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Nursing > Care of the Postpartum Patient > Flashcards

Care of the Postpartum Patient Flashcards

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1
Q

Postpartum period

A

Birth to return of reproductive organs to prepregnant state (about 6 weeks).

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2
Q

Puerperium

A

4th trimester of pregnancy

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3
Q

Involution

A

Return of the uterus to non pregnant state

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4
Q

At full term the uterus weighs____ times its prepregnant weight. At 6 wks, it is ______ grams

A

11,60-80

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5
Q

Subinvolution

A

Failure of the uterus to return to its prepregnant state

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6
Q

Posterior pituitary release___ and its two functions are_____

A

Releases oxytocin
Promotes homeostasis
Prevents hemorrhage

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7
Q

Oxytocin

A
  • Causes contractions which compresses blood vessels and helps stop bleeding
  • Helps uterus get smaller
  • Plays a role in breastfeeding and milk ejection
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8
Q

Afterpains

A

Contractions that occur after birth and are more noticeable in 2nd and subsequent pregnancies

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9
Q

Lochia

A

Uterine Discharge

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10
Q

Lochia rubra

A

(Red) from birth to 3-4 days

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11
Q

Lochia serosa

A

(pink) day 3 or 4 until about 10 days

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12
Q

Lochia alba

A

(white/yellow) can continue until 4-8 wks after delivery

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13
Q

Fundus

A

At about the umbilicus after delivery

Decreased about 1cm/day

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14
Q

Fluid loss for vaginal delivery

A

500 cc

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15
Q

Fluid loss for c-section

A

1000 cc

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16
Q

1st degree laceration

A

involve only the skin of the perineal are

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17
Q

2nd degree laceration

A

involves the skin, and the perineal muscles of the perineal area

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18
Q

3rd degree laceration

A

involves the skin, perineal muscles and the anal sphincter

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19
Q

4th degree laceration

A

skin, perineal muscles, complete tear of anal sphincter and involves the tissue lining the rectum, extensive repair needed

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20
Q

Ovulation

A
  • If not breastfeeding, ovulations returns in 7-9 weeks.

- If breastfeeding, ovulation returns in 2-18 months depending on exclusivity of breastfeeding

21
Q

Interventions for mom’s not breastfeeding

A
  • Tight supportive bra
  • Back to shower water is stimulating
  • ice packs
22
Q

Clotting factors and fibrinogen are ____ during pregnancy

A

increased

23
Q

BUBBLE HE

A
  • Breasts
  • Uterus
  • Bladder
  • Bowel
  • Lochia
  • Episiotomy
  • Homer’s sign
  • Emotional status
24
Q

Focused assessment- breasts

A

-Assess for engorgement and sore or cracked nipples

25
Q

Focused assessment-uterus

A
  • Should be at about the level of the umbilicus shortly after delivery
  • Prevention of uterine atony
26
Q

Focused assessment- bladder

A

-Assess for emptying, burning, ability to void

27
Q

Focused assessment- bowel

A

-May not have BM until 2-3 days

28
Q

Focused assessment- Lochia

A
  • Assess for amount, color
  • Excessive is more than a pad an hour.
  • Expression of clots may occur with fundal massage
29
Q

Focused assessment- episiotomy

A

Assess for approximation, also assess perineum for swelling or bruising.

30
Q

Focused assessment- Homans sign

A
  • Performing human’s sign is controversial so check with your institution or provider. Performed by quickly dorsiflexing the foot upward.
  • C/S patients will typically have mechanical SCDs
31
Q

Rubella

A

Vaccination during the postpartum period if not immune. Informed consent is important. Women must not become pregnant for at least 1 month after administration. Side effects can be problematic.

32
Q

Rhogam

A

-Given to Rh negative moms at about 28 wks gestation

33
Q

Vaginal delivery hospitalization stay

A

48 hours

34
Q

C-section delivery hospitalization stay

A

96 hours

35
Q

Uterine atony-starts

A

(Early) Immediately postpartum within 24 hrs

36
Q

Uterine atony-etiology

A

Failure of uterus to regain tone caused by stretching (macrosomia, multiple gestation), anesthesia, MGSO4

37
Q

Uterine atony-comments

A

uterus never feels firm, even after fundal massage; very dangerous, Large, boggy uterus

38
Q

Lacerations-starts

A

Immediately postpartum, but continues to trickle

39
Q

Lacerations-etiology

A

Difficult birth (i.e. forceps)

40
Q

Lacerations- comments

A

Uterus is firm

Lacerations might need suturing

41
Q

Subinvolution of the uterus or of placental site-starts

A

(late) Later in postpartum, lochia remains heavy after 24 hours

42
Q

Subinvolution of the uterus or of placental site-etiology

A
  • Retained placental fragments

- Abnormal placental attachment

43
Q

Subinvolution of the uterus or of placental site- comments

A

Uterus may be firm, but higher than appropriate level

44
Q

Endometritis- starts

A

1-2 days postpartum

45
Q

Endometritis- etiology

A

Is an infective process, so cause is anything that might lead to infection (C/S, STI)

46
Q

Endometritis- comments

A

Classic infective symptoms:

  • Increased temp and WBC
  • Abdominal pain and foul smelling lochia also may have NO lochia.
47
Q

Hematoma-starts

A

1-2 days postpartum

48
Q

Hematoma-etiology

A

Internal bleed into perineal tissue; Caused by unlighted lacerations, episotomy

49
Q

Hematoma-comments

A

C/o perineal pressure, pain

Nursing (22 decks)

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