[20] MIDTERMS | POSTPARTUM P2 Flashcards
COMFORT MEASURES
OXYTOCIN (PITOCIN)
- produced by ____
- stored in the ____
- uterus to contract
- control ____
- can increase ____; always measure ____ before administering
OXYTOCIN (PITOCIN)
- produced by hypothalamus
- stored in the posterior pituitary
- uterus to contract
- control postpartum hemorrhage
- can increase BP; always measure BP before administering
COMFORT MEASURES
OXYTOCIN
If BP >____ mm Hg:
* Withhold agent
- Notify woman’s physician
- prevent HTN & CVA
OXYTOCIN
If BP >140/90 mm Hg:
* Withhold agent
- Notify woman’s physician
- prevent HTN & CVA
COMFORT MEASURES
ACETAMINOPHEN (TYLENOL)
- ____ Analgesic
- 1-2 tablets PO every ____ hours PRN
- For relief of ____
ACETAMINOPHEN (TYLENOL)
- Narcotic Analgesic
- 1-2 tablets PO every 4 hours PRN
- For relief of mild to moderate pain
COMFORT MEASURE
ACETAMINOPHEN (TYLENOL)
- Determine whether woman is sensitive to acetaminophen
- Monitor ____, ____ & UO
- Administer with food or after meals if GI upset occurs
- Take ____ with tablet
ACETAMINOPHEN (TYLENOL)
- Determine whether woman is sensitive to acetaminophen
- Monitor bowel sounds, RR & UO
- Administer with food or after meals if GI upset occurs
- Take 1 full glass with tablet
COMFORT MEASURES
DOCUSATE SODIUM (COLACE, SURFAK)
- prevent ____
- Lower ____ of feces
- allow ____ & water to penetrate & soften stool
DOCUSATE SODIUM (COLACE, SURFAK)
- prevent constipation
- Lower surface tension of feces
- allow lipids & water to penetrate & soften stool
COMFORT MEASURES
DOCUSATE SODIUM (COLACE, SURFAK)
Possible adverse effects:
- occasional ____
- D____
DOCUSATE SODIUM (COLACE, SURFAK)
Possible adverse effects:
- occasional abdominal pain
- Diarrhea
COMFORT MEASURES
Monitoring Uterine Status
- if (+) ____, investigate other causes
Determine relationship of fundus to umbilicus
- Assess ____ of fundus
- Note if fundus is in ____ or displaced to either side of abdomen
- Record results of assessment
Monitoring Uterine Status
- if (+) atony, investigate other causes
Determine relationship of fundus to umbilicus
- Assess firmness of fundus
- Note if fundus is in midline or displaced to either side of abdomen
- Record results of assessment
COMFORT MEASURES
Monitoring Uterine Status
- Monitor uterine status every ____ or more frequently if problems arise
Monitoring Uterine Status
- Monitor uterine status every 8 hours or more frequently if problems arise
COMFORT MEASURES - RELIEF OF PERINEAL DISCOMFORT
EPISIOSTOMY HEALING
REEDA Scale:
R - ____
E - ____
E - ____
D - ____
A - ____
EPISIOSTOMY HEALING
REEDA Scale:
R - Redness
E - Edema
E - Ecchymosis
D - Discharge
A - Approximation
COMFORT MEASURES - RELIEF OF PERINEAL DISCOMFORT
EPISIOSTOMY HEALING
REDNESS
- without excessive ____
- normal ____ associated with healing
- ____ with redness
- infection
EPISIOSTOMY HEALING
REDNESS
- without excessive tenderness
- normal inflammation associated with healing
- pain with redness
- infection
COMFORT MEASURES - RELIEF OF PERINEAL DISCOMFORT
EPISIOSTOMY HEALING
EDEMA
- ____ edema is common
- ____ edema interferes with healing
EPISIOSTOMY HEALING
EDEMA
- mild edema is common
- severe edema interferes with healing
COMFORT MEASURES - RELIEF OF PERINEAL DISCOMFORT
EPISIOSTOMY HEALING
ECCHYMOSIS
- few ____ bruises (common)
- ____ bruises (interfere with normal healing)
EPISIOSTOMY HEALING
ECCHYMOSIS
- few small superficial bruises (common)
- larger bruises (interfere with normal healing)
COMFORT MEASURES - RELIEF OF PERINEAL DISCOMFORT
EPISIOSTOMY HEALING
DISCHARGE
- ____ should be present
EPISIOSTOMY HEALING
DISCHARGE
- No discharge should be present
COMFORT MEASURES - RELIEF OF PERINEAL DISCOMFORT
EPISIOSTOMY HEALING
APPROXIMATION
- ____ should not be separated
EPISIOSTOMY HEALING
APPROXIMATION
- Suture line should not be separated
COMFORT MEASURES - RELIEF OF PERINEAL DISCOMFORT
REEDA SCALE SCORING
REDNESS
- 0 - None
- 1 - < ____ cm of incision bilaterally
- 2 - < ____ cm of incicion bilaterally
- 3 - > ____ cm of incision bilaterally
REEDA SCALE SCORING
REDNESS
- 0 - None
- 1 - < 0.25cm of incision bilaterally
- 2 - < 0.5cm of incicion bilaterally
- 3 - > 0.5cm of incision bilaterally
COMFORT MEASURES - RELIEF OF PERINEAL DISCOMFORT
REEDA SCALE SCORING
EDEMA
- 0 - None
- 1 - Perineal < ____ cm from incision
- 2 - Perineal < ____ cm from incision
- 3 - Perineal > ____ cm from incision or affects vulvar area
REEDA SCALE SCORING
EDEMA
- 0 - None
- 1 - Perineal < 1cm from incision
- 2 - Perineal < 1-2cm from incision
- 3 - Perineal > 2cm from incision or affects vulvar area
COMFORT MEASURES - RELIEF OF PERINEAL DISCOMFORT
REEDA SCALE SCORING
ECCHYMOSIS
- 0 - None
- 1 - < ____ cm bilaterally or ____ cm unilaterally of incision
- 2 - < ____ cm bilaterally or ____ cm unilaterally of incision
- 3 - > ____ cm bilaterally or ____ cm unilaterally of incision
REEDA SCALE SCORING
ECCHYMOSIS
- 0 - None
- 1 - < 0.25cm bilaterally or 0.5cm unilaterally of incision
- 2 - < 0.25-1cm bilaterally or 0.5-2cm unilaterally of incision
- 3 - > 1cm bilaterally or 2cm unilaterally of incision
COMFORT MEASURES - RELIEF OF PERINEAL DISCOMFORT
REEDA SCALE SCORING
DISCHARGE
- 0 - None
- 1 - ____
- 2 - ____
- 3 - ____
REEDA SCALE SCORING
DISCHARGE
- 0 - None
- 1 - Serous
- 2 - Serosanguinous
- 3 - Bloody, purulent
COMFORT MEASURES - RELIEF OF PERINEAL DISCOMFORT
REEDA SCALE SCORING
APPROXIMATION
- 0 - Closed
- 1 - Skin separation < ____
- 2 - Skin and ____ separation
- 3 - Skin, ____, and ____ separation
REEDA SCALE SCORING
APPROXIMATION
- 0 - Closed
- 1 - Skin separation < 3mm
- 2 - Skin and subcutaenous fat separation
- 3 - Skin, subcutaneous fat, and fascial separation
COMFORT MEASURES - RELIEF OF PERINEAL DISCOMFORT
- first 24 hours
- reduce edema
- reduce possibility of hematoma formation
- provide numbing of the tissues
ICE PACK
COMFORT MEASURES - RELIEF OF PERINEAL DISCOMFORT
ICE PACK
Attain maximum effect:
- Apply ice pack for approximately ____ minutes
- Then remove for about ____ minutes
ICE PACK
Attain maximum effect:
- Apply ice pack for approximately 20 minutes
- Then remove for about 10 minutes
COMFORT MEASURES - RELIEF OF PERINEAL DISCOMFORT
- decreases pain
- promotes circulation to tissues
- healing
- reduce incidence of infection
SITZ BATH
COMFORT MEASURES - RELIEF OF PERINEAL DISCOMFORT
SITZ BATH
- Cleaning the equipment
- Adding water to 102 to 105 F (____ C)
- Have a ____ to pat dry perineum after the sitz bath
- Have a clean ____ to apply
SITZ BATH
- Cleaning the equipment
- Adding water to 102 to 105 F (38-40 C)
- Have a clean, unused towel to pat dry perineum after the sitz bath
- Have a clean perineal pad to apply
COMFORT MEASURES - RELIEF OF PERINEAL DISCOMFORT
SITZ BATH
- Place a ____ within reach
- Ask woman to use it if she feels ____ or develops difficulty ____
- Check woman at frequent intervals
- Water should be ____
- Caution woman:
-Using ____ cream or spray on her perineum
-Who has a great deal of ____ perineal edema
SITZ BATH
- Place a call bell within reach
- Ask woman to use it if she feels dizzy or lightheaded or develops difficulty hearing
- Check woman at frequent intervals
- Water should be pleasantly warm not hot
- Caution woman:
-Using analgesic cream or spray on her perineum
-Who has a great deal of generalized perineal edema
COMFORT MEASURES - RELIEF OF PERINEAL DISCOMFORT
SITZ BATH
- Use sitz bath ____ x/day
- Maximum of ____ minutes each time
SITZ BATH
- Use sitz bath 3-4x/day
- Maximum of 20 minutes each time
COMFORT MEASURES - RELIEF OF PERINEAL DISCOMFORT
- Reduces perineal edema
- Reduces response of nerve endings which cause perineal discomfort
COOL SITZ BATH
COMFORT MEASURES - RELIEF OF PERINEAL DISCOMFORT
SITZ BATH
Using a bath tub:
- Draw only ____ inches of water
- Assess the temperature
- Use water ____
- Not for bathing
SITZ BATH
Using a bath tub:
- Draw only 4 to 6 inches of water
- Assess the temperature
- Use water only for the sitz
- Not for bathing
COMFORT MEASURES
RELIEF OF DISCOMFORT FROM IMMOBILITY AND MUSCLE STRAIN
- Reduce the incidence of complications: C____ and T____
- Promote a feeling of general well-being
- Monitor any signs of ____ or ____
RELIEF OF DISCOMFORT FROM IMMOBILITY AND MUSCLE STRAIN
- Reduce the incidence of complications: Constipation
and Thrombophlebitis - Promote a feeling of general well-being
- Monitor any signs of dizziness or weakness
COMFORT MEASURES
RELIEF OF DISCOMFORT FROM IMMOBILITY AND MUSCLE STRAIN
- F____
- Effects of medications
- Loss of ____
- Dizziness or faintness when woman stands up
- Instruct to use ____ in the bathroom
RELIEF OF DISCOMFORT FROM IMMOBILITY AND MUSCLE STRAIN
- Fatigue
- Effects of medications
- Loss of blood
- Dizziness or faintness when woman stands up
- Instruct to use emergency call button in the bathroom
COMFORT MEASURES
RELIEF OF DISCOMFORTS LIKE BREAST ENGORGEMENT AND NIPPLE SORES
MANUAL MASSAGE
- ____ her hands around the breast
- Firmly slides her fingers ____
- ____ her hands to massage all areas of the breast
RELIEF OF DISCOMFORTS LIKE BREAST ENGORGEMENT AND NIPPLE SORES
MANUAL MASSAGE
- Cups her hands around the breast
- Firmly slides her fingers forward toward the nipple
- Rotates her hands to massage all areas of the breast
COMFORT MEASURES
RELIEF OF DISCOMFORTS LIKE BREAST ENGORGEMENT AND NIPPLE SORES
- Rubbing a small amount of ____ into the nipples may aid healing
- ____ are not effective and should be removed before nursing if used
RELIEF OF DISCOMFORTS LIKE BREAST ENGORGEMENT AND NIPPLE SORES
- Rubbing a small amount of breast milk into the nipples may aid healing
- Ointments are not effective and should be removed before nursing if used
COMFORT MEASURES
RELIEF OF DISCOMFORTS LIKE BREAST ENGORGEMENT AND NIPPLE SORES
- Teach a woman to ____ daily with clear water; bath or shower and dry with a soft towel
- Wear a ____; 24 hours a day
RELIEF OF DISCOMFORTS LIKE BREAST ENGORGEMENT AND NIPPLE SORES
- Teach a woman to wash her hands daily with clear water; bath or shower and dry with a soft towel
- Wear a supportive and not excessively tight bra; 24 hours a day
SAFETY MEASURES
RESUMPTION OF ACTIVITY
- ____ daily naps are essential
- 2nd week at home: resume ____
- Delay returning to work for ____ weeks; resume all activities by ____ to ____ weeks
RESUMPTION OF ACTIVITY
- 1 or 2 daily naps are essential
- 2nd week at home: resume light housekeeping
- Delay returning to work for 6 weeks; resume all activities by 4 to 5 weeks
SAFETY MEASURES
SEXUAL ACTIVITY
Can resume if:
- Healed ____
- ____ has stopped
- Return to prepregnant levels of sexual interest and activity (____ months postpartum)
- When ____ women experience decreased libido for several months (normal)
SEXUAL ACTIVITY
Can resume if:
- Healed episiostomy
- Lochial flow has stopped
- Return to prepregnant levels of sexual interest and activity (3 months postpartum)
- When breastfeeding women experience decreased libido for several months (normal)
SAFETY MEASURES
POSTPARTAL EXERCISES
- ____ should begin while in the birthing unit and to continue them at home
- Help maintain ____ and ____ levels
- Improve ____ fitness
- Project a feeling of well-being
- Increase self-esteem
- Promote less fatigue
POSTPARTAL EXERCISES
- Simple exercises should begin while in the birthing unit and to continue them at home
- Help maintain insulin and HDL cholesterol levels
- Improve aerobic fitness
- Project a feeling of well-being
- Increase self-esteem
- Promote less fatigue
