Families Exam 2 Flashcards
How often should you assess the mom’s BP and HR for the first 2 hours after birth?
q 15 mins
How often should you assess the mom’s temp for the first 8 hours after birth?
q 4 hrs
What temperature increase is normal in the mom for the first 24 hours after birth?
100.4
What can a decreased BP and increased HR in the mom indicate after birth?
shock, bleeding
How long after delivery does milk production begin?
3-5 days
What should be assessed during the uterine assessment?
- fundal height
- uterine placement
- consistency
What should the uterus feel like?
FIRM
What should be done if a boggy uterus is assessed?
- fundal massage
- admin of oxytocin or methylergonovine
- breastfeeding (releases oxytocin)
What can cause urinary retention in the mom after birth?
- loss of bladder elasticity
- meds/anesthesia
What amount of urine output is normal for the mom for 2-3 days after birth?
> 3,000 mL
How often should you assess the mom’s ability to void after birth?
q 2-3 hrs
When is lochia rubra normal?
days 1-3
When is lochia serosa normal?
days 4-10
When is lochia alba normal?
days 10-28
When should hemorrhage be suspected after birth?
if lochia is heavy with clots
What does a first degree laceration tear through?
skin
What does a second degree laceration tear through?
skin and mucles
What does a third degree laceration tear through?
skin, muscles, and the external anal sphincter muscle
What does a fourth degree laceration tear through?
skin, muscles, the external anal sphincter muscle, and the anterior rectal wall
What is rooming in?
the baby’s crib is by the mother’s bed
What can be used to help with lacerations?
- ice packs
- dermoplast spray
- sitz bath
- stool softener
What should you assess for post-epidural?
- maternal hypotension
- fetal bradycardia
- return of sensation and motor control
What can be used to help with hemorrhoids?
- sitz bath
- topical creams
- rectal suppositories
- witch hazel pads
What happens to HCT after birth?
it decreases for 3-4 days and is back to normal by 8 weeks
What happens to WBC’s after birth?
can be 20-25,000 within the first 4-7 days
How long does the taking-in phase last?
24-48 hours
Should you teach during the taking-in phase?
NO
How long does the taking-hold phase last?
day 2-3 and lasting 10 weeks
Should you teach during the taking-hold phase?
YES
What medication is given for PIH?
mag sulfate
After a vaginal birth, what amount of blood loss indicates post partum hemorrhage?
> 500 mL
After a c-section, what amount of blood indicates post partum hemorrhage?
> 1000 mL
What should be assessed when post partum hemorrhage is suspected?
- fundus
- bleeding
- bladder distention
What medications are given for post partum hemorrhage?
oxytocin or methylergonovine
What patient should methylergonovine not be given to?
a patient with HTN
What should be assessed when there are lacerations/hematomas?
- lochia
- pain
- source of bleeding
- VS
- vulva/perineum/rectum
- hemodynamic status
What problems can occur from a hematoma?
urge to defecate and difficulty voiding
How long should a mom breastfeed for to prevent engorgement?
until breast is soft and completely empty
How many times a day should a mom nurse?
8-12
When should you warm the breasts?
before breastfeeding
When should you cool the breasts?
after breastfeeding
What does the lochia look like with endometritis?
dark and profuse
Does endometritis affect the baby?
NO
What happens to the uterus with endometritis?
tender and enlarged
What happens to the breast with mastitis?
it is painful/tender with a localized hard mass and reddened area
Should you stop breastfeeding if experiencing mastitis?
NO
What side should you start feeding on with mastitis?
the unaffected side
What characteristics of the urine indicate UTI?
- cloudy
- blood-tinged
- malodorous
- sediment visible
- retention
What urine specimen is done when testing for UTI?
clean catch
What medication is given for vulvovaginitis?
metronidazole
What can happen to the neonate if the mom has vulvovaginitis?
- preterm birth
- LBW
- infection
- miscarriage
What characteristics does discharge have with vulvovaginitis?
thick and white
What characteristics does discharge have with gonorrhea?
yellow- green
What risks does gonorrhea have to the neonate?
- blindness
- transmission
How long is postpartum blues normal?
up to 10 days
When is it considered post partum depression?
if symptoms increase after 10 days of post partum blues
What is the biggest risk for those with postpartum depression?
rejection/harm to the infant
What medication is given to the mom and baby for HIV?
retrovir
What should be encouraged to a pregnant mom with HIV?
Hep B, pneumonia, and flu vaccines
What should be done at birth to an infant born to a mom with HIV?
BATH
What is normal when first starting to breastfeed?
cramping
Hand to mouth/hand, rooting, and sucking are infant cues for what?
hunger
Slow sucking, soft breasts, and a sleeping baby are infant cues for what?
satisfaction
When should you burp the baby?
when alternating breasts
What position should you place the baby in after feeding?
on their back
How should you help flat/inverted nipples?
- roll them in your fingers prior to feeding
- wear a breast shield in between feedings
How should you help sore/irritated/cracked nipples?
- breast milk, air dry
- breast creams
What type of bra should a breastfeeding mom wear?
well-fitting, supportive
What type of bra should a non-breastfeeding mom wear?
tight-fitting
If a non-breastfeeding mom experiences engorgement, what can be done?
cold compress = fresh cold cabbage leaves in bra
Why is the basal body temp contraception method not reliable?
other variables can change temperture
When should you take your temperature if using the basal body temp contraception method?
before getting out of bed in the morning
How long before sex do you have to insert the diaphragm? How long do you have to leave it in after?
6 hours before, 6-24 hours after
What should you do before inserting the diaphragm?
empty bladder
What should the diaphragm be washed with?
mild soap and warm water
What type of barrier method requires a prescription and a visit to a provider?
diaphragm
What are the main side effects of combined and progestin-only birth controls?
- HA
- N/V
- breast tenderness
- breakthrough bleeding
What hormonal contraceptive is safe when breastfeeding?
progestin-only (minipill)
What does the emergency oral contraceptive do?
prevents fertilization
How often are injectable progestins given?
4x/year, q 11-13 weeks
What hormonal contraceptive does not impair lactation?
injectable progestins
How long is fertility delayed after discontinuing injectable progestins?
up to 18 months
How is the vaginal ring beneficial?
vaginal delivery of hormones means lower doses and less adverse effects
What method of contraception can cause discomfort during intercourse?
vaginal ring
How long are implantable progestins effective for?
3 years
