Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

4500 Gender & reproductive health > Class 8 postpartum > Flashcards

Class 8 postpartum Flashcards

1
Q

what are the goals of postpartum stay?

A

-help transition to home
- support care for birther/parent(s) and newborn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How long does Postpartum last?

A

6-12 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

how long does someone with a non-complicated vaginal delivery stay in hospital?

A

24-48 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

how long does someone with c-section stay in hospital usually?

A

4 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what do we assess for in 4th stage? (BUBBLLEE)

A

B-breasts
U- uterine fundus/uterotonics
B- Bowels
B- Bladder
L- Lochia
L- Legs
E- episiotomy/lacerations
E- emotional

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

how often do we check vitals after delivary?

A

BP, HR, RR
q15 min x4
q30 min x2

Temp: x1 and prn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

how often do we check the fundus after birth?

A

Q15 min x4
q30 min x2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Why do we want birthers to empty their bladder?

A

prevent bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What meds are usually given post delivery for pain ?

A

Acetaminophen and NSAIDS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what vaccination do we want to ensure birthers have before disharge?

A

Rubella

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

When is WINRHO indicated?

A

If the birther is Rh negative
AND
the infant is Rh positive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What should breasts be like 1-2 days post delivery?

A

soft - regular feedings

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What should breasts be like days 2-3 post delivery?

A

filling
-can use warm cloths/icepacks between feedings

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What should breasts be like 3-5 days post delivery?

A

full & soft with feeding
- can give lanolin to prevent cracks, blistering/abraisons

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are some abnormal signs in nipples?

A

cracks
soreness
blistering
abrasions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

how how many hours should a baby be fed?

A

2-3 hours min
and PRN (signs of hunger)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What should the shape of the Uterus be PP?

A

round like a grapefruit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Where should uterus be PP?

A

midline on abdomen
height at umbilicus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What kind of uterus do we not want?

A

a boggy one

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what are the 3 interventions we can do for normal after pains of the uterus?

A

acetaminophen
NSAIDS
heat packs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What does it mean if the uterus is too high up (past the ubilicus)?

A

not contracting properly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

If the uterus is off to one side what does that indicate?

A

likely need to empty the bladder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

how long does it take to no longer palpate the uterus?

A

after 2 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

When might the uterus rise 1 cm above the umbilicus?

A

12 hours post birth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

For uterine fundal assessment where does the nurse place their hands?

A

one hand on top of the uterus

the other hand over the symphysis pubis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What are the 4 steps of a uterine fundal massage?

A
  1. patient supine, knees flexed, feet together
  2. one hand on top of fundus, other hand above pubis symphsis
  3. Massage: rotate upper hand to massage uterus until firm
  4. Expel blood clots: downward pressure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is our FIRST intervention with a boggy uterus/too high above the umbilicus?

A

FUNDAL MASSAGE!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

When should someone be able to void PP and what is minimum amount?

A

within 8 hours
250ml

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What 2 Gu things are not normal PP?

A

Dysuria (after 8 hours)
distension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

How many days after birth is it normal to pass large amounts of urine?

A

2-5 days after birth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What do we not want someone to have while voiding?

A

pain
difficulty
dysuria
fever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

When should someone hav a BM PP?

A

by day 2 or 3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

When is it a good time to use stool softeners/laxatives?

A

early PP period
after extensive perineal repair

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What is Lochia?

A

the stuff that comes out post partum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What do we assess for with Lochia?

A

colour
amount
odour
clots

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

how do we measure blood loss accurately?

A

Hbg or Hct
weight of perineal pad & clots
(1g=1ml of blood)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

When should someone contact the HCP?

A

If lochia is heavier or has a bad odour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What colour can lochia be at day 1-3 ish?

A

Lochia Rubra: Dark red

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What colour can lochia be day 3-10 (or up to 2 -4 weeks)?

A

Lochia Serosa - pink/brownish red

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What colour can lochia be from day 10 to 4-8 weeks?

A

Yellowish white

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

how much bleeding is too much?

A

saturating a peripad in an hour is too much

large clots - bigger than a loonie

Go to triage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What is a normal amount of lochia blood loss?

A

scant to moderate - with a few small clots

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What is a large amount of Lochia blood loss and what could it mean?

A

filling a whole pad in 1 hour
- uterine atony
-cervical/vaginal lacerations that needs repairs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What is Excessive bleeding PP?

A
  • perineal pad that is saturated in 15 min
  • pooling under the buttocks
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What are we concerned with for the patients legs PP?

A

DVT (VTE)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What is normal to see in legs PP?

A

a small amount of bilateral edema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What does a normal episiotomy look like?

A

minimal edema
intact
Dry drsg
edges well approximated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

how long does the C-section dressing stay on for?

A

24 hours - then inspect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

What is first degree laceration?

A

involves:
skin
structures superficial to muscles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

What is a 2nd degree laceration?

A

involves:
extends through muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What is thirds degree laceration?

A

invovled:
extends through the anal sphincter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

what is a 4th degree laceration?

A

involves:
anterior rectal wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

what are the 4 things someone can do with an episotomy/laceration?

A

ice packs
tub bath/sitz bath
analgesics
side-lying

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

When can someone who had C-section shower?

A

after the drsg is removed 24-48 hours after
- uncovered promotes healing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Regarding a birthers emotional state what would they normally feel regarding care, sleep, and mood?

A

Care: for self and infant
Sleep: not restless
mood: excited, happy, interested/invovled in infant care

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

regarding emotional status what should we always ask birthers and why?

A

“how was your delivery?”
because they may have experienced trauma and it could lead to ptsd if they don’t have an outlet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

What vaccine do we give PP if they are not vacinated?

A

Rubella (MMR)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

When do we not give a vaccine?

A

if the person is immunocompromised

59
Q

How soon can someone resume intercourse PP?

A

2-4 weeks (we prefer 6 weeks)
as is comfortable & no bleeding & fully healed

60
Q

What are some main requirements for discharge?

A

-both birther & baby stable
-baseline mobility
- adequate pain control
- GU/GI adequate
- can recognize hunger cues and effectively feed baby

61
Q

When does baby need their first check up?

A

2 weeks
-earlier if had jaundice

62
Q

When should the birther have their first follow up?

A

6 weeks

63
Q

What are the 4 complicated PP issues that put the birther at risk?

A
  1. hemorrhage
  2. infection
  3. thromboembolic conditions (DIC)
  4. Emotional disorders
64
Q

What is a PP hemorrahage?

A

ANY blood loss that has the potential to cause hemodynamic instability

65
Q

What is considered a late/secondary PPH?

A

usually at home
between 24hrs and 12 weeks post partum

66
Q

What is the leading cause of PP mortality world wide?

A

PPH

67
Q

How do we prevent PPH?

A

in 3rd stage labour we:
1. give oxytocin post delivery- especially anterior shoulder birth
2. fundal massage
3. gentle cord contraction
4. Uterotonics
5. inspect placenta
6. prevent full bladder
7. observe birther closely

68
Q

What are the 4 Ts?

A
  1. Tone - uterine atony
  2. Tissue- placenta
  3. Trauma - uterine & tears & lacerations
  4. Thrombin - can’t coagulate
69
Q

What are the first 2 things we do if someone is boggy?

A
  1. Fundal massage
  2. figure out which of the 4 Ts
70
Q

What is the most common cause of Tissue issues?

A

retained placenta

71
Q

Which of the 4 Ts is the leading cause of PPH?

A

Tone issues

72
Q

Why can a long labour or an oxytocin induced labour cause tone issues = PPH?

A

because the uterus gets tired and stops wanting to contract properly

73
Q

What bloodwork do we care about with uterine atony management?

A

CBC
T&S
antibody screen
coag study
HGB
platelets

74
Q

What do we use uterotonics for?

A

manage and prevent PPH

75
Q

What is the MOA of uterotonics?

A

encourage uterus to clamp down on open blood vessels at the open placental site

76
Q

What is a first line uterotonic?

A

Oxytocin - not many side effects

77
Q

What are the 3 second line uterotonics?

A
  1. Misoprostal
  2. Ergotamine (IM)
  3. Carboprost (IM)
78
Q

Who should not get Ergotamine?

A

Those with HTN

79
Q

Who should not get carboprost?

A

-people with asthma (bronchospasm)
-people with tears without epidural (due to explosive diarrhea)

80
Q

What are two negative side effects of misoprostol?

A
  1. can cause febrile
  2. can cause heart issues if given too fast (bolus)
81
Q

What does a Bakri balloon do and how long does it stay in?

A

reduces postpartum bleeding
stays in 12-14 hours

82
Q

What are the Obstetrical emergencies?

A
  1. PPH
  2. Uterine Inversion
83
Q

What is the obstetrical emergency Uterine Inversion?

A

uterus turns inside out

84
Q

What are the 3 uterine inversions?

A

Incomplete- can’t see it
complete- protrudes through cervical OS
Prolapse- outside

85
Q

What causes Uterine inversion?

A
  1. placenta impants wrong
  2. too much pressure on fundus
  3. pull too hard on the cord
  4. Tocolysis (to reduce contractions)
  5. Fetal macrosomia
  6. Uterine atony - boggys not firm
  7. placental tissue implants too hard into uterine wall
86
Q

What do we do for Uterine Inversion management?

A
  1. AVOID aggressive fundal massage!
  2. 18G IV
  3. Fluid resus
  4. tocolytics then put it back
  5. then uterotonics
  6. antibiotics
87
Q

when we think of the 4 Ts, what does Tissue always refer to?

A

Placenta (placenta issues)

88
Q

What are the 4 risk factors for tissue issues = PPH?

A
  1. retained placenta fragments
  2. Placenta accrete, increta, percreta
  3. Placental abruption
  4. Placental previa
89
Q

What is succenturiate lobe?

A

additional placental lobes that get stuck

90
Q

What is placenta accrete syndrome?

A

How deep the placenta is in the uterus

91
Q

How do we manage retained placenta?

A

*Empty bladder
Manual removal of placenta
Uterotonic meds
blood components
Frequent VS
Pain control
18 G
Tocolytics

92
Q

What does Trauma refer to in the 4 Ts?

A
  1. Lacerations
  2. Pelvic hematomas
  3. Uterine rupture
  4. Inversion of the uterus
  5. manual removal of placenta
  6. trauma like vacuums & forceps
93
Q

When do we suspect there’s trauma d/t laceration?

A
  • bleeding keeps going even though the uterus is firm
  • Perineal laceration 1st, 2nd, 3rd, 4th degree - common
  • episiotomies can extend to 3rd or 4th degree
94
Q

When is bleeding less concerning?

A

Intermittent or dark red
- likely just pooling

95
Q

Which T should we assess for first?

A

Tone
then if not that, move to the others

96
Q

What causes the most bleeding?

A

cervical tear

97
Q

How do we manage laceration?

A

IV PRN
Pain management
Repair
Labs PRN

98
Q

What is a pelvic hematoma?

A

collection of blood in the connective tissue

99
Q

What are the 3 types of pelvic hematomas?

A
  1. Vulvar
  2. Vaginal
  3. Retroperitoneal
100
Q

Which type of pelvic hematoma is most common?

A

Vulvar

101
Q

What causes vaginal pelvic hematomas?

A

forceps
episiotomy
primagravida

102
Q

Which pelvic hematoma is life threatening?

A

retroperiotneal

103
Q

How do we differentiate between uterine atony/TONE or TRAUMA with
1. uterus
2. bleeding
3. blood presentation

A

Tone:
1. boggy uterus
2. intermittent bleeding
3. Dark blood & clots

Trauma:
1. firm uterus
2. continuous bleeding
3. bright red blood (arterial)

104
Q

What are the 3 main Thrombin risk factors?

A
  1. Idiopathic thrombocytopenia purpura (ITP)
  2. von Willebrand Disease (vWD)
  3. Disseminated Intravasuclar coagulation (DIC)
105
Q

What is Idiopathic thrombocytopenia purpura (ITP) ?

A

-Autoimmune disorder
- low platelets
- antibodies decrease lifespan of platelets

106
Q

How do we manage ITP?

A
  1. corticosteroids/IV immuneglobulin
  2. Platelet transfusion
  3. splenectomy - to stop storage of platelets
107
Q

What is Von Willebrand Disease (VWD)?

A

a type of hemophelia

platelets can’t stick together

bleeding from mucous membranes

heavy menses/bruise easily

108
Q

What is the management of VWD?

A

-DDAVP - hormone to help with hemostability
-plasma transfusion

109
Q

What is Disseminated Intravascular Coagulation (DIC) ?

A

clotting system freaks the fuck out and you get clots everywhere in the body

Too much clotting at the site of the bleed and then there’s nothing left for the rest of the body so you get bleeding

109
Q

What is the main goal in DIC?

A

fix the root of the problem !

Fix the main bleed so it can stop over clotting that area

110
Q

What are some signs of DIC?

A
  • spontaneous bleeding
  • petechiae where BP cuff was
  • tachycardia
    -hypotension
  • Diaphoresis
  • Low PLT, fibrinogen, PTT
111
Q

How do we manage someone with DIC?

A

-catheter with urometer - can cause renal failure
- O2 & perfusion
- Fluid & blood replacement

112
Q

what is Tranexamic acid?

A

antifibrinolytic
- controls bleeding by preventing breakdown of clots
- is not a uterotonic
- given with other meds

113
Q

what % of blood loss does hemorrhagic shock show in a PP patient?

A

may not appear until 30-40% blood loss

114
Q

What is a late sign of hemorrhagic shock?

A

Decreased BP

115
Q

What is the first thing people with hemorrhagic shock say that we need to pay attention to?

A
  • light headed
  • feel tired
  • decrease U/O
116
Q

how do we manage hemorrhagic shock?

A
  1. 18g IV - 2 lines
  2. Fluid rsuscitation
  3. blood administration
  4. labs prn
  5. oxygen
  6. I/O - cathether
117
Q

What are common symptoms of a PP infection?

A

Fever >38 degrees
tachycardia
localized pain

117
Q

up to how many days is an infection considerd post partum?

A

up to 42 days

118
Q

what is considered a massive transfusion emergency?

A

4 or > units of PRBC within 1 hour and ongoing need expected

119
Q

besides infection what can also cause fever in early PP?

A

VTE or thrombophlebitis

119
Q

What are the 5 most common places for infection PP?

A

endometrium (endometritis)
breasts (Mastitis)
wounds
UTI
Resp inf. (PN)

120
Q

What are specific S/S associated with endometritis in addition to regular infection signs?

A

-uterine tenderness of fundal height above expected location
- bogginess on fundal palpation
- foul-smelling lochia

120
Q

What is the biggest risk factor for endometritis PP?

A

c-section birth

121
Q

How do we know the antibiotics are working for someone with endometritis?

A

-fever decrease
- uterine tenderness decrease
- Lochia odor decrease

122
Q

With episiotomy site or perineal tear/repair site infection when do symptoms normally tend to appear?

A

after discharge from the hospital

123
Q

what is different about mastitis infection in terms of signs/symptoms than regular infection?

A

-usually localized to one breast
- flu-like
- axillary adenopathy

124
Q

What are the 6 signs of sepsis

A
  1. hypotension
  2. tachycardia
  3. tachypnea
  4. fever
  5. decreased U/O
  6. decreased LOC
125
Q

What are 2 main things to teach someone to prevent Mastitis?

A
  • proper latch & positioning
  • avoid engorgement - breast empty as possible
  • Pain relief- NSAIDS, cool compress
126
Q

why are we concerned about postpartum psychological complications?

A
  • interfere with attachment
  • threaten safety and well-being of family members
  • impacts social/emotional development of baby/other children
127
Q

What does PMD (perinatal mood disorders) emcompass?

A
  • depression
  • anxiety
  • OCD
  • bipolar disorder
  • psychosis
128
Q

which disorder is considered a psychiatric emergency?

A

postpartum psychosis

129
Q

How do we identify perinatal depression?

A

intense and pervaisive sadness
severe and labile mood swings
last MORE THAN 2 WEEKS

130
Q

What time frame is considered baby blues?

A

under 2 weeks

131
Q

what time frame is considered perinatal depression?

A

over 2 weeks

132
Q

This condition is mild, does not impair function, and resolves on its own under 2 weeks usually

A

PP baby blues

133
Q

When do baby blues start?

A

day 3-4 PP

134
Q

When does postpartum depression begin?

A

after the first 2 weeks PP

135
Q

Which postpartum mental illness does not resolve on its own?

A

postpartum depression

136
Q

This tool is used to assess postnatal depression

A

Edinburgh postnatal depression scale

137
Q

What are the main feelings of baby blues?

A
  • Sad, anxious, or overwhelmed feelings​
  • Crying spells​
  • Loss of appetite​
  • Difficulty sleeping
138
Q

What are signs of postpartum psychosis?

A
  • Seeing or hearing things that are not there​
  • Feelings of confusion​
  • Rapid mood swings​
  • Trying to hurt yourself or your baby
139
Q

What are signs of postpartum depression?

A
  • Same signs as baby blues, but they last longer and are more severe​
  • Thoughts of harming yourself or your baby​
  • Not having any interest in the baby
140
Q

When should someone call a health care provider with postpartum blues/depression/psychosis?

A
  • The baby blues continue for more than 2 weeks​
  • Symptoms of depression get worse​
  • Difficulty performing tasks at home or at work​
  • Inability to care for yourself or your baby​
    Contact CRISIS Services if you have: ​
  • Thoughts of harming yourself or your baby

4500 Gender & reproductive health (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions