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OB > Ch. 18 Maternal physiologic changes > Flashcards

Ch. 18 Maternal physiologic changes Flashcards

1
Q

Define involution

A

Return of the uterus to a nonpregnant state after birth (483)

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2
Q

By the end of the 3rd stage where is the uterus located

A

Midline 2cm below level of umbilicus (483)

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3
Q

Within 12hrs where is the uterus located

A

1cm above umbilicus (483)

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4
Q

When should the uterus be nonpalpable

A

After 2wk, and should return to its nonpregnant location by 6wks after birth (483)

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5
Q

Define subinvolution

A

Failure of the uterus to return to a nonpregnant state (483)

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6
Q

What is the most common cause of subinvolution

A

Retained placental fragments and infection (483)

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7
Q

Define hemostasis

A

Process which causes bleeding to stop, keep blood damaged blood vessels

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8
Q

How does breastfeeding help with decreasing blood loss and reduce risk for postpartum hemorrhage

A

It increases the release of oxytocin, which strengthens and coordinates uterine contractions, which compresses blood vessels and promote hemostasis

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9
Q

Define lochia

A

postbirth uterine discharge, initially bright red and may contain small clots
Persist (4-8) after birth (484)

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10
Q

What are the characteristics of lochia rubra

A

Bright red blood and Decidua and trophoblastic debris

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11
Q

What are the characteristics of lochia serosa

A

After 3-4days
Pink or brown
Discharge last b/w 22-27days

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12
Q

Define the characteristics of lochia alba

A

Yellow-white

Leukocytes, Decidua, epithelial cells, mucus, serum, bacteria

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13
Q

What can happen to the lochia if the mother is taking oxytocin

A

Flow of lochia is often scant until effects of the medication wear off

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14
Q

How can you differentiate b/w lochia bleeding and nonlochial bleeding

A

Lochia- trickles or gush w/message

nonlochial- bloody discharge spurts from vagina, excessive and bright red

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15
Q

T/F amount of lochia is usually less after a cesarean birth b/c the surgeon sanctions the blood and fluids from uterus

A

True (485)

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16
Q

How long does it take for the abdominal wall to return almost to its pre-pregnant state

A

6wk

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17
Q

Decreases in human chronic somatomammotropin, estrogen, cortisol, and placental enzyme insulinase reverse the diabetogenic effects of pregnancy which results in

A

Lower blood glucose levels in the immediate postpartum.

Mothers with type 1 will require less insulin for several days after birth

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18
Q

After birth which hormones decrease/increase

A

Decrease- estrogen, progesterone

Increase- prolactin

19
Q

In nonlactating women ovulation occurs as early as

A

27days

mean 7-9wk

20
Q

What is the mean time for ovulation after birth in lactating women

A

6months

21
Q

What is responsible for the suppression of ovulation on lactating women

A

Persistence of elevated serum prolactin levels

22
Q

About how long does it take for the dilation of the urethra and renal pelvis to return to their nonpregnant state

A

6wk

23
Q

If dilation of the urethra persist for 3months or longer their is an increase risk for

A

UTI

24
Q

When should the renal glycosuria induced by pregnancy disappear

A

1wk

25
Q

What are some of the causes of bladder distention in the postpartum women

A

Decreased voiding due to decreased urge to void

Postpartal diuresis

26
Q

What is the average blood loss for a vaginal birth

A

300-500ml

27
Q

What is the average blood loss for a cesarean birth

A

500-1000ml

28
Q

What happens to the mothers cardiac output after birth

A

Remain elevated over nonpregnant values for 12wk

29
Q

What happens to the heart rate and blood pressure, respirations after birth

A

Return to nonpregnant levels within a few days

30
Q

When does the colostrum transition into mature milk

A

About 72-96hrs after birth

31
Q

t/f Following birth, the women’s 1st menstrual cycle will be heavier than normal and then return to pre-pregnant volume

A

True

32
Q

What is the puerperium stage

A

4th trimester, 3-6wk

interval part between birth and the return of the reproductive organs to their nonpregnant state

33
Q

Define autolysis

A

Self- destruction of excess hypertrophied tissue in the uterus

34
Q

How long should it take until the uterus is nonpalpable

A

After 2wk postpartum

35
Q

How long does it take for the uterus to return to its normal size

A

6wks

36
Q

T/F Breastfeeding intensifies after birth pains

A

True because it stimulates contractions

37
Q

Does lochia have an odor

A

It should smell like normal menstrual flow. If it is foul there may be an infection

38
Q

How long should breast tenderness persist

A

24-48hrs after lactation

39
Q

How should your explain the concept of the legal exercises

A

Pretend to stop the flow of urine midstream

40
Q

During the first 10-12 days after birth, what its the common and acceptable WBC value

A

20,000-25,000

41
Q

What is the most serious complication of bladder distention

A

Excessive urinary bleeding

42
Q

What is the average weight loss immediate after birth

A

11-13lbs

Followed by return to prepregnancy weight in 2-3months

43
Q

T/F afterpains are more noticeable in uterus that were overdistended

A

True

44
Q

T/F afterpains are more painful in multifarious women

A

True

OB (24 decks)

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