Final AD - postpartum

Question 1

What is involution?

Answer 1

describes the process by which the uterus returns to the non-pregnant state. The uterus undergoes a dramatic reduction in size, although it will remain slightly larger than its size before the first pregnancy. The uterus is predominantly composed of a muscle layer, the myometrium, which is covered by serosa and lined by the decidua basalis. The process of uterine involution results from a decrease in the size of the myometrial cells rather than from a decrease in the number of myometrial cells. The decrease in cell size results in myometrial thickening and ischemia from reduced blood flow to the contracted uterus.

Question 2

What is sub-involution?

Answer 2

failure of the uterus to return to its pre-pregnancy size. Remains enlarged with continued lochia discharge and can result in PP hemorrhage. Prolonged vaginal bleeding and irregular or excessive vaginal bleeding. Uterus is enlarged and higher than normal in the abdomen relative to the umbilicus. Boggy uterus and prolonged lochia discharge with irregular or excessive bleeding.

Question 3

what is the nursing assessment for involution?

Answer 3

Cup one hand just above the symphysis pubis to support the lower segment of the uterus, and with the other hand palpate the abdomen to locate the fundus. Never palpate the fundus without cupping the uterus. Document the fundal height, location, and uterine consistency. Document the position and location of the uterus by number or fingerbreadths and according to agency policy. (If above the umbilicus, document as +1, U +1, 1/U. If below the umbilicus, document as -1, U -1, or U/1)

Question 4

Burping a baby?

Answer 4

Burping is usually performed midway and at the end of the feeding to remove excess air from the infant’s stomach. To burp the baby properly, parents are taught to either hold the baby over their shoulder or on their lap with the baby’s head supported. The baby’s back is gently rubbed until air is expelled

Question 5

Release of suction when baby is finished?

Answer 5

The mom should place her finger between the breast and the baby’s mouth. Gently break the suction.

Question 6

How to know if there is an adequate latch?

Answer 6

latching should include complete areola, baby jaw should be wide.

Question 7

Lochia Rubra (Day 1-3)?

Answer 7

Normal: bloody, small clots, fleshy, earthy odor, red or red brown

Abnormal: large clots, saturated perineal pads, foul odor

Question 8

Lochia Serosa (day 4-10)?

Answer 8

Normal: decreased amount; serosanguineous pink or brown tinted

Abnormal: excessive amount, foul smell, continued or recurrent reddish color

Question 9

Lochia Alba (day 11-21)?

Answer 9

Normal: white, cream, or light-yellow color, decreasing amounts

Abnormal: persistent lochia serosa, return of lochia rubra, foul odor, discharge continuing

Question 10

Interventions for a subinvoluted uterus

Answer 10

Monitor fundal position and consistency
Monitor lochia for color, amount, consistency, and odor
Monitor VS
Encourage the client to use activities that can enhance uterine involution - breastfeeding, early and frequent ambulation, and frequent voiding