Ch 17 & 25 Lecture Flashcards
Placental site heals by __.
exfoliation.
involution
The process whereby the uterus decreases in size.
The uterus will reach its pre pregnant size by 5−6 weeks postpartum.
Uterine debris in the uterus is discharged through __,
which consists of blood, fragments of decidua, white blood cells, mucus and some bacteria.
lochia
Lochia rubra is red (first 2–3 days, or longer)
Lochia serosa is pink (day 3 to day 10)
Lochia alba is white (continues until the cervix is closed)
Ovulation usually occurs within ___.
70 to 75 days (non-breastfeeding women) or
6 months in lactating women.
The uterus becomes displaced and deviated to the right when __.
the bladder is full
Blood loss averages __.
200 to 500 mL (vaginal), 700 to 1000 mL (cesarean)
The most common neurologic symptom is ___.
headache
Many women experience headaches due to estrogen drops.
Headaches may be increased with spinal or epidural anesthesia.
A common discomfort for postpartum women is intense tremors that resemble shivering. There is no medical reason for this and the nursing intervention is to __.
cover with warm blankets.
Postpartum blues
NOT postpartum depression
Transient period of depression; sometimes occurs during the first few days postpartum
Mood swings, Anger, Weepiness, Anorexia, Difficulty sleeping, Feeling of being let down
Lasts 2 weeks or less and goes away
Principles of conducting a postpartum assessment:
i. Select the time that will provide the most accurate data
ii. Consider client’s need for premedication
iii. Provide an explanation of the purpose of the assessment
iv. Ensure that the woman is relaxed before starting; be gentle
v. Document and report the results clearly
vi. Take appropriate body fluid precautions
vii. Teach the client as you perform assessment
Obtaining maternal vital signs postpartum:
i. Vital signs should be obtained when the mother is at rest
ii. Elevated temperature should last only 24 hours
iii. Increase in BP should be transient
iv. Pulse rate may be slow
v. Breath sounds should be clear
BUBBLEHE
Breast Uterus Bladder Bowel Lochia Episitomy, lacerations, edema Homans/Hemorrhoids Emotional
Suppression of lactation in the non-breastfeeding mother:
- Suggest a tight fitting sports bra
- Apply ice
- Avoid breast stimulation; avoid heat
- Engorgement
- Lactation usually suppressed in 5-7 days
- cabbage leaves on breasts
assessment of loch
for character, amount, color, odor,
Presence of any clots
Teach the patient:
Normal changes of lochia
Effect of position on lochia
Hygienic measures: Wash hands, Peri-bottle for cleaning, Watch for bleeding
episiotomy/laceration wound assessment (REEDA)
- Redness
- Edema
- Ecchymosis
- Discharge
- Approximation
nursing notes for perineum care:
- ice pack for pain
- Pad count for correct assessment of bleeding amount
- Assess Efficacy of any comfort measures
nursing assessment of lower extremities
Assess for signs of thrombophlebitis. Some facilities have discontinued performing a Homans sign; supporters use it as a screening tool (it could dislodge a clot if present)
Assess legs for edema, redness, tenderness, and warmth.
Assess for return of sensation following anesthesia BEFORE ambulation. Ambulate to prevent thrombophlebitis and teach signs.
