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Practice Assessment VATI RN Comprehensive Predictor Remediation

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Practice Assessment: VATI RN Comprehensive Predictor Remediation 1. Postpartum immunization recommendations for the mom: I learned postpartum moms should receive the MMR, Rho(D) immune globin, Varicella, and TDaP immunizations as quickly as possible in the postpartum period.  A client who has a titer of less than 1:8 is administered a subcutaneous injection of rubella vaccine or a measles, mumps, and rubella (MMR) vaccine during the postpartum period to protect a subsequent fetus from malformations. The client should not get pregnant for 1 month following the immunization.  All Rh-negative mothers who have newborns who are Rh-positive must be given Rho(D) immune globulin administered IM within 72 hours of the newborn being born to suppress antibody formation in the mother. Test the client who receives both the rubella vaccine and Rho(D) immune globulin after 3 months to determine whether immunity to rubella has been developed.  If the client has no immunity, varicella vaccine is administered before discharge. The client should not get pregnant for 1 month following the immunization. A second dose of vaccine is given at 4-8 weeks.  The TDaP (tetanus-diphtheria-acellular pertussis) vaccine is recommended for women who have not previously received it. Administer prior to discharge or as soon as possible in the postpartum period 2. Effective Breast Feeding for Newborns: I learned it is normal for breastfed newborns to have yellow stools which I previously assumed as an abnormal finding.  Newborns should be breastfed every 2-3 hours. Parents should awaken the newborn to feed at least every 3 hours during the day and at least every 4 hours during the night until the newborn is feeding well and gaining weight adequately. Breastfeeding should occur 8-12 times within a 24-hour window. Then, a feed-on-demand schedule can be followed.  Encourage the mother to breastfeed at least 15-20 min per breast to ensure that her newborn receives adequate fat and protein, which is richest in the breast milk as it empties the breast.  Avoid educating mothers regarding the duration of newborn feedings. Mothers should be instructed to evaluate when the newborn has completed the feeding, including slowing of newborn suckling, a softened breast, or sleeping. Both breasts should be offered to ensure that each breast receives equal stimulation and emptying.

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