Ch 12- PP Physiological Changes(15-20) Flashcards
How long is the “Fourth Trimester”
6 wks
PP CV changes
5
- blood loss
- anemia (lasts 8 wks)
- increas erisk DVT
- risk for ortho hypo
- PP chills (vascular instability)
PP Respiratory Changes
2 (6 risks for PE)
- decreased diaphragm pressure
- increase risk PE w/oxytocin, tocolytics, multiples, infection, preeclampsia, bedrest
PP Immune system changes
2
- initial WBC increase
- mild temp elevation in 1st 24hrs
BUBBLEEAR
- Breasts
- Uterus/Abd
- Bowel
- Bladder
- Lochia
- Episiotomy/lacer
- Extremeties
- Attachment
- Rubella/RhoGAM
Bubbleear assessment requirements
3
- void before assessing
- VS, heart sounds, LS, BS, pain
- potition: flat or low fowlers for fundus
Lochia
Rubra characteristics
- 1-3 days
- dark red
- moderate to scant
Lochia
Serosa
- 4-10 days
- pink/brown
- scant
Lochia
Alba description
- 10+ days
- yellowish white
- scant
Follow up visit when?
4-6 wks
POST BIRTH discharge teaching
Call 911 for
* Pain in chest
* Obstructed breathing (SOB)
* Seizures
* Thoughts of hurting yourself or baby
Call Provider if
* Bleeding soak thru pad in 1 hr or clot egg size
* Incision not healing
* Red or swollen leg warm to touch
* Temp 100.4+
* Headache that does not get better with meds, or changes in vision
PP Breast Changes
3
- breast fullness
- swelling due to milk
- colostrum (gold)
PP Breast possible complications and interventions
4 comp, interventions feeding vs nonfeeding
- Complications: tenderness, cracking, bleeding, mastitis
- Feeding: warmth, massage, pump, latch education
- Not feeding: cold, tight bra, limit warm showers
PP Uterus Finding
- contracts, decreases to normal size
- 1 fingerwidth per day
PP uterus complications and interventions
1 comp, 1 intervention
- Comp: hemorrhage
- Intervention: assess fundal tone, relation to umbilicus, and position
PP Bowel Findings
2
- 1st a decrease in motility then returns by 2 wks
- hemorrhoids common
PP Bowel complications and interventions
2 comp. 4 interventions
- comp: constipation, hemorrhoids
- interventions: stool softeners, fluids, movement, small frequent meals
PP Bladder Findings
3
- increase urination
- decrease sense of urination
- risk of infection
PP Bladder complications and interventions
3 comp, 2 interventions
- Comp: stress incontinence, infection, uterine displacement (full bladder)
- Interventions: kegel, void within 2-4 hrs of delivery
PP Lochia Findings
3 pieces to assessing
- days
- color
- amount
PP Lochia complications and interventions
2 comp, 4 interventions
- Comp: infection, excessive blood loss
- Inter: COAT (clot, odor, amount, type (color))
PP episiotomy/laceration findings
2
- healing, returning to baseline
- lacerations: swelling, pain
PP Epis/lacer complications and interventions
3 comp, 2 inter
- Comp: painful urination, urinating less due to pain, possible infection
- Inter: NSAIDs, REEDA assessment
