Exam #2 Postpartum

Question 1

Care for mothers who are not breastfeeding

Answer 1

Advise mothers to wear a bra except when showering
When showering, let water flow over back rather than chest
Avoid breast stimulation
Apply cold packs
Acetaminophen and ibuprofen for pain relief

Question 2

Uterine involution

Answer 2

Spongy layer cast off as lochia
Basal layer divides into two layers in first 48-72 hours
Outermost layer of basal layer sloughed off
Innermost layer closest to the myometrium lays foundation for new endometrium

Question 3

The placental site can take up to ____ to completely heal

Answer 3

6 weeks

Question 4

Expected return of menses and ovulation for lactating mothers

Answer 4

Usually as long as the individual is breastfeeding, may vary if formula supplements are used. Highly effective (98%) contraception method if 100% breastfeeding until 6 months.

Question 5

Expected return of menses and ovulation for non-lactating mothers

Answer 5

7-12 weeks for menstruation (may take as long as 3 years)

70-75 days for ovulation

Question 6

Risk factors for uterine atony

Answer 6

Prolonged labor
Anesthesia
Difficult birth
Grandmultiparity
Full Bladder
Incomplete expulsion of placenta or membranes
Infection
Overdistension of uterus
Obesity
Preeclampsia

Question 7

Nursing care for boggy uterus

Answer 7

fundal massage

Question 8

Nursing care for postpartum perineal edema

Answer 8

Cooling packs

Sitz baths

Question 9

Lochia first 1-3 days

Answer 9

Lochia rubra, few small clots. 4-8 peripads daily.

Question 10

Lochia after 2-3 days

Answer 10

Serosa— pinkish-brown

Question 11

Lochia after 2-3 weeks

Answer 11

alba—tan-white

Question 12

Postpartum CBC

Answer 12

High WBCS
Low H&H
Low platelets

Question 13

Expected postpartum temperature

Answer 13

36.2-38, elevations seen for only the first 24 hours and <100.4°

Question 14

BUBBLEHE Postpartum Assessment

Answer 14

Breasts
Uterus
Bowels
Bladder
Lochia
Episiotomy/lacerations
Homan's sign/hemorrhoids
Emotions

Question 15

Postpartum blues peaks around…

Answer 15

2 weeks. Transient in nature

Question 16

RhoGam should be administered within ____ of birth

Answer 16

72 hours

Question 17

Care for episiotomy/laceration

Answer 17

Sitz baths, perineal care, peri bottle, ice packs

Question 18

Care for hemorrhoids

Answer 18

Side-lying position, tucks wipes, anesthetic ointments, manual replacement of hemorrhoids, stool softener, diet changes (fiber and fluid)

Question 19

Care for afterbirth pains

Answer 19

Warm bottle on abdomen
Prone position
Ibuprofen
Oxytocic agents (pitocin or methergine)

Question 20

Postpartum perineal assessment—REEDA

Answer 20

Redness
Edema
Ecchymosis
Drainage
Approximation

Question 21

The uterus reaches its prepregancy size by ____ postpartum

Answer 21

5-6 weeks

Question 22

complete healing of an episiotomy may take

Answer 22

4-6 months

Question 23

urinary tract postpartum

Answer 23

decreased sensitivity to pressure
decreased sensation of filling
urinary stasis
hematuria may be masked by lochia

Question 24

HR post partum

Answer 24

bradycardia common

Question 25

prevention of thromboembolism postpartum

Answer 25

early ambulation

Question 26

CO declines to prepregnancy levels by

Answer 26

6-12 weeks

Question 27

puerperal diuresis

Answer 27

increase in urination 12 hours after delivery caused by a decrease in estrogen

Question 28

return to prepregnancy weight is typically achieved by

Answer 28

6-8 weeks

Question 29

Postpartum chill

Answer 29

tremors after birth; of no concern if not accompanied by a fever

Question 30

afterpains—more common in

Answer 30

multipara

Question 31

rx for afterpains

Answer 31

oxytocic agents, breastfeeding, warm water bottle, ibuprofen

Question 32

nutrition for breastfeeding: ___kcals more than normal

Answer 32

200kcal, consider iron supplements

Question 33

postpartum blues typically occurs when?

Answer 33

10-14 days after birth