Maternity Nursing Chap 14 Flashcards
The first 1 to 2 hours after birth are called the ________.
-fourth stage of labor
The nursing care management approach of _________ has one nurse caring for both the mother and her infant. It is also called __________ care or __________ care.
- couplet care
- mother and baby
- single room maternity
___________ is a classification of medications that stimulates contraction of the uterine smooth muscle.
-oxytocic
________ is the failure of the uterine muscle to contract firmly. It is the most frequent cause of __________ following childbirth.
- uterine atony
- excessive bleeding (hemorrhage)
A ________ is a perineal treatment that involves sitting in warm water for approximately 20 mins to soothe and cleanse the site and increase blood flow, thereby enhancing healing.
-sitz bath
Painful cramps experienced by many women when the uterus contracts after childbirth are called _________.
-afterpains (afterbirth pains)
__________ is the dilation of the blood vessels supplying the intestines as a result of the rapid decrease in intraabdominal pressure after birth. It causes blood to pool in the viscera and thereby contributes to the development of _________ when the woman who has recently given birth stands up.
- splanchnic engorgement
- orthostatic hypotension
A complaint of pain in calf muscles when dorsiflexion of the foot is forced is called __________. The presence of pain can be associated with the presence of a thrombophlebitis.
-positive Homans’ signs
__________ exercises can assist women to regain pelvic muscle tone that is often lost when pelvic tissues are stretched and torn during pregnancy and birth.
-kegel
___________ is the swelling breast tissue caused by increased blood and lymph supply to the breasts preceding lactation.
-engorgement
_________ vaccine can be given to postpartum women whose antibody titer is lower than 1:8 or whose enzyme immunoassay value is lower than 0.8. It is used to prevent nonimmune women from contracting this TORCH infection during a subsequent pregnancy.
-rubella
__________, also referred to as RhoGAM, is a medication given within 72 hours of birth to Rh-negative, antibody (Coombs’)-negative women who have given birth to Rh-positive newborns to prevent the formation of maternal sensitization. The _________ test may be performed if a large fetomaternal transfusion is suspected to determine the amount of fetal blood present in the maternal circulation more accurately so the correct dosage of RhoGAM can be given.
- Rh immune globulin
- Kleihauer-Betke
Reasons for breastfeeding in fourth stage of labor:
- it takes advantage of the infant’s alert state during the first period of reactivity
- aids in contraction of the uterus to prevent hemorrhage
- is a good opportunity to instruct the mother and assess breasts
- facilitates the bonding and attachment process
- stimulates infant’s bowel so bilirubin-containing meconium is passed
Measures to assist with voiding:
- help her to assume an upright position on bedpain or in bathroom
- listen to running water
- put hands in warm water
- pour water over perineum with peri bottle
- stand in shower or sit in a sitz bath
- put spirits of peppermint in bedpan
- provide analgesics
Measures to prevent thrombophlebitis:
- have woman exercise legs with active ROM of knees, ankles, feet, and toes
- wear support hose
- keep well hydrated
Measures for bottle feeding mother to suppress lactation and relieve discomfort of engorgement:
- have woman wear supportive bra or breast binder continuously for at least the first 72 hours postpartum
- avoid stimulating breasts (no warm water during shower, no infant sucking, no pumping or removal of milk from the breasts)
- apply ice packs or cabbage leaves intermittently to relieve soreness
- use a mild analgesic
What are the 2 major interventions to prevent postpartum hemorrhage in early postpartum period?
- maintain uterine tone: massage fundus if boggy, expel clots when fundus is firm, administer oxytocic medications, have woman breastfeed
- prevent bladder distention
True or False: The effectiveness of the rubella vaccine might be reduced if a postpartum woman receives both Rh immunoglobulin and a rubella vaccine.
True
True or False: Before sitting down in a sitz bath, the woman should relax her gluteal muscles to reduce discomfort when entering the bath and then tighten them after she is sitting in the bath.
False–Tighten gluteal muscles and keeping them tightened when entering the bath and then relaxing them after she is in the bath
True or False: Tucks are used to soothe sore hemorrhoids.
True
True or False: Medications such as estrogen and bromocriptine (Parlodel) are often used to suppress lactation for the bottle feeding woman.
False–These are no longer used.
True or False: The most common cause of excessive bleeding after birth is unrepaired vaginal or cervical lacerations.
False–most common cause is uterine atony, failure of the uterine muscle to contract firmly.
True or False: Ice packs are most effective in minimizing perineal edema during the first 36 hours following birth.
False–The first 24 hours to decrease and then after to provide anesthetic effect.
True or False: An appropriate time to administer pain medication to a breastfeeding woman would be immediately after a feeding session.
True
True or False: Rubella vaccine should not be given to a woman who is breastfeeding her infant.
False–It’s not communicable in breast milk and can be given to breastfeeding mothers.
True or False: A woman should be expected to void at least 250 mL of urine spontaneously within 2 hours following vaginal birth.
False–within 6 to 8 hours
True or False: Chinese women often avoid the use of hormonal methods as a primary method of contraception.
True
True or False: A depressed postpartum woman who is experiencing suicidal ideation should call the warm line that she learned about at discharge.
False–This is not a crisis intervention line. Usually relates to infant feeding, crying, sibling rivalry.
Recovery room nurse report:
-outline essential information that should be reported regarding the condition of the woman and her new baby and the significant events and finding from her prenatal and childbirth periods
Measures to prevent transmission of infection from person to person:
-include clean environment, handwashing, use of Standard Precautions, proper care and use of equipment
Infection prevention measures to teach the woman:
- teach avoidance of walking barefoot
- use of hand washing
- hygienic measures (general, breast, perineal)
- prevention of bladder infection
- measures to enhance resistance to infection, including nutrition and rest
