L1: intro Flashcards
Explain GTPA
G: gestations, T: term (37w or more), P: preterm, A: abortion, L: living
What are the categories of vaginal discharge that nurses use to describe the amount of lochia on a maternity pad
Scant, light, moderate, heavy
First Breast in BUBBLLEEP
Breasts: During the first 24hr, breasts should be soft, maybe a little tender, nipple should look normal. The secretion is colostrum. After 72-96hr, the breasts get heavier and lumpier as they fill with true milk (white-blueish milk). After the first 3 days, the breasts should be full
Explain engorgement
Engorgement is when the breasts are overfilling with milk. Breasts will fill heavy and sore. The condition should resolve within 1-2days with frequent breastfeeding
U in BUBBLLEEP
Uterus: The uterus should be midline, contracted (firm), and the fundus height should be appropriate to day. Height starts at 1cm above or below the umbilicus and lowers 1-2cm everyday.
After 2 weeks should the uterus be palpable
no
Where is the fundus 24hrs after birth
halfway bw the umbilicus and the pubis symphysis
During involution the fundus (uterus) descends how many cm every 24hrs
1-2cm/day
Involution is
The return of the uterus back to it’s normal state
Postpartum is also known as:
puerperium or 4th trimester
What is the postpartum period
time between birth and the return of the reproductive organs to there normal state (lasts about to 6 weeks)
A uterine massage is done to
contract the uterus
Bladder in BUBBLLEEP
Assess amt and frequency of pee. Full bladder can prevent uterus from contracting. If patient is not peeing within 8hrs, we will put a catheter in. C-section moms will get a catheter in right away for 12hrs.
Bowel function in BUBBLLEEP
Listen for bowel sounds esp for c-section pts. Ask if they had a bowel movement and if they are passing gas. Should have one by 2-3 days. Women may not have bowel movements for many reasons (loss of muscle tone, dehydrated, not eating enough, scared, etc..)
Lochia in BUBBLLEEP
Lochia: lochia should be decreasing everyday.
1. Rubra: red with small clots in first 4 days
2. Serosa: pink and will last ~10days
3. Alba: whitish and will last ~10-14 days
Clots should be smaller than plum and should break apart.
There shouldn’t be an offensive odour
What is abnormal lochia amts
Patients should not be soaking a pad in an hr. For vaginal birth, the avg is 500ml and for C-section the avg is 1000mL
Legs in BUBBLLEEP
Check for edema (some is normal) and pain. A warm, red, tender area could be a sign of a blood clot.
Episiotomy in BUBBLLEEP
episiotomy is an incision in the perineum. Assess using REEDA. Give pt ice and peri-bottle for comfort
Emotional status in BUBBLLEEP
check for postpartum distress such as tearful, sad, fatigued, depressed, etc…
P in BUBBLLEEP
Assess pain using PQRST, provide intervention measures
Postpartum vitals
BP: Should be normal (around 80/120mmHg) Respirations: 16-24 breaths/min SPO2: above 90% Pulse: 60-100 bpm Temp: 36.2-38 C
Postpartum hypotension or hypertension could be caused by:
Hypotension: hemorrhage
Hypertension: orthostatic hypertension, pre-eclampsia (hypertension due to organ damage), anxiety
T or F: Women should use contraception when they start ovulating.
FALSE. 1 month after birth.
T or F: Only an Rh (-) women who gives birth to am Rh (+) baby needs to have WinRho within 72 hrs after birth
True
Signs of hypovolemic shock
- BP drops when mom has 30-40% blood volume.
- Tachycardia
- cool an clamy
- grey complexion
- looks lethargic
- Soaking through pad in an 1hr (hemorrhage)
Vital signs for newborns
- Resp: 30-60 breathpm
- pulse: 110-180 bpm
- Temp: 36.5-37.2 C
- BP: 60-80/40-50mmHg
what are typical newborn measurments
Head circumference: 33-35 cm
Head to heel length: 45-55 cm
The frequency that newborn should be eating
Every 2-3hrs for breastmilk.
Every 3-4hrs for formula
At least 8 feeds/day
If a newborn is feeding well how many wet diapers should there be
Day 1: 1 and up Day 2: 2 and up Day 3: 3 and up Day 4: 4 and up Day 5 and up: 6 or more
If a newborn is feeding well how many soiled diapers should there be
Day 1-2: 2 and up (meconium: black)
Day 3-4: 3 and up (Transition stool: brown, yellow)
Day 4 and up: 3 (milks stool: yellow, soft)
What positions should babies sleep in
On back
Newborns follow ups
2-3 day check up after birth
Follow up at 2-4 weeks
Every 2months until 18m
Annually afterwards
