Exam 2: post partum Flashcards
peurperium
period after delivery of placenta, lasting for 6 weeks “fourth trimester”
Reproductive adaptations: fundus descends
1 to 2 cm every 24 hours
Reproductive adaptations: by the end of 10 days, the fundus usually cannot be
palpated because it descends into the true pelvis
Reproductive adaptations: afterpains
uterine contraction when the women is breast feeding
Reproductive adaptations: cervix
returs to it’s prepregnant state by week 6 but it never regains the same appearance
Assessment of uterine involutions:
after delivery
12 hours after
24 hours after
day 2 after
day 3 after
after delivery: midline, halfway between the umbilicus and the symphysis pubis
12 hours after birth: at level of umbilicus
24 hours after birth: 1 cm or finger breadth below the umbilicus
day 2: 2 cm below umbilicus
day 3: 3 cm below
When does luchia rubra start
3-4 days after birth
What is luchia rubra like
blood, mucus, tissue, and blood
when does luchia serosa start
3 to 10 days after birth but can last up to 22 to 27 days post partum
What is luchia serosa
pinkish brown
old blood, serum, leukocytes, and debris
when does lochia alba start
10 to 14 days but can last up to 3-6 weeks post partum
What is lochia alba
creamy, white, or light brown
leukocytes, decidua, epithelial cells, mucus, serum, and bacteria
What are the normal amounts of lochia:
scant
light
moderate
large or heavy
scant: 1 to 2 in (10 mL loss)
light or small: 4 inch (10-25 mL loss)
moderate: 4-6 inch (25-50 mL loss)
Large or Heavy: pad saturated in within 1 hour
Endocrine system adaptations: placental hormone adaptations
expulsion of placenta results in dramatic decrease of placental-produced hormones
estrogen and progesterone levels drop markedly
prolactin levels increase
decrease in hCG, hPL, cortisol
Ovulation and menstruation: non lactating vs lactating women
non-lactating: return usually 7 to 9 weeks after birth
lactating: depends on breast feeding frequency and duration; 2-18 months
Cardiovascular system adaptations: blood volume
which increased during the pregnancy drops rapidly after birth and returns to normal within 4 weeks postpartum
Cardiovascular system adaptations: volume plasma
is reduced because of the blood loss
Cardiovascular system adaptations: RBC production
return to normal after the 2nd week of delivery
Cardiovascular system adaptations: WBC
elevated first 4-6 days and then return to levels
Cardiovascular system adaptations: CO
pulse
bp
remains high for the first few days post partum and then gradually to non-pregnant values within 3 months of birth
pulse: 40 to 60 first 2 weeks during delivery
bp: same as during the one during labor and return to normal one week after delivery
Cardiovascular system adaptations: coagulation factors
increased during pregnancy tend to remain elevated during post partum for about 2-3 weeks
risk of thromboembolism in the lower extremities and lung
What is Homan’s sign
diagnose DVT
What can happen if a post partum women has urinary retention
uterine atony which allows excessive bleeding
uterus will go up and to the side
what occurs at night for the first 2 to 3 days involving urine production
profuse diuresis
GI system adaptation
relief or pressure on organs
decreased bowel tone for several days
decreased peristalsis occurs
hunger and thirst
stretch marks change to
silvery lines
Assessment in post partum period:
during 1 hour
during 2nd hour
during 24 hour
after 24
during 1 hr: every15 minutes
during 2 hr: every 30 minutes
during 24 hr: every 4 hour
after 24 hr: every 8 hour
What are the three stages of attachment
contact: The sensory experiences of touching, holding, gazing
emotional state: emerges from affective experience of new parent toward their infant and parental role
individualization: differentiate needs of own to needs of infant
Discharge: uterine fundus is
firm
