins with how, it may be right.

Dissociation

-if crisis is not resolved in earlier phase it will become worse

-past history of violence is the most important factor in determining present situaino

Roles of nurses-

Meds

Development of relationships

Setting limits on what is unacceptable

Client education

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