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NR 327 Exam 3 with complete verified solutions 2025
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NR 327 Exam 3 with complete verified solutions 2025
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NR 327 Exam 3 with completeverified solutions 2025
Atony - answer •Lack of muscle tone that results in failure of the
uterine muscle fibers to contract firmly around blood vessels when
the placenta separates. The relaxed muscles allow rapid bleeding
from the endometrial arteries at the placental sire, bleeding
continues until the uterine muscle fibers contract to stop the flow of
blood.
•Risks: overdistention of the uterus from any cause (multiple
gestations, large infant, or
hydramnios) makes it more difficult for the uterus to contract with
enough firmness to prevent excessive bleeding. Multiparity results
in muscle fibers that have been stretched repeatedly and these
flaccid muscle fibers may not remain contracted after birth.
Intrapartum factors include contractions that were barley effective,
resulting in prolonged labor, contractions that were excessively
vigorous, resulting in precipitate labor and labor that was induced
or augmented with oxytocin. Retention of a large segment of the
placenta does not allow the uterus to contract firmly and therefore
can result in uterine atony
•Manifestations: uterine fundus that is difficult to locate, soft or
boggy feel when the fundus is located, uterus that becomes form as
it is massaged but loses its tone when massage is stopped, fundus
that is located above the expected level, excessive lochia especially
if it is bright red, excessive clots expelled with or without massage,
saturation of one peripad in 15 minutes.
Surfactant - answer Surfactant is a complex substance containing
phospholipids and a number of apoproteins. This fluid is produced
by the Type II alveolar cells, and lines the alveoli and smallest
bronchioles. Surfactant reduces surface tension throughout the
lung. It is also important because it stabilizes the alveoli.That is, at
,a constant surface tension, small alveoli will generate bigger
pressures within them than will large alveoli. Smaller alveoli would
therefore be expected to empty into larger alveoli as lung volume
decreases. This does not occur, however, because surfactant
differentiallyreduces surface tension, leading to alveolar stability
and reducing the likelihood of alveolar collapse. If the lungs did not
secrete surfactant, this surface tension would be much higher and it
would not be able to inflate normally.Surfactant is formed relatively
late in fetal life; thus premature infants born without adequate
amounts experience respiratory distress syndrome which is caused
by lack of surfactant and may die. It is commonly suffered by
premature babies born before 28-32 weeks of gestation.
With a normal delivery and healthy baby -how often should APGAR
scores be taken? - answer At birth and again at five minutes
What does APGAR assess? - answer COLOUR, HEARTRATE,
GRIMACE, ACTIVITY, RESPIRATIONS
Newborn Characteristics that lead to Heat Loss - answer *Thin Skin
*Blood vessels close to the surface
Little subcutaneous fat so little insulation Preterms even less
*Newborns have 3x more body surface area vs. their weight
compared with adults
*Lose heat 4x faster than adults
*Cannot shiver like adults
Term newborns flex to conserve heat Preterms can't flex so lose
heat
Methods of Heat Loss - answer Evaporation
Conduction
Convection
Radiation
,Methods of Heat Loss
Evaporation - answer Definition:
Wet surfaces exposed to air
Occurs:
*Immediately p birth
*During baths
Prevention:
*Dry quickly, wrap, and place hat on baby at birth
*During baths wrap baby while washing head
*Wrap and hat baby p bath to allow baby temperature to stabalize
Methods of Heat Loss
Conduction - answer Definition:
Loss of heat via direct contact with cold surface
Occurs:
*Scales, NIC Bed, Warmer not preheated at birth, Cold stethoscopes,
Cold hands
Prevention:
*Prewarm Warmer Unit at birth
*Place blanket on cold scale and zero out
*Warm Stethoscope and hands
Methods of Heat Loss
, Convection - answer Definition:
Loss of heat from body surface to cooler air currents
Occurs:
*Removal from incubator for procedures
*Ceiling air vents, drafty doorways or windows
*Oxygen unheated or moisturized
Prevention:
Perform necessary procedures efficiently, Keep baby well wrapped &
capped, Moisturize & heat O2
Methods of Heat Loss
Radiation - answer Definition:
Loss of heat via transfer of heat from body surface to cooler
surfaces and objects not in direct contact with the body
Occurs:
*Walls of a room, a window, even an incubator, ice for blood draws
Prevention:
*Line incubator with blanket to insulate from incubator side
*Keep away from drafts and walls
special features of brown fat (5) - answer brown color
principal function
sympathetic innervation
use of uncoupling protien 1
found more in newborns than in adults
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