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NR-NUR121 | Mother and Child Nursing (MCN) > [19] MIDTERMS | POSTPARTUM P1 > Flashcards

[19] MIDTERMS | POSTPARTUM P1 Flashcards

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1
Q

Six week period after childbirth

A

POSTPARTUM

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2
Q

“4th trimester of pregnancy”

A

PUERPERIUM

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3
Q

PUERPERIUM

  • Latin word
  • ____ - “child”
  • ____ - “to bring forth”
A

PUERPERIUM

  • Latin word
  • Puer - “child”
  • Parere - “to bring forth”
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4
Q

PSYCHOLOGICAL CHANGES OF THE POSTPARTAL PERIOD

  • “childless or “parents of one”
  • new role as parents (parenthood)
A

TRANSITION PHASE

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5
Q

PHASES OF THE PURPERIUM

  • “time of reflection”
  • passive
  • dependent
  • “birth experience”
A

TAKING IN PHASE

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6
Q

PHASES OF THE PURPERIUM

  • initiates action
  • Greater independence
  • ideal for teaching
A

TAKING HOLD

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7
Q

PHASES OF THE PURPERIUM

  • Giving up:
    old role
    previous lifestyle
    ideal birth experience
  • Readjustment of relationships
A

LETTING GO

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8
Q

MATERNAL CONCERNS & FEELINGS IN THE POSTPARTAL PERIOD

  • feeling abandoned & less important after giving birth
A

ABANDONMENT

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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

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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

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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
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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

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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

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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

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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

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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
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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
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18
Q

PHYSIOLOGIC CHANGES

  • reduction in size & return of uterus to a nonpregnant state
A

INVOLUTION

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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
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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)

NR-NUR121 | Mother and Child Nursing (MCN) (26 decks)

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