[19] MIDTERMS | POSTPARTUM P1 Flashcards
1
Q
Six week period after childbirth
A
POSTPARTUM
2
Q
“4th trimester of pregnancy”
A
PUERPERIUM
3
Q
PUERPERIUM
- Latin word
- ____ - “child”
- ____ - “to bring forth”
A
PUERPERIUM
- Latin word
- Puer - “child”
- Parere - “to bring forth”
4
Q
PSYCHOLOGICAL CHANGES OF THE POSTPARTAL PERIOD
- “childless or “parents of one”
- new role as parents (parenthood)
A
TRANSITION PHASE
5
Q
PHASES OF THE PURPERIUM
- “time of reflection”
- passive
- dependent
- “birth experience”
A
TAKING IN PHASE
6
Q
PHASES OF THE PURPERIUM
- initiates action
- Greater independence
- ideal for teaching
A
TAKING HOLD
7
Q
PHASES OF THE PURPERIUM
- Giving up:
old role
previous lifestyle
ideal birth experience - Readjustment of relationships
A
LETTING GO
8
Q
MATERNAL CONCERNS & FEELINGS IN THE POSTPARTAL PERIOD
- feeling abandoned & less important after giving birth
A
ABANDONMENT
9
Q
MATERNAL CONCERNS & FEELINGS IN THE POSTPARTAL PERIOD
___ in the baby in terms of the baby’s sex, size or look may be experienced by parents or partners
A
DISAPPOINTMENT
10
Q
- conflicting feelings of joy & emotional letdown during first few weeks after birth
- evidenced by tearfulness, feelings of inadequacy, mood lability, anorexia & sleep disturbance
A
POSTPARTUM BLUES OR BABY BLUES
11
Q
POSTPARTUM BLUES OR BABY BLUES
MOOD ELATION / DEPRESSION
- Fluctuating ____
- response to dependence & low self-esteem ____
- being away from home
- physical discomfort
- ____ engendered by assuming a new role
- Not having support from the partner
A
MOOD ELATION / DEPRESSION
- Fluctuating hormones
- response to dependence & low self-esteem exhaustion
- being away from home
- physical discomfort
- tension engendered by assuming a new role
- Not having support from the partner
12
Q
PSYCHOLOGICAL ADJUSTMENT- Maternal Role Attainment
- Occurs during pregnancy
- Woman looks to role models, especially her mother
- How to mother
A
(1) ANTICIPATORY STAGE
13
Q
PSYCHOLOGICAL ADJUSTMENT- Maternal Role Attainment
- Begins when the child is born
- Woman is still influenced by the guidance of others
- Tries to act as she believes others expect her to act
A
(2) FORMAL STAGE
14
Q
PSYCHOLOGICAL ADJUSTMENT- Maternal Role Attainment
- Begins when the mother begins to make her own choices about mothering
- Begins to develop her own style of mothering and finds ways of functioning that work well for her
A
(3) INFORMAL STAGE
15
Q
PSYCHOLOGICAL ADJUSTMENT- Maternal Role Attainment
- Final stage of maternal role attainment
- When woman reaches this stage, she is comfortable with the notion of herself as a mother
A
PERSONAL STAGE
16
Q
INFLUENCING FACTORS
- S____
- A____
- P____
- M____ relationships
- A____
- Previous ____
- S____ status
A
INFLUENCING FACTORS
- Social support
- Age
- Personality traits
- Marital relationships
- Anxiety / Depression
- Previous child care skills
- Temperament of infant
- Socio-economic status
17
Q
CHALLENGES OF THE POSTPARTAL WOMEN
- Finding ____ for themselves
- Feelings of ____
- F____
- Feeling of ____
- Finding time for their ____
- ____ behavior
A
- Finding time for themselves
- Feelings of incompetence
- Fatigue
- Feeling of responsibility
- Finding time for their older children
- Infant’s behavior
18
Q
PHYSIOLOGIC CHANGES
- reduction in size & return of uterus to a nonpregnant state
A
INVOLUTION
19
Q
TWO MAIN PROCESSES INVOLVED IN INVOLUTION
- Sealing of ____
- Reduction of organ to approximate ____ size
A
- Sealing of placenta site
- Reduction of organ to approximate pregestational size
20
Q
PHYSIOLOGIC CHANGES
WEIGHT OF THE UTERUS
- ____ - immediately after birth
- ____ - at the end of the first week
- ____ - complete involution (6 weeks) (similar to prepregnant weight)
A
WEIGHT OF THE UTERUS
- 1000g - immediately after birth
- 500g - at the end of the first week
- 50g - complete involution (6 weeks) (similar to prepregnant weight)
21
Q
PHYSIOLOGIC CHANGES
FUNDAL HEIGHT
- 1 hr later: fundus on level of ____, where it remains for approximately the next 24 hours.
- Decreases ____ per day
A
FUNDAL HEIGHT
- 1 hr later: fundus on level of umbilicus, where it remains for approximately the next 24 hours.
- Decreases one fingerbreadth per day
22
Q
PHYSIOLOGIC CHANGES
- The uterus in the 1st hour postpartum is boggy (soft or flabby)
- Abnormal; failure of the uterus to contract adequately after delivery
- Allows hemorrhage to flow into the uterus
A
UTERINE ATONY
23
Q
PHYSIOLOGIC CHANGES
- Contraction of the uterus after birth “intermittent cramping”
A
AFTER PAINS
24
Q
PHYSIOLOGIC CHANGES
AFTER PAINS
Noticed most by:
- M____
- Those who gave birth to ____ or ____ births
A
AFTER PAINS
Noticed most by:
- Multiparas
- Those who gave birth to large babies or multiple births
25
Q
- Vaginal discharge after giving birth, containing blood, mucus, and uterine tissue
A
LOCHIA
26
Q
TYPE OF LOCHIA
- Color: Red
- Duration: 1-3 days
- Composition: Blood fragments of decidua, mucus
A
LOCHIA RUBRA
27
Q
TYPE OF LOCHIA
LOCHIA RUBRA
- Color: ____
- Duration: ____ days
- Composition: Blood fragments of ____, mucus
A
LOCHIA RUBRA
- Color: Red
- Duration: 1-3 days
- Composition: Blood fragments of decidua, mucus
28
Q
TYPE OF LOCHIA
- Color: Pink
- Duration: 3-10 days
- Composition: Blood, mucus, and leukocytes
A
LOCHIA SEROSA
29
Q
TYPE OF LOCHIA
LOCHIA SEROSA
- Color: ____
- Duration: ____ days
- Composition: Blood, mucus, and ____
A
LOCHIA SEROSA
- Color: Pink
- Duration: 3-10 days
- Composition: Blood, mucus, and leukocytes
30
Q
TYPE OF LOCHIA
- Color: White
- Duration: 10-14 days (or up to 6 weeks)
- Composition: Largely mucus
A
LOCHIA ALBA
31
Q
TYPE OF LOCHIA
LOCHIA ALBA
- Color: ____
- Duration: ____ days (or up to ____ weeks)
- Composition: Largely ____
A
LOCHIA ALBA
- Color: White
- Duration: 10-14 days (or up to 6 weeks)
- Composition: Largely mucus
32
Q
LOCHIA
HEAVY AMOUNT
- Stain larger than ____ inches in length within 1 hour
- ____ to ____ ml
A
HEAVY AMOUNT
- Stain larger than 6 inches in length within 1 hour
- 50 to 80 ml
33
Q
LOCHIA
MODERATE AMOUNT
- stain ____ inches in length within 1 hour
- ____ ml
A
MODERATE AMOUNT
- stain < 6 inches in length within 1 hour
- 25-50 ml
34
Q
LOCHIA
SMALL AMOUNT
- stain less than ____ inches in length after 1 hour
- ____ to ____ ml
A
SMALL AMOUNT
- stain less than 4 inches in length after 1 hour
- 10 to 25 ml
35
Q
LOCHIA
SCANT AMOUNT
- stain less than ____ inch in length after 1 hour
- only on tissue when the woman wipes
A
SCANT AMOUNT
- stain less than 1 inch in length after 1 hour
- only on tissue when the woman wipes
36
Q
THE CERVIX
DURING NSD:
- SOFT & MALLEABLE
- ____ & ____ are open
- External os size of a ____ opening (end of 7 days)
- appears slitlike or ____ (star shaped)
A
DURING NSD:
- SOFT & MALLEABLE
- internal & external os are open
- External os size of a pencil opening (end of 7days)
- appears slitlike or stellate (star shaped)
37
Q
THE VAGINA
After vaginal birth:
- soft, with few ____
- Diameter greater than normal
- ____ PERMANENTLY TORN
- “____” to heal vagina
A
After vaginal birth:
- soft, with few rugae
- Diameter greater than normal
- HYMEN PERMANENTLY TORN
- “KEGEL EXERCISE” to heal vagina
38
Q
HORMONAL SYSTEMS
- Decrease in ____ as soon as placental is delivered
- By ____: Progestin, Estrogen, and Estradiol revert back to prepregnancy levels
- Decrease in ____ and ____ - almost negligible by 24 hours
- Decrease in ____ (12 days), then begins to as as a new menstrual cycle is initiated
A
- Decrease in pregnancy hormones as soon as placental is delivered
- By Week 1: Progestin, Estrogen, and Estradiol revert back to prepregnancy levels
- Decrease in hCG and hPL - almost negligible by 24 hours
- Decrease in FSH (12 days), then begins to as as a new menstrual cycle is initiated
39
Q
URINARY SYSTEM
- NSD: UO of ____ ml/day (diaphoresis & diuresis)
- Transient loss of ____ and ____ of bladder decreases sense to void
- Increase possibility of ____ and ____
A
- NSD: UO of 3,000 ml/day (diaphoresis & diuresis)
- Transient loss of tone and edema of bladder decreases sense to void
- Increase possibility of urinary stasis and UTI
40
Q
CIRCULATORY SYSTEM
- Decrease in blood volume
Amount of blood:
* ____ ml in VSD
* ____ ml in CS
A
- Decrease in blood volume
Amount of blood:
* 300 - 500 ml in VSD
* 500 - 1,000 ml in CS
41
Q
GASTROINTESTINAL SYSTEM
- Mother is usually hungry after giving birth
- NSD: ____
- CS: NPO; ____ must occur before DAT
- Replace fluid loss
- Diet is a case-to-case basis, as ordered by doctor
- The occurence of ____ due to consistent pushing during labor
- Decreased ____
A
- Mother is usually hungry after giving birth
- NSD: DAT
- CS: NPO; Flatulence must occur before DAT
- Replace fluid loss
- Diet is a case-to-case basis, as ordered by doctor
- The occurence of hemorrhoids due to consistent pushing during labor
- Decreased abdominal muscle tone
42
Q
INTEGUMENTARY SYSTEM
- Rectus muscle tone is not regained; ____
- ____ appear reddened and will fade in time
- ____ strengthens abdominal muscles and returns abdominal support
- Linea nigra and chloasma becomes barely detectable in ____ time
A
- Rectus muscle tone is not regained; DIASTASIS
- Stretch marks appear reddened and will fade in time
- Modified sit-ups strengthens abdominal muscles and returns abdominal support
- Linea nigra and chloasma becomes barely detectable in 6 weeks time
43
Q
RETROGRESSIVE CHNAGES OF THE PUERPERIUM
- ____ after labor
- Sleep hunger
- ____ - return to prepregnant weight
A
- Exhaustion after labor
- Sleep hunger
- Weight loss - return to prepregnant weight
44
Q
TEMPERATURE
- Slight ____ of temperature during first 24 hours after birth (due to dehydration that occured during labor)
- If ____ during first 24 hours, temp returns to normal
- Oral temp above ____ C (febrile), may indicate postpartal infection
A
- Slight increase of temperature during first 24 hours after birth (due to dehydration that occured during labor)
- If adequate fluid during first 24 hours, temp returns to normal
- Oral temp above 38 C (febrile), may indicate postpartal infection
45
Q
PULSE
- Rapid or thready pulse is a sign of ____
A
- Rapid or thready pulse is a sign of hemorrhage
46
Q
BLOOD PRESSURE
- Decrease in BP may indicate ____
- ____ mmHg systolic or ____ mmHg diastolic may indicate postpartal hypertension
- ____ - occurs on standing due to lack of adequate blood volume to maintain nourishment of brain cells
A
- Decrease in BP may indicate bleeding
- 140 mmHg systolic or 90 mmHg diastolic may indicate postpartal hypertension
- Orthostatic hypotension - occurs on standing due to lack of adequate blood volume to maintain nourishment of brain cells
47
Q
PROGRESSIVE CHANGES OF THE PUERPERIUM
- ____ hormone is responsible for milk production
- ____ is responsible for the let-down reflex, allowing breastmilk to flow
- Breast ____ may increase body temperature
- Proper attachment of baby to breast must occur to avoid ____
- Increase ____ to ensure proper breastfeeding
A
- Prolactin hormone is responsible for milk production
- Oxytocin is responsible for the let-down reflex, allowing breastmilk to flow
- Breast engorgement may increase body temperature
- Proper attachment of baby to breast must occur to avoid mastitis
- Increase fluid intake to ensure proper breastfeeding
48
Q
MESTRUAL CYCLE
- If not exclusively breastfeeding, menstrual cycle resumes ____ after birth
- If breastfeeding, menstrual cycle resumes in ____ (lactational ammenorrhea)
A
- If not exclusively breastfeeding, menstrual cycle resumes 6-10 weeks after birth
- If breastfeeding, menstrual cycle resumes in 3 or 4 months (lactational ammenorrhea)
