exam Flashcards
How long are the mother in the baby in the recovery period following birth?
4 hours
The recovery period for the mother includes:
vitals signs and fundal rubs q 15 minutes x4, q30 minutes x2, q hour x2.
The recovery period for the baby includes:
vital signs q 15 minutes x4, q30 minutes x2, q hour x2
What is a fundal rub?
A fundal rub is the massaging of the uterus. We want the fundus to be firm, not soft or boggy. With the massage, we are assisting the uterus back to the prepregnant state. Clots or lochia may be expelled during a rub.
What is Lochia?
Lochia is postpartum discharge. Immediately during the postpartum period it is dark red AKA rubra. Lochia rubra is normal and is described as scant, moderate, or heavy.
It is very important to assess lochia (color, amount and consistency) throughout the postpartum stay. Saturation of a perineal pad within 1 hour can indicate postpartum hemorrhage - this is a medical emergency!
It is normal for a postpartum patient to have a gush of lochia when getting out of bed due to the pooling of lochia in the vaginal cavity.
What is Methylergonovine?
It is a drug that produces sustained uterine contractions
Check blood pressure before giving, and do not give if >140/90
What is Oxytocin (Pitocin)?
It is an exogenous hormone used to contract the uterus to control bleeding
What is misoprostol (Cytotec)?
It is a synthetic prostaglandin used to contract the uterus to control bleeding
What is an Episiotomy?
Surgical incision into the perineum, widens the birth canal, only used for a vaginal delivery.
What are nursing interventions used to care for an Episiotomy?
- Wash hands before and after cleansing perineum
- Wash perineum with mild soap and warm water at least once daily
- Clean from pubis to anal area
- Change pad with each void or defecation or at least four times per day
- Apply a covered ice pack to perineum from front to back during first 24 hours to decrease edema formation and increase comfort
- Educate the use of a squeeze bottle to cleanse the perineum
- Fill a sitz bath with comfortable water and encourage woman to use at least twice a day for 20 minutes. Gluteal muscles must be clenched entering and relaxed after in the bath
- Apply anesthetic cream or spray after cleansing perineal area sparingly three or four times per day
- Apply Tucks witch hazel pads after voiding or defecating
- Apply hemorrhoidal cream as ordered to anal area after cleansing
Why is Rubella status important for a postpartum patient?
For women who have not had rubella or who are serologically non-immune, a rubella vaccine is recommended to prevent the possibility of contracting Rubella in future pregnancies, given as the MMR vaccine
Can cause fetal malformation if contracted in early pregnancy
Why are hemoglobin and hematocrit assessed postpartum?
They assess blood loss during birth, especially after a C-section.
Hgb: 12-18
Hct: 37-52%
Why is blood type/Rh factor assessed postpartum?
Rh incompatibility or ABO incompatibility can occur when the mother has an incompatible blood type with the baby
When Rh-negative women become pregnant with an Rh-positive fetus, they are injected with Rh immune globulin within 72 hours after birth to prevent sensitization
What is APGAR?
The Apgar is a rapid assessment of a newborn based on five signs:
- heart rate
- respiratory effort
- muscle tone
- reflex irritability
- generalized skin color
Evaluations are made at 1 and 5 minutes after birth and are assigned a score from 0-2
Where do you take a pulse on a newborn?
Axillary (armpit)
