Page 680 - Saunders Comprehensive Review For NCLEX-RN

1. The risks of prematurity, low birth weight, and
neonatal death increase if the mother has hepatitis B
infection.

2. Hepatitis is transmitted through blood, saliva,

vaginal secretions, semen, and breast milk and across
the placental barrier.

B. Interventions

1. Minimize the risk for intrapartum ascending infections
(limit the number of vaginal examinations).
2. Remove maternal blood from the neonate
immediately after birth.
3. Suction the fluids from the neonate immediately after
birth.
4. Bathe the neonate before any invasive procedures
including injections.
5. Clean and dry the face and eyes of the neonate before
instilling eye prophylaxis.
6. Infection of the neonate can be prevented by the
administration of hepatitis B immune globulin and
hepatitis B vaccine soon after birth but after the
newborn is bathed.
7. Discourage the mother from kissing the neonate until
the neonate has received the vaccine.
8. Inform the mother that the hepatitis B vaccine will be
administered to the neonate and that a second dose
should be administered at 1 month after birth and a
third dose at 6 months after birth.

Support breast-feeding after neonatal treatment for hepatitis B;

breast-feeding is not contraindicated if the neonate has been
vaccinated.
X. Hematoma
A. Description
1. Hematoma occurs following the escape of blood into
the maternal tissue after birth.
2. Predisposing conditions include operative delivery
with forceps or injury to a blood vessel.
B. Assessment (Box 22-4)

C. Interventions

1. Monitor vital signs.
2. Monitor client for abnormal pain, especially when
forceps delivery has been performed.
3. Apply ice to the hematoma site.

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