Exam 2 part 2

Question 1

is the postpartum period from delivery of the placenta to about 6 weeks

Answer 1

puerperium

Question 2

nursing is based on the family as the primary caregivers

Answer 2

family centered maternity care

Question 3

how often should assessment be done for the first hour PP

Answer 3

q15 min

Question 4

how often should assessment be done in the second hour PP

Answer 4

q30 min

Question 5

how often should assessment be done in the next 22 hours PP

Answer 5

q4-8 hours

Question 6

for the perineum assessment you check for

Answer 6

REEDA

Question 7

REEDA

Answer 7

Redness
Edema
Ecchymosis
Drainage, bleeding for laceration
Approximation-the incision line is looking normal

Question 8

medication given for cramping

Answer 8

NSAIDs

Question 9

medication used for topical perineal pain

Answer 9

Dermoplast (benzocaine topical)
Tucks
Ice packs

Question 10

medication for moderate or incisional pain

Answer 10

Narcotic/acetominophen combo like vicoden

Alternate ibuprofen with narcotic combo or give together

Question 11

cut through skin and muscle

Answer 11

2nd degree

Question 12

cut through skin, muscle, anus

Answer 12

3rd degree

Question 13

cut through skin, muscle, anus, and rectum

Answer 13

4th degree

Question 14

BUBBLE-E

Answer 14

Breast
Uterus 
Bowels
Bladder
Lochia
Episiotomy 
Emotional state

Question 15

used for early irritation while breast feeding

Answer 15

lanolin

Question 16

Signs and symptoms of mastitis

Answer 16

Sore/ localized inflammation
Fatigue
Flu-like symptoms

Question 17

What should be taught to minimize risk of mastitis

Answer 17

complete emptying of breasts

Question 18

when does engorgement occur

Answer 18

48-72 hours PP

Question 19

treatment for engorgement

Answer 19

Cold frozen peas
NSAIDs
Cabbage leaves

Question 20

how is the uterus measured

Answer 20

fingerbreaths

Question 21

where will the uterus be immediately after delivery

Answer 21

may be below the umbilicus

Question 22

where will the uterus be 6-12 hours PP

Answer 22

level of umbilicus

Question 23

how much does the uterus go down PP

Answer 23

1cm per day

Question 24

when the uterus us firm, at the midline, contracted, pressure on blood vessels which minimizes bleeding

Answer 24

Normal

Question 25

if the uterus is soft and boggy it can lead to

Answer 25

excessive bleeding

Question 26

if the uterus is deviated from the midline it can be due to

Answer 26

a full bladder

Question 27

if there is continuous bleeding (without clots) and firm uterus can be due to

Answer 27

suspected vaginal or cervical laceration

Question 28

when should you not be able to feel the fundus above the symphysis

Answer 28

2 weeks PP

Question 29

approaches pre-pregnant size and position by

Answer 29

6 weeks PP

Question 30

migrate to uterus and perform autolysis/ absorption of material

Answer 30

proteolytic enzymes

Question 31

the cervix may appear nulliparous but pulled anterior and upward on examination

Answer 31

cesarean cervix

Question 32

sloughing of spongy outer layer of decidua and top layer of basal decidua

Answer 32

lochia

Question 33

lochia with many different cells, dark red first 3 days PP

Answer 33

rubra

Question 34

``` lochia that is pinkish brown 3-10 days PP Serous exudate Decidua RBC WBC ```

Answer 34

serosa

Question 35

lochia that is creamy white Mostly WBC Lasts 1-2 weeks post serosa

Answer 35

Alba

Question 36

when does lochia end

Answer 36

6 weeks PP

Question 37

how many times a day can you use a Sitz bath

Answer 37

3-4

Question 38

a drop in what signals the anterior pituitary to secrete prolactin

Answer 38

progesterone and estrogen

Question 39

colostral phase is endocrine function and lasts up to

Answer 39

72-96 hours

Question 40

breasts fill with mature breast milk. MAny cellular and hormonal changes

Answer 40

stage of lactogenesis II

Question 41

what can the temperature be up to for the first 24 hours

Answer 41

100.4 (38)

Question 42

decrease in BP after several days may indicate

Answer 42

hemorrhage

Question 43

increase in BP after several days may indicate

Answer 43

postpartum pre-eclampsia

Question 44

increased risk for DVT and thromoembolism for up to

Answer 44

6 weeks

Question 45

10% drop in hematocrit is a sign of PP

Answer 45

hemorrhage

Question 46

epileptics have high risk of seizures in first

Answer 46

24 hours PP

Question 47

how long should you wait to get pregnant after receiving the rubella vaccine

Answer 47

3 months

Question 48

when does menstruation resume for bottle feeding women

Answer 48

6-8 weeks PP

Question 49

fathers absorption, preoccupation, and interest in infant

Answer 49

engrossment

Question 50

normal period of lability that occurs from birth up to 2 weeks postpartum It is an adjustment reaction with depressed moods

Answer 50

postpartum blues

Question 51

causes of postpartum blues

Answer 51

Psychological changes Hormonal shifts Fatigue

Question 52

Treatment of postpartum blue s

Answer 52

``` Rest Regular meals Reassurance that this passes Understanding partner/family Help at home ```

Question 53

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

Answer 53

Postpartum depression

Question 54

treatment for postpartum depression

Answer 54

SSRI CBT may need hospitalization

Question 55

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

Answer 55

PP psychosis