Exam #2 Postpartum Flashcards
Care for mothers who are not breastfeeding
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
Uterine involution
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
The placental site can take up to ____ to completely heal
6 weeks
Expected return of menses and ovulation for lactating mothers
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.
Expected return of menses and ovulation for non-lactating mothers
7-12 weeks for menstruation (may take as long as 3 years)
70-75 days for ovulation
Risk factors for uterine atony
Prolonged labor Anesthesia Difficult birth Grandmultiparity Full Bladder Incomplete expulsion of placenta or membranes Infection Overdistension of uterus Obesity Preeclampsia
Nursing care for boggy uterus
fundal massage
Nursing care for postpartum perineal edema
Cooling packs
Sitz baths
Lochia first 1-3 days
Lochia rubra, few small clots. 4-8 peripads daily.
Lochia after 2-3 days
Serosa— pinkish-brown
Lochia after 2-3 weeks
alba—tan-white
Postpartum CBC
High WBCS
Low H&H
Low platelets
Expected postpartum temperature
36.2-38, elevations seen for only the first 24 hours and <100.4°
BUBBLEHE Postpartum Assessment
Breasts Uterus Bowels Bladder Lochia Episiotomy/lacerations Homan's sign/hemorrhoids Emotions
Postpartum blues peaks around…
2 weeks. Transient in nature
RhoGam should be administered within ____ of birth
72 hours
Care for episiotomy/laceration
Sitz baths, perineal care, peri bottle, ice packs
Care for hemorrhoids
Side-lying position, tucks wipes, anesthetic ointments, manual replacement of hemorrhoids, stool softener, diet changes (fiber and fluid)
Care for afterbirth pains
Warm bottle on abdomen
Prone position
Ibuprofen
Oxytocic agents (pitocin or methergine)
Postpartum perineal assessment—REEDA
Redness Edema Ecchymosis Drainage Approximation
The uterus reaches its prepregancy size by ____ postpartum
5-6 weeks
complete healing of an episiotomy may take
4-6 months
urinary tract postpartum
decreased sensitivity to pressure
decreased sensation of filling
urinary stasis
hematuria may be masked by lochia
HR post partum
bradycardia common
prevention of thromboembolism postpartum
early ambulation
CO declines to prepregnancy levels by
6-12 weeks
puerperal diuresis
increase in urination 12 hours after delivery caused by a decrease in estrogen
return to prepregnancy weight is typically achieved by
6-8 weeks
Postpartum chill
tremors after birth; of no concern if not accompanied by a fever
afterpains—more common in
multipara
rx for afterpains
oxytocic agents, breastfeeding, warm water bottle, ibuprofen
nutrition for breastfeeding: ___kcals more than normal
200kcal, consider iron supplements
postpartum blues typically occurs when?
10-14 days after birth
