Chapter 17 Flashcards
Function of oxytocin
Stimulates uterine contractions to help prevent hemorrhage and bleed
An increase/decrease of which placental hormone is associated with breast engorgement, diaphoresis, vaginal secretions?
Estrogen
An increase/decrease of which placental hormone is associated with increased muscle tone?
Progesterone
An increase/decrease of which placental hormone is associated with a decrease in blood sugar?
Placenta enzyme
What hormones would you expect to increase in breastfeeding woman?
Prolactin
Oxytocin
Ovulation can suppressed
up to ______ in breastfeeding women
6 mos
Ovulation can start as early as _______ for mom-breastfeeding women
1-3 months
Postpartum chill is normal in first 2 hrs after giving birth unless accompanied by a fever. True/False
True
Common laboratory and diagnostic tests postpartum
Hgb, Hct, WBCs, Platelets
Rho D
Kleihaur Betke rest
An Rh- mother should be as administered Rho (D) within ______
72h
Fundal height, uterine placement, & consistency should be assessed every
8h
Clients are advised to void every
2-3 hrs to prevent uterine displacement and atony
Oxytoxics such as ______________, ____________, ______________, _____________, & __________ can be given IM or IV after delivery to help with uterine involution.
Oxytocin, mistoprosol, methylergonovine, ergonovine, carboprost
Perineum care:
ice packs can be applied for the first _________ to reduce edema and provide an anesthetic effect
24-48h
Perineal Care:
Sitz baths can be done at least ______ at a temperature between _________C (________F)
Two times a day
38-40 C or 100 - 104 F
Perineal care:
Explain how to cleanse the perineal area
Squeeze bottle w/ warm water and antiseptic sol. to perineal area after each void
Blot, not white
use topical antiseptic cream/spray (benzocaine) sparingly
Analgesics such as _________ can be taken for pain and discomfort
Acetaminophen, ibuprofen, codeine, hydrocodone
When is colostrum produced?
During pregnancy and for 2-3 days after birth
Cracked nipples is an indication of _________and can be accompanied by __________
Mastitis
Flu-like symptoms
Best prevention for sore nipples
Proper latching
Blood loss during childbirth in an uncomplicated pregnancy is about _________mL and ________mL for a cesarean birth.
300-500 mL (10%)
500-1000 mL (15-30%)
Hypovolemic shock occurs as a result to normal blood loss from vaginal or cesarean birth. True/False
False
What can you expect to see with the clients Hct levels after delivery?
Moderate decrease for about 3-4 days than increase by week 8
You can expect WBC levels to be around _________ after delivery
20,000-25,000
What can you expect to see with the clients coagulation and fibrinogen levels after delivery?
Increase and remains elevated for 2-3 weeks
Hypercoagulability predisposes the postpartum client to
Thrombus formation
Orthostatic hypotension can occur w/in the first 48 hrs postpartum. True/False
True
A clients temperature can elevate to _______C (______F) as a result of dehydration after labor during first 24h and should return to normal
after 24h
38
100.4
Signs of venous thrombosis includes:
Redness, swelling, calf pain, warmth
Nursing interventions to prevent venous stasis and thrombosis
Ambulate
Antiembolism stockings (remove when ambulatory)
Meds as prescribe
You can expect bowel
elimination and movement to be delayed up to _________
2-3 days
What can you advise client to do to promote bowel elimination/movement?
Increase fluids and fiber intake
Ambulate
Stool softeners as prescribed (docusate sodium)
Enemas & suppositories are contraindicated for clients w/ 3rd to 4th degree perineal lacerations. True/False
True
Excessive urine >3,000mL/day is a normal finding in the first 2-3
days. True/False
True
A distended bladder can result to
Urinary retention and uterine displacement and atony
Evidence of a distended bladder includes:
Fundal height above umbilicus or baseline level
Fundus displaced midline
Bladder bulges above symphysis pubis
Excessive lo his
Tenderness over bladder
Frequent voiding of ___________ is indicative of urinary retention w/overflow
<150 mL
Patient is encouraged to void every
2-3 h
What diastasis recti? Will this require surgery?
Separation of abdominal muscle from 2cm to 4cm
No, will reserve within 6 weeks
A client with a titer of <1:8 for rubella is administered a SubQ injection of MMR vaccine to protect against _________
Subsequent fetal malformations
Clients to receive live vaccines such as rubella and varicella should be advised NOT to:
Get pregnant for 1 month
