Exam 2 part 2 Flashcards
is the postpartum period from delivery of the placenta to about 6 weeks
puerperium
nursing is based on the family as the primary caregivers
family centered maternity care
how often should assessment be done for the first hour PP
q15 min
how often should assessment be done in the second hour PP
q30 min
how often should assessment be done in the next 22 hours PP
q4-8 hours
for the perineum assessment you check for
REEDA
REEDA
Redness Edema Ecchymosis Drainage, bleeding for laceration Approximation-the incision line is looking normal
medication given for cramping
NSAIDs
medication used for topical perineal pain
Dermoplast (benzocaine topical)
Tucks
Ice packs
medication for moderate or incisional pain
Narcotic/acetominophen combo like vicoden
Alternate ibuprofen with narcotic combo or give together
cut through skin and muscle
2nd degree
cut through skin, muscle, anus
3rd degree
cut through skin, muscle, anus, and rectum
4th degree
BUBBLE-E
Breast Uterus Bowels Bladder Lochia Episiotomy Emotional state
used for early irritation while breast feeding
lanolin
Signs and symptoms of mastitis
Sore/ localized inflammation
Fatigue
Flu-like symptoms
What should be taught to minimize risk of mastitis
complete emptying of breasts
when does engorgement occur
48-72 hours PP
treatment for engorgement
Cold frozen peas
NSAIDs
Cabbage leaves
how is the uterus measured
fingerbreaths
where will the uterus be immediately after delivery
may be below the umbilicus
where will the uterus be 6-12 hours PP
level of umbilicus
how much does the uterus go down PP
1cm per day
when the uterus us firm, at the midline, contracted, pressure on blood vessels which minimizes bleeding
Normal
if the uterus is soft and boggy it can lead to
excessive bleeding
if the uterus is deviated from the midline it can be due to
a full bladder
if there is continuous bleeding (without clots) and firm uterus can be due to
suspected vaginal or cervical laceration
when should you not be able to feel the fundus above the symphysis
2 weeks PP
approaches pre-pregnant size and position by
6 weeks PP
migrate to uterus and perform autolysis/ absorption of material
proteolytic enzymes
the cervix may appear nulliparous but pulled anterior and upward on examination
cesarean cervix
sloughing of spongy outer layer of decidua and top layer of basal decidua
lochia
lochia with many different cells, dark red first 3 days PP
rubra
lochia that is pinkish brown 3-10 days PP Serous exudate Decidua RBC WBC
serosa
lochia that is creamy white
Mostly WBC
Lasts 1-2 weeks post serosa
Alba
when does lochia end
6 weeks PP
how many times a day can you use a Sitz bath
3-4
a drop in what signals the anterior pituitary to secrete prolactin
progesterone and estrogen
colostral phase is endocrine function and lasts up to
72-96 hours
breasts fill with mature breast milk. MAny cellular and hormonal changes
stage of lactogenesis II
what can the temperature be up to for the first 24 hours
100.4 (38)
decrease in BP after several days may indicate
hemorrhage
increase in BP after several days may indicate
postpartum pre-eclampsia
increased risk for DVT and thromoembolism for up to
6 weeks
10% drop in hematocrit is a sign of PP
hemorrhage
epileptics have high risk of seizures in first
24 hours PP
how long should you wait to get pregnant after receiving the rubella vaccine
3 months
when does menstruation resume for bottle feeding women
6-8 weeks PP
fathers absorption, preoccupation, and interest in infant
engrossment
normal period of lability that occurs from birth up to 2 weeks postpartum
It is an adjustment reaction with depressed moods
postpartum blues
causes of postpartum blues
Psychological changes
Hormonal shifts
Fatigue
Treatment of postpartum blue s
Rest Regular meals Reassurance that this passes Understanding partner/family Help at home
Feeling of sadness, crying, insomnia, anger and thoughts of harming self (thoughts of harming baby are rare), worthlessness, impaired concentration
At least 4 symptoms most of the days for 2 weeks
Postpartum depression
treatment for postpartum depression
SSRI
CBT
may need hospitalization
Most severe form
Evident in first 3 months PP
Agitated, hyperactive, insomnia, irrational, poor judgment, extreme mood instability
Delusions/hallucinations support her beliefs that she, her baby and/ or the world is evil
PP psychosis
