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Women's Health > Exam 3 pt 2 > Flashcards

Exam 3 pt 2 Flashcards

1
Q

what is classified as a hemorrhage

A

> 500 EBL for vag delivery
1000 EBL for Csection
OR peripad saturation in 15 min or less

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2
Q

failure of the uterus to return to a nonpregnant state

A

sub involution

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3
Q

recognized causes of subinvolution

A
  • retained placental fragments

- pelvic infection

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4
Q

s/s of sub involution

A
  • prolonged lochial discharge
  • irregular or excessive bleeding
  • sometimes hemorrhage
  • boggy uterus or larger than normal
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5
Q

med treatment of sub involution

A

Ergonovine or methylergonovine

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6
Q

other treatment of sub involution

A

dilation and curettage may be performed to remove retained placental fragments
antibiotic therapy if cause is infection

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7
Q

if woman’s uterus is not firm…

A

perform uterine massage and allow her to void

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8
Q

cardiovascular system changes postpartum

A

blood volume decreases
cardiac output decreases
hematocrit, hemoglobin, and WBC changes

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9
Q

gastrointestinal system changes postpartum

A
  • abdomen returns to post pregnancy 6 wks after birth
  • striae may persist
  • diastasis recti abdominis
  • lukewarm quick shower
  • blood goes to abdominal organs not brain*can cause HYPOTENSION
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10
Q

when can pt eat post partum

A

when you are sure they are not going back to OR

monitor for 1-3 hours, if scant bleeding then can eat

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11
Q

describe bowel evacuation post partum

A

occurs 2-3 days after childbirth

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12
Q

urinary system changes postpartum

A

diuresis and diaphoresis

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13
Q

what urine component disappears by 1 wk post partum

A

renal glycosuria because HPL hormone is gone

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14
Q

why does postpartal diuresis occur

A

getting rid of the fluid given in labor and the 1000 mL plasma

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15
Q

how often should you monitor pt for bladder distention postpartum

A

Q1H, catheters if necessary Q4H

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16
Q

musculoskeletal system changes postpartum

A

pelvis returns to pre pregnancy position(hip pain)

joints are stabilized 6-8 wks after birth due to RELAXIN

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17
Q

endocrine system changes postpartum

A
  • decrease in estrogen and progesterone

- pituitary hormones, ovarian function, and prolactin stay elevated in breastfeeding mother

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18
Q

integumentary system changes postpartum

A

hair falls out may lose 20% of hair and cholasma disappears

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19
Q

when does ovulation occur if not lactating

A

27 days after birth

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20
Q

when does ovulation occur if lactating

A

70-75 days after birth

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21
Q

what birth control pills can be given if breastfeeding

A

progesterone only* (no estrogen to be able to breast feed so IUD or depo)

22
Q

immune system changes postpartum

A

need for rubella vaccine determined

23
Q

when is mom given RHOGAM postpartum

A

if mom is Rh negative and the baby is Rh positive RHOGAM is given within 72 hours of delivery

24
Q

describe milk 24 hours after delivery then 72-96 hours after

A

24 hrs- milk is thick (colostrum)

72-96 hrs-milk matures based on supply demand

25
Q

very condensed breast milk

very rich in fats and nutrients because baby’s stomach is very small and can only handle a little bit

A

colostrum

26
Q

engorgement support

A

frequent feedings, moist heat PRN, supportive bra, allow milk to dry on areolas, lanolin

27
Q

important to remember when breastfeeding

A

need to alternate breast every feed

28
Q

when does engorgement of breasts occur

A

in 24-36 hrs after milk comes in

29
Q

relief for nonbreastfeeding mothers

A

ice packs,cold cabbage Q2H, ASA/Motrin, NO heat, NO massage/stimulation/expression of milk

30
Q

do not let nonbreastfeeding mothers….

A

pump/feed even once d/t supply demand system

31
Q

when does the amount of menstrual flow return to prepregnancy volume

A

within 3-4 cycles (first menstrual cycle is heavier than normal)

32
Q

red discharge in the hospital that should subside by 5 days

A

rubra

33
Q

serous discharge, blood with serum up to 3-4 wks

A

serosa

34
Q

white discharge, WBC shedding with mucus

A

alba

35
Q

describe the different levels of peripad saturation

A 
scant-less than 1 in
light-less than 4 in
moderate- >4 in
heavy- saturation of peripad in 1 hr
*hemorrhage- saturation of peripad in 15 min
36
Q

Rubin Stages of Development

A

1) Taking In
2) Taking Hold
3) Letting Go

37
Q

describe the Taking In stage

A 
day 1 (first 24 hrs for vag and first 48 hrs for csec)
focus is self and meeting basic needs
38
Q

describe the Taking hold stage

A

begins after day 1 (>25 hrs for vag and >49 hrs for csec)
focus is care of baby and competent mothering
optimal teaching period by nurses

39
Q

describe the letting go stage

A

begins after taking hold phase (abt 2 wks)

focus is forward movement of family as a unit with interacting members

40
Q

what psychological change is common following birth

A

labile emotions/fluctuate (fatigued and tired d/t loss of placenta and rapid shift of hormones)

41
Q

what are the postpartum blues

A

occur 1-10 days after birth
weepy (loss of placenta)
approx. 50-80% of all women
emotional and liable for no reason

42
Q

symptoms of postpartum blues

A

depression, a let down feeling, restlessness, fatigue, insomnia, headache, anxiety, sadness, and anger

43
Q

coping with postpartum blues

A

rest, relaxation techniques, self care, plan a day out, talk with partner

44
Q

describe depression potpartum

A

usually starts at 2 wks and lasts up to one year
grossly underdiagnosed, underassessed
tense, irritable, sleeplessness, feels inept as mother

45
Q

what do we give mothers for depression

A

SSRIs and birth control

46
Q

describe psychosis postpartum

A

rare
occurs within 3 weeks postpartum
bipolar or major depression precipates it

47
Q

what elevates risk of psyhological risks postpartum

A

history of previous psychological history (anxiety/depression)
*the worse the psychiatric illness, the more we worry about them and the greater risk they are

48
Q

C-section post op assessment

A 
assess uterine firmness/position
assess lochia and incision site for bleeding
assess abdominal distention
ambulate and warm compress
assess bowel sounds
inspect dressing for infection
assess lungs
49
Q

abdominal distention can have referred pain where

A

to shoulder

50
Q

cannot feed pt until…

A

bowel sounds return

Women's Health (31 decks)

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