32: Postpartum Care

Question 1

Vaginal discharge PP:

Answer 1

lochia for 4-8 weeks

Question 2

Stages of lochia

Answer 2

rubra
serosa
alba

Question 3

Mother adaption phases:

Answer 3

Taking IN

Taking HOLD

Question 4

Release of what hormone immediately after delivery and during breastfeeding that helps the mother FEEL better:

Answer 4

Oxytocin

Question 5

Benefits of skin-skin contact:

Answer 5

Stabilize infant

Helps with BF

Question 6

PP pain is caused by:

Answer 6

Uterine contractions during involution

Question 7

What can increase PP uterine cramps?

Answer 7

BF (due to release of oxytocin)

Question 8

How to reduce breast engorgement?

Answer 8

Early and frequent BF

Question 9

Resume sexual activity, when?

Answer 9

Whenever the couple feels they are ready.

Question 10

COCP is contraindicated for how long:

Answer 10

21 days PP due to risk of embolism

Question 11

IUD can be inserted, when:

Answer 11

Immediately PP
OR
4 weeks

Question 12

First breast milk is:

Answer 12

colustrum

Question 13

Breastmilk will arrive within:

Answer 13

2-4 days

Question 14

This hormone increases breast milk production

Answer 14

PROLACTIN

Question 15

This hormone causes milk let-down

Answer 15

OXYTOCIN

Question 16

The baby is smacking or licking:

Answer 16

RE-POSITION!!!

Question 17

Breast tenderness, redness…fever, flu-like symptoms

Answer 17

Mastitis

Question 18

Risks for developing mastitis:

Answer 18

stress 
fatigue
cracked nipples
plugged ducts
trauma
restriction (tight bras)
vigorous exercises

Question 19

Antibiotic for mastitis?

Answer 19

penicillinase-resistant PCN

Cephalosporins

Question 20

Complication of untreated mastitis:

Answer 20

breast abscess

Question 21

deep red nipple, burning, shooting/stabbing pain during and after breastfeeding:

Answer 21

Nipple candidiasis

Question 22

Most common risk for PP infection:

Answer 22

C-section

Question 23

Sudden fever >102.2 PP?

Answer 23

Possible GBS

Question 24

Risks for uterine infection (metritis):

Answer 24

C-Section
Prolonged birth
PROM
Traumatic birth
Obesity
retained placental fragments

Question 25

How to prevent PP uterine infection from C-section?

Answer 25

ABT prophylaxis within 60 minutes of C-Section

Question 26

Involuted uterus should be below pubic symphysis by:

Answer 26

2 weeks

Question 27

SSx of subinvolution

Answer 27

increased bleeding
large than expected and boggy uterus
malodorous lochia (infection too)

Question 28

Pharmacologic treatment of subinvoluted uterus:

Answer 28

Methergine
Ergotrate
(helps with contraction to get back to normal size)

Question 29

Increased bleeding after 24 hrs and until 12 weeks:

Answer 29

2ndary PP hemorrhage

Question 30

Evaluate for what if increased bleeding during first week?

Answer 30

Von Willebrand’s disease (the factor decreases after birth)

Question 31

A sudden increased but transient bleed within 10 days is:

Answer 31

normal. sloughing of placental site

Question 32

PP women at risk for embolism due to:

Answer 32

stasis
vascular trauma
hypercoagulability

Question 33

Mild, transient PP depression:

Answer 33

PP BLUES

Question 34

PP depression usually manifests when?

Answer 34

2 months PP

Question 35

These people are at risk for PP psychosis:

Answer 35

have bipolar disorder

hx of mental health illnesses

Question 36

These complementary supplements can help with PMAD:

Answer 36

st johns wort
kava root
omega 3 fatty acids