Level 1 perinatal care
§ lowest LVL of care, basic community hospital taking care of healthy moms and babies
-can provide neonatal resuscitation at
... [Show More] every delivery; evaluate and provide postnatal care to healthy newborn infants; stabilize and provide care for infants born at 35-37 weeks GA who remain physiologically stable; and stabilize newborns who are ill or less than 35 weeks until transfer to another facility
Level 2 perinatal care
§ Can take care of moms at level 1 , but able to manage small complication of baby. Doesn't need intubation but can do minor respiratory support
AKA special care nurseries and REQ'd to hae pediatric hospitalists, neonatologists and prenatal NP's in addition to level 1 HCP's
stabalize infants born before 32 weeks and weighiing less than 1500g until transfer to a NICU
Level 3 perinatal care (NICU)
§ Can take care of level 1 and 2 but can provide more intense supportive care.
NICU are able to
-provide sustained life support
-provide comprehensive care for infants born at all GA's and birth weights w/ critical illness
-offer prompt access to full range of pediatric specialists
-perform advanced imaging and interpretation on an urgent basis including CT, MRI and ECG
Level 4 perinatal care
§ THighest level of NIC provided -they could handle rare cardiac defects and need a specialized surgery such as surgical repair of complex congenital or acquired conditions
-full range of pediatric medical subspecialists
-provide ECMO (extracorporeal membrane Oxygenation)
Gravida/Para
# of pregnancies, # of live births
Nulliparous
female who has borne no offspring
multiparous
a woman who has given birth two or more times
multigravida
woman who has been pregnant more than once
grand multiparous
>6 deliveries
Preterm
20-37 weeks gestation
-latepreterm is 34-36 6/7
Term pregnancy
38-42 weeks
-37-39 (early term)
-39-41 (full term)
-41-42 *(late term)
Puerperal
pertaining to (immediately after) childbirth
puerperium
period from delivery until the reproductive organs return to normal
BUBBELE
Breasts
Uterus
Bladder
Bowels, Lochia
Episiotomy (incision at the perineum)
Lower extremities
Emotional Status
cultural competence
-providing services, support and assistance
-responsive to beliefs, interpersonal styles, attitudes, language and behaviors of individuals with greatest likelihood of ensuring maximum acceptance and participation
Cultural Assessment techniques
-use conversational approach
-open ended questions
-integrate cultural and childbearing assessments
-listen with interest
-nonjudgemental
Goal of maternity staff
-meaningful experience for childbearing family
-ensure health of mother & child
-birth is significant life event
-honor birth wishes of couple
-family centered care respets autonomy to family members, approaches childbirth decisions in nonjudgemental manner
-focus: teach new mother self/infant care
Ethical issues in maternity nursing (3)
-informed consent
-right to privacy
-confidentiality
ex: maternal/fetal conflict, abortion, fetal research, assisted reproductive technology, embryonic stem cell research, human genome project
Intepreters
-communicate verbally (female and not a family member)
-can work w/ written communication
-maintain strict confidentiality
-do not paraphrase
-use translator phone
Normal Newborn
§ In a state of adjustment from intrauterine life to external uterine life
§ Adaption and changes are profound.
§ Body systems are changing.
§ Way they receive and process O2 changes circulatory system.
Neonatal period
first 28 days of life
transitional period after birth lasts??
lasting 6-8 hours after birth (unstable time)
Apgar scale
a standard measurement system that looks for a variety of indications of good health in newborns
-§ Done at 1 and 5 minutes, if not acceptable it is repeated at 10 Mn intervals if first 2 scores are not good.
-color, HR, respiration, reflex response, muscle tone
APGAR components
Appearance (skin color, want pink baby)
Pulse (want > 100)
Grimace (want cry or pull away)
Activity (want flexing arms and legs resisting extension)
Respiration (want strong cry)
0-3 APGAR
severe distress, needs resuscitation [Show Less]