Postnatal Quiz Q and A (Aug 2008)

ollybolly · #1 (**permalink**) 07-Aug-2008, 20:07

Thanks to all those who took part in the quiz, we hope you enjoyed it. For those that missed it, here are the question and answers for you:

1.When is the heel prick test done and what does it screen for?
Answer – Around day 5-7, its tests for Phenylketonuria, Congenital hypothyroidism, Sickle Cell disorders, Cystic fibrosis

2.What is a lotus birth?
Answer - lotus birth is the nonseverence of the umbilical cord. It is the practice of leaving the umbilical cord uncut, so that the baby remains attached to their placenta until the cord separates at the umbilicus exactly as a cut cord does at 3 to 10 days after birth, but naturally. This prolonged contact can be seen as a time of transition, allowing the baby to slowly and gently let go of his/her attachment to the mother's body.

The placenta is left to drain then wrapped in a cotton cloth and placed in a placenta bag, usually handmade. It is then carried with the baby until it seperates naturally. The placenta can be treated every 24 hours with salt and lavender oil.

3) What is checked during the mother’s postnatal check?
Answer - BP (if indicated), Temp, Pulse, PU’d, BO, breasts, uterus, perineum, Lochia, general wellbeing etc

4) What is checked during the neonate’s postnatal check?
Answer – colour, feeding, PU’d, BO, colour of stools, eyes, mouth etc

5) What is the definition of the involution of the uterus?
Answer - The return of the uterus to its pre-pregnant size, tone, and position.

6.) Name 5 things that are examined/checked/looked for on the initial examination of the newborn?
Answer – Any of the following: colour, resp rate, muscle tone & symmetry of movement, head – size, shape, symmetry, suture lines, fontanelles. Eyes – symmetry, clear, oedema, bruising, haemorrhage, spacing. Ears – symmetry, low set? Associated with downs, skin tags. Mouth – palate arched and intact, ?teeth, tongue tie. Chest – spacing and position of the nipples. Digits present and correct. Limbs equal length. Talipes. External genitalia inspected. Back and spine examined. Temperature.

7. What injection is offered for administration to the baby after birth?
Answer – Vitamin K

8. What is Vitamin K and why is it given?
Answer - Vitamin K is used as a prophylactic measure to prevent classic-onset haemorrhagic disease (HDN), which occurs in approximately 1 in 10,000 babies. In about half of babies who suffer this bleeding problem after the first week of life, many will die or sustain significant brain damage due to the disease, because of bleeding into the brain. It can be given via intra-muscular injection or orally. It is not a necessary intervention; all parents must be given informed choice about it before giving it.

9. What is the technical name for the blood loss that the woman looses 4-6 weeks following delivery?
Answer – Lochia.

Extra points for the person that can name the ‘stages’ of Lochia, the days each stage happens and the colour of each stage…
Answer - Lochia rubra is the first discharge, red in color because of the large amount of blood it contains. It typically lasts no longer than 3 to 5 days after birth.
Lochia serosa is the term for Lochia which has thinned and turned brownish or pink in color. It contains serous exudate, erythrocytes, leukocytes, and cervical mucus. This stage continues until around the tenth day after delivery.
Lochia alba is the name for Lochia once it has turned whitish or yellowish-white. It typically lasts from the second through the third to sixth week after delivery. It contains fewer red blood cells and is mainly made up of leukocytes, epithelial cells, cholesterol, fat, and mucus.

10. What things will a midwife be checking for on a postnatal visit?

general wellbeing of mother and baby
feeding, how often how well, what type, milk etc
healing of sutures/c/s wound
uterine involution
urination and bowel movements of mother and baby
support needed
sterilising advice.
Breast feeding support
postbirth discussion
Lochia loss, any pain or discomfort
general appearance of mother and baby

bonus question:
when does a midwife's responsibility for the family finish and who does she discharge to?
NICE guidelines state that a midwife is responsible for the family until day 28 after which they discharge to a health visitor. The majority of families are usually discharged around day 12 - 14 if there are no concerns