“Difference Between Caput Succedaneum and Cephalhematoma” plus 2 more nursing article(s): NursingCrib.com Updates
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| Difference Between Caput Succedaneum and Cephalhematoma Posted: 25 Jan 2011 05:56 PM PST 
CAPUT SUCCEDANEUM Definition A caput succedaneum is an edema of the scalp at the neonate's presenting part of the head. It often appears over the vertex of the newborn's head as a result of pressure against the mother's cervix during labor. The edema in caput succedaneum crosses the suture lines. It may involve wide areas of the head or it may just be a size of a large egg. Causes - Mechanical trauma of the initial portion of scalp pushing through a narrowed cervix
- Prolonged or difficult delivery
- Vacuum extraction
The pressure (at birth) interferes with blood flow from the area causing a localized edema. The edematous area crosses the suture lines and is soft. Caput Succedaneum also occurs when a vacuum extractor is used. In this case, the caput corresponds to the area where the extractor is used to hasten the second stage of labor. Signs and Symptoms - Scalp swelling that extends across the midline and over suture lines
- Soft and puffy swelling of part of a scalp in a newborn's head
- May be associated with increased molding of the head
- The swelling may or may not have some degree of discoloration or bruising
Management - Needs no treatment. The edema is gradually absorbed and disappears about the third day of life.
Complication - Jaundice – results as the bruise breaks down into bilirubin.
CEPHALHEMATOMA Definition Cephalhematoma is a collection of blood between the periosteum of a skull bone and the bone itself. It occurs in one or both sides of the head. It occasionally forms over the occipital bone. The swelling with cephalhematoma is not present at birth rather it develops within the first 24 to 48 hours after birth. Causes - Rupture of a periostal capillary due to the pressure of birth
- Instrumental delivery
Signs and Symptoms - Swelling of the infant's head 24-48 hours after birth
- Discoloration of the swollen site due to presence of coagulated blood
- Has clear edges that end at the suture lines
Management - Observation and support of the affected part.
- Transfusion and phototherapy may be necessary if blood accumulation is significant
Complication | Difference between a Caput Succedaneum and Cephalhematoma | | INDICATORS | CAPUT SUCCEDANEUM | CEPHALHEMATOMA | | Location | Presenting part of the head | Periosteum of skull bone and bone | | Extent of Involvement | Both hemispheres; CROSSES the suture lines | Individual bone; DOES NOT CROSS the suture lines | | Period of Absorption | 3 to 4 days | Few weeks to months | | Treatment | None | Support | image from emedicine.medscape.com
Related posts: - Difference Between Adult and Fetal Circulation
- The Fetal Skull
- Nursing Care Plan – Postpartum Hemorrhage
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| Exercises During Pregnancy Posted: 25 Jan 2011 05:31 PM PST 
Goal of Performing Prenatal Exercises: To strengthen the muscle that will be used in labor and delivery.  squatting Guidelines in Performing Exercises during pregnancy: - Exercise should be done in moderation. Recommend that moderate exercise should be done 30 or more minutes daily.
- The pregnant woman should avoid strenuous activity or intensifying training.
- Exercises where there is a risk of falling or abdominal trauma should be avoided.
- Pre-natal exercises should NOT be done during a hot or humid weather.
- All exercises in supine position after the first trimester of pregnancy should not be done by the pregnant woman as this position increases the risk of supine hypotensive syndrome.
 Tailor-sitting - Should be individualized. Meaning the exercises recommended for each pregnant woman should be according to ones age, physical condition, customary amount of exercise and the stage of pregnancy.
- Adequate fluid intake before and after exercise should be practiced by the pregnant woman.
- Exercises that cause fatigue should be stopped.
- It is important to follow the health care provider's advice about taking the pulse rate during the exercise and keeping it within a certain range.
- The pregnant woman should stop the exercise and seek medical advice if she experiences the following:
- Chest pain
- Dizziness
- Headache
- Decreased fetal movement
 - Signs of labor
Squatting and tailor sitting - Strengthen perineal muscle
- Increase perineal circulation
- Make more pelvic joints pliable
Pelvic Rock - Maintains good posture
- Relieves abdominal pressure and low backaches
- Strengthen abdominal muscles following delivery
 modified knee-chest position Modified knee-chest position - Relieves pelvic pressure and cramps in thighs or buttocks
- Relieves discomfort from hemorrhoids
Shoulder circling - Strengthens muscles of the chest
Walking  shoulder circling - Best exercise
- Promotes circulation
Kegel's - 10 seconds contraction, 10 seconds relaxation (30 times a day)
- Relieves congestion and discomfort in pelvic region
- Tones up pelvic floor muscles
images from pregnancy.gemzies.com, medindia.net, moondragon.org, albertrotella.robopeoples.com, pregnancyatoz.com Related posts: - Signs of Pregnancy
- Estimates in Pregnancy
- Ectopic Pregnancy
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| Hearing Tests Posted: 25 Jan 2011 05:05 PM PST 
- Rinne's Test
 rinne test Definition Rinne's test is a hearing test that compares the perception of sounds as it compares the patient's ability to hear a tone conducted via air and bone through the mastoid process. It should always be accompanied by a Weber's test that is used to detect a sensorineural hearing loss, confirming the nature of hearing problem. Purpose To evaluate a patient’s hearing ability by air conduction compared to that of bone conduction. Equipment: Tuning fork Procedure - Explain the procedure to the patient to promote cooperation.
- Sit the patient in a chair comfortably.
- Strike a 512 Hz tuning fork softly (knees or elbows slightly not the table) otherwise the vibrations will be excessive and cause the patient discomfort.
- Place the vibrating tuning fork on the base of the mastoid bone. Hold the fork for 2-3 seconds to allow sufficient time to make a mental note of the stimulus intensity.
- Ask the client to tell you when the sound is no longer heard.
- After the sound is no longer appreciated the vibrating top is held one inch from the external auditory meatus.
- The patient is asked whether the sound is louder behind or in front – referring to bone and air conduction respectively.
Interpretation of Results Normal: A patient with normal hearing will hear the tone of the vibration longer and louder when the tuning fork is held next to the ear than that against the mastoid bone. Positive Hearing Loss or "Reversed Rinne": When a patient hears a louder and longer tone when the vibrating tuning fork is held against the mastoid bone than when it is held next to the ear. - Weber's Test
 Definition Weber's test is a quick hearing test that is performed with Rinne's test. Purpose The Weber test is used to determine a patient's hearing ability by bone conduction and is useful in detecting a unilateral (one-sided or asymmetrical) conductive hearing loss and unilateral sensorineural hearing loss. Equipment: Tuning Fork Procedure - Explain the procedure to the patient to promote cooperation.
- Sit the patient in a chair comfortably.
- Strike a 512 Hz tuning fork softly (knees or elbows slightly not the table) otherwise the vibrations will be excessive and cause the patient discomfort.
- Place the vibrating tuning fork on the middle of the patient's head. Hold the fork for 2-3 seconds to allow sufficient time to make a mental note of the stimulus intensity.
- Ask client if the sound is heard better in one ear or the same in both ears.
Interpretation of Results Normal Response: sound is heard equally at both ears. Sensorineural Hearing Loss: loudest sound in unaffected ear. This is because the affected ear is less effective at picking up sound even if it is transmitted directly by conduction into the inner ear. Conductive Hearing Loss: Loudest sound in affected ear (hears vibrations only). This is because the conduction problem masks the ambient noise of the room, whilst the well-functioning inner ear picks the sound up via the bones of the skull causing it to be perceived as a louder sound than in the unaffected ear. Watch a video on rinne and weber's test courtesy of Youtube.com http://www.youtube.com/watch?v=FNy7dgOwu30 images from drdavidson.ucsd.edu, drdavidson.ucsd.edu Related posts: - Head-To-Toe Assessment (L. Ears)
- Blood Glucose Tests – IGTT
- Blood Glucose Tests – OGTT
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