Maternity- Postpartum Flashcards
What is important to provide a client during the fourth stage of labor?
Comfort measures
What is an important thing that occurs during the first stage of labor?
Parent newborn, bonding should occur
What is the main goal during the immediate of postpartum period
Prevent postpartum hemorrhage
What is the postpartum period Classified as
Interval between birth and the return of the reproductive organs to their non-pregnant state
Consider to last six weeks
What drug does breast-feeding stimulate?
Release of endogenous oxytocin
What kind of uterus prevents excessive, bleeding and hemorrhage
Affirm and contracted uterus
Why is endogenous oxytocin administered postpartum?
To improve the quality of uterine contractions
After delivery of the placenta, what decreases
Estrogen, hormones
What is decreased estrogen associated with?
Breast engorgement, diaphoresis and dieresis
Decrease vaginal lubrication
What does decreased progesterone result in?
Increase muscle tone throughout the body
And lactating clients what remains elevated to suppress ovulation
Blood prolactin levels
The return of ovulation is influenced by
Breast-feeding, frequency length of each feeding and use of supplementation
In a patient who is breast-feeding what is the length of time till the next first post partum ovulation
Six months
In non-lactating client when does ovulation resume
7-9 weeks after birth
What is the postpartum assessment immediately following delivery?
Vitals
Uterine firmness and location
Uterine position relation to the midline
Amount of vaginal bleeding
How often should blood pressure and pulse be assessed within the first two hours after birth
Every 15 minutes
How often should the temperature be assessed for the first eight hours after birth?
Every four hours, then at least every eight hours
What is the focus postpartum physical assessment include
Breast
Uterus (fundal, height, uterine placemen)
Bowel (G.I. function)
Bladder
Lochia (color odor amount)
Episiotomy (edema, Ekhymosis
approximation)
When does involution occur?
With contractions of the uterine, smooth muscle, whereby the uterus returns to the pre-pregnancy dtate
What rapidly decreases in size at the end of the third stage of labor
The uterus
Where should the fundal height descend into the pelvis after birth?
Approximately one finger breath per day
One hour after delivery where should the fundus be located?
Rise to the level of the umbilicus
Every 24 hours the fundus should descend approximately
1-2 cm
 After two weeks postpartum the uterus should lie
Within the true pelvis, and should not be palpable
How often should you assess the fundal height, uterine placement and neuter and consistency?
Every eight hours
How do you assess the fundal height, uterine placement and uterine consistency
Client supine with me slightly flexed
Lower peroneal pad and observe Loki. I flow is the fundus is palpated.
Cup one hand just above the symphysis pubis to support the lower segment, the other hand palpate the abdomen to locate the fundus
What should you never do when palpating the fundus?
Never palpate the fundus without cupping the uterus
How do you measure the fundal height?
By placing fingers on the abdomen, and measuring how many finger breaths fit between the fundus in umbilicus
What can displays of fundus from being midline?
A full bladder
What should you do with the fundus is boggy
Lightly massage the fundus in a circular motion
If uterus does not firm after massage and keep massaging and notify provider
If the fundal height is above the umbilicus. How would you document that?
+1 +2
If the fundus is below the umbilicus, how would you document that?
-1 -2
What do you administer Im or IV after placenta is delivered to promote uterine contractions
Oxytocin
What stimulates the production of natural oxytocin and prevents hemorrhage
Early breast-feeding
What did you encourage the patient to do to prevent possible uterine displacement and atony
Encourage emptying of the bladder
What is lochia Rubria?
Dark red color bloody consistEncy
How long does Loki Rubria last?
1 to 3 days
What is Loki I serosa
Pinkish brown color contains small clots
How long does Loki serosa last?
4 to 10 days
What is lochia alba?
Yellowish white creamy color
How long does lochia alba last?
10 to 8 weeks postpartum
How was lochia I amount assess
Quantity of saturation on the peroneal pad
What does scant Lochia
Less than 2.5 cm
What is light Lochia
2.5 to 10 cm.
What is moderate lochia?
More than 10 cm
What does heavy lochia?
One pad saturated within two hours
What is excessive blood loss determined by Lochia
One pad saturated in five minutes or less, or pooling of blood under Buttock
How often should you assess lochia after delivery?
Check at least every 15 minutes for the first hour
What can result in a gush of Lochia with the expression of clots and dark blood
Massaging the uterus or ambulation
What decreases the amount of lochia after birth?
Cesarean section
What are manifestations of abnormal lochia?
Excessive bright red blood
Numerous large clots
Excessive blood loss
Foul odor
Persistent Heavy Lochia rubra
Continued flow of lochia, serosa or alba beyond the normal length
What does continuous flow of lochia serosa or Alba beyon the normal length indicate
Endometritirs
What happens to the cervix directly after birth
Cervix a soft
How long after birth does it take for the cervix to shorten and regain its form?
2-3 days
What is never completely restored after birth
Muscle tone of vagina
What is a normal finding from episiotomy site in early postpartum.
Bright red trickle of blood
How do you promote comfort measures in peroneal tenderness
Apply ice packs
Heat therapy
Sitz baths
PCA pump
Client information about Sitz baths
Squeeze bottle filled with warm water after each avoiding to cleanse the perineal area
Block the perineal area to clean it after toileting, starting from front to back
How often does the secretion of colostrum occurred after pregnancy?
2 to 3 days immediately after birth
How soon after birth is milk produced by the breast
3 to 5 days after
What is engorgement of the breast?
Phone list of breast, tissue, result of lymphatic circulation, milk, production, and temporary vein. Congestion
May appear tight, tender, warm in full
How does someone who does not plan on breast-feeding resolve engorgement
Put breast binders or support bras on or ice pack and cabbage leaves
What is mastitis?
Infection in a milk, duck of the breast with concurrent flu like manifestations
What are the four positions of breast-feeding?
Football (under the arm)
Cradle
Across the lap
Side lying
Why is it so important? The newborn has a proper latch on the nipple
To prevent soreness
The newborn must take part of the areola and nipple, not just the tip of the nipple
If you do not plan on breast-feeding, what should you not do?
Stimulate the breast or Xpress breastmilk
How much weight should you lose after you have a baby
 About 19 pounds during the first five days
What vital sign is concerning and should be a valuated in the postpartum period
Tachycardia
Elevation of temperature after 24 hours or that persits after two days
Operative, vaginal birth, and Ninos Victor lacerations increase the risk of
Temporary postpartum anal incontinence that usually resolves within six months
What physical changes in the G.I. system can be noticed
Increase appetite, following delivery
Constipation
Hemorrhoids
What might not occur for 2 to 3 days after delivery?
Spontaneous bowel movement
What is contraindicated for clients who have third fourth degree peroneal lacerations
Enemas and suppositories
Distended bladder as a result of urinary retention can cause what
Infection
What is evidence of a distended bladder
Fundal height above umbilicus
Fundus displaced from midline
Bladder bulges above the symphysis pubis
Voiding less than 150 mL
If a patient cannot avoid within 6 to 8 hours after delivery what is required
Catheterization
What education should you teach a patient who is not immune to rubella and is receiving the rubella vaccine during postpartum period
Should not get pregnant for four weeks following immunization
What should you teach a patient who has no immunity to Varcella before discharge
Client should not get pregnant for one month following the immunization a second dose of vaccine is given at 4 to 8 weeks
What education should you give a patient who is not received a tetanus diphtheria vaccine?
It is recommended people around baby should have it
A nurse is performing a bundle assessment for a client who is 72 days postpartum and observes the peroneal pad for lochia. The pad is saturated approximately 12 cm which lochia that is bright, red and contain small cloths, which of the following findings should the nurse document
Moderate lochia rubra
Excessive lochia serosa
Light lochia rubra
Scant lochia serosa
Moderate lochia rubra
During ambulation to the bathroom and postpartum client experience as a gush of dark red blood that soon stops on assessment a nurse finds the uterus to be firm midline, and that level of the umbilicus, which of the following findings. Should the nurse interpret this data of being.
Evidence of possible vaginal hematoma
An indication of a cervical or peroneal laceration
A normal post cereal discharge of lochia
Abnormal excessive lochia rubra flow
A normal pastoral discharge of lochia
A nurse is completing postpartum, discharged, teaching to a client who has no immunity to Varcella, and was given the first solo vaccine which of the following statements by the client indicates an understanding of the teaching
I will need to use contraception for three months before considering pregnancy
I need a second vaccination at my postpartum visit
I was given the vaccine because my baby is O positive
I will be tested in three months to see if I have developed immunity
I need a second vaccination at my postpartum visit
A nurse is assessing a postpartum client for fundal height location inconsistency the fundus is noted to be displaced, laterally to the right, and there is uterine atony. The nurse should identify which of the following conditions as a cause of the uterine atony
Poor involution
Urinary retention
Hemorrhage
Infection
Urinary retention
A nurse is providing education to a client who is two hours postpartum and has peroneal laceration which of the following information should the nurse include(select)
Use the peroneal squeeze bottle to cleanse the perineum
Sit on the perineum while resting in bed
Apply topical anesthetic, cream or spray to the perineum
Wipe the perineum thoroughly with the back and forth motion
Apply cold or ice packs to the perineum
Use the peroneal squeeze bottle to cleanse the perineum
Apply topical anesthetic, cream or spray to the perineum
Apply cold or ice packs to the perineum
When should bonding start with a newborn?
Start during pregnancy, and continuing to fourth stage of labor
During the first 2 to 6 weeks after birth, the client goes through what kind of period
Acquaintance with a newborn as well as physical restoration
The client also focuses on confidently caring for the newborn
When does the family achieve maternal identity?
Four months, following birth
What is the first phase of maternal roll attainment?
Dependency taking in the phase
What happens during the dependent, taking in phase of maternal Rollertainment?
Flash first, 24 to 48 hours
Focuses on meeting personal needs
Relies on others for assistance
Excited talkative
Wants to talk about birth experience
What is the second phase of maternal Rollertainment?
Dependent independent, taking hold phase
What is the dependent independent taking hold phase of maternal Rollertainment
Begins on day two or three
List 10 days to several weeks
Focuses on baby care
Improving caregiving competency
Wants to take charge, but needs acceptance from others
Wants to learn and practice
May experience baby blues
What is the third phase of maternal Rollertainment
Inter-dependent letting go face
What is the inter-dependent letting go phase of maternal roll attainment?
Focuses on family as unit
Reese Sumption of rule, intimate partner individual
What should the nurse assess about the bonding experience?
Maternal emotional readiness to care for the infant in assessing how comfortable the client appears in providing Infant care
What are behaviors that facilitate an indicate parent infant bonding
Considers the infant as family member
Holds infant face to face
Maintains I contact
Identify infants, unique characteristics, relates them to family members
Names, infant
Maintains close proximity
Response to crying
Smiles, talks to infant
What are behaviors that impaired and indicate a lack of parent infant bonding
Apathy when the infant cries
Discuss when infant void stools or spits up
Disappointment an infant
Turns away from infant
Does not see close proximity
Does not talk to infant
Does not talk about infants, unique features
Perceives infant as uncooperative
What are some manifestations of mood swings conflict about Materna roll or personal insecurity
Feeling of being down
Feeling of inadequacy
Feeling of anxiety
Emotional liability with frequent crying
W what actions facilitate bonding in an infant and parent
Skin to skin contact
Room being quiet
Early breast-feeding
Cuddling, bathing, feeding diapering
How can I coparent bond with an infant?
 Using skin to skin contact
Eye contact
Observing infant similarities to parents
Talking singing readiness
What are the transitional faces to fatherhood?
Expectations and intentions
Confronting reality
Creating the role of involved Father
Reacting rewards
What is the expections and intention phase of fatherhood?
Desires to be deeply, and emotionally connected with the infant
What is confronting reality of fatherhood?
Understands that reality does not always meet expectations. Feeling sad frustrated or jealous.
Unable to talk with other parent, who is consumed with infant caregiving
What is creating the role of involved Father ?
Decides to become actively involved in the care of an infant
What is reaping the rewards of a father?
Include infants miles, in a sense of completing their scent meaning
What are adverse responses from a sibling?
Regression and toileting, and sleep habits
Aggression toward infant
Increasing attention seeking behaviors
What should you do to encourage sibling adaptation to the infant
Take sibling on tour of obstructive unit
Lip sibling be the first want to see infant
Provide gift from infant
Arrange time for one parent to spend with a sibling. Well other is caring for infant.
A nurse concludes that a parent of a newborn is not showing positive indications of parent infant bonding. The parent appears to be very anxious and nervous when asked to bringing the newborn to the other parent, which of the following action, should the nurse use to promote parent infant bonding.
And the parent, the newborn, and suggest they change the diaper
As the parent why they are so anxious and nervous
Tell the parents that they will grow accustomed to the newborn
Provide education about infant care when the parent is present
Provide education about infant care when the parents present
A client in early postpartum period is very excited and talkative. They repeatedly tell the nurse every detail of the labor and birth because client will not stop talking. The nurse is having difficulty completing the postpartum assessment which of the following action should the nurse take
Come back later when the client is more cooperative
Give the client some time to express feelings
Tell the client they need to be quiet so the assessment can be completed
Redirect the clients focus so that they will become quiet
Give the client time do expressed feelings
A nurse is caring is caring for a client who is one day post partum the nurse is assessing for maternal adaptation, and parent infant bonding, which of the following behaviors by the client indicates a need for the nurse to intervene (select)
Demonstrates apathy when the newborn cries
Touches the newborn and maintains close, physical proximity
Who is the newborns behavior is uncooperative during the diaper changing
Identifies and relates newborn characteristics to those of family members
Interprets the newborn’s behavior is meaningful in a way of expressing needs
Demonstrates apathy when the newborn cries
Fuse the newborn behavior is uncooperative during diaper changing
A nurse is caring for a client who is two days postpartum. The client states my four-year-old son was toilet trained and now it’s frequently wedding himself which of the following statements should the nurse provide to the client.
Your son was probably not ready for toilet training and should wear training pants
Your son is showing an adverse sibling response
Your son may need counseling
You should try sending your son to preschool to resolve the behavior
Your son is showing an adverse sibling response
A nurse in delivery room is planning to promote parent infant binding for a client who just delivered which of the following is a priority action by the nurse
Encourage the parents to touch and explore the neonates features
Limit, noise and interruption in the delivery room
Place the neonate on the clients breast
Position the neonate skin to skin on the clients chest
Position the neonate skin to skin on the clients chest
What should you assess in a clients knowledge of postpartum care
Clients current knowledge
Clients home support system who will be there to assist
Clients readiness for learning ability to verbalize or demonstrate the information that has been given
How do you cleanse perineal care?
Cleanse from front to back with warm water but area from front of back
Emphasize the importance of hand hygiene prior to what to prevent infection
Breast care, perineal care
If you are breast-feeding, what kind of brush do not wear?
Underwire bra, cause clogged milk, ducks
Client, education and breast-feeding
Infant will nurse about 8 to 12 times in 24 hour. Period.
Allow infant to feed until breast softens, then offer second brass to infant before completing feeding
Start each feeding with different breast
How do you relieve breast engorgement well breast-feeding?
Take a warm shower or apply warm compress before breast-feeding
Empty each breast completely at feedings using pump if needed
Apply cool compresses after feeding
What can you do for sore nipples after breast-feeding?
Apply small amount of breast milk to the nipple and allow it to air dry
What are some education for a client who does not plan on breast-feeding?
Suppression of lactation
Where will fitting supportive bra continuous for first 72 hours
Avoid breast stimulation and running warm water over brass
How do you regain pelvic floor muscle?
Keagle exercises
How long after a cesarean birth, did you post pone abdominal exercises
4 to 6 weeks
Following a vaginal birth, what should you limit in exercise?
Climbing stairs the first four weeks postpartum
Climb no more than one flight of stairs once a day and do not live more than 10 pounds first two weeks
How many calories a day should an non lactating and client consume
1800 to 2200 cal per day
How many calories should a lactating client consume?
Add an additional 452, 500 cal per day to the pregnancy diet
How long should you continue taking prenatal vitamins following birth?
Six weeks
When is it safe to resume sexual intercourse after birth?
Buy second through fourth week, when bleeding has stopped, and perineum has healed
When will menses for lactating clients resume
Six months or until cessation of breast-feeding
Report to the doctor if you have breast with localized areas of this
Pain and tenderness with firmness, he and swelling or nipple, cracks, redness, bruising blisters are fissures
Report to the doctor if your calves have this
Localized, pain, tenderness, redness, and swelling warmth
A nurse is conducting a home visit for a client who has one week postpartum in breast-feeding the client reports brass encouragement, which of the following recommendations for the nurse make
Apply cold compresses between feedings
Take a warm shower right after feedings
Apply breastmilk to nipples and allow them to air dry
Use various infant positionings for feedings
Apply cold compresses between feedings
A nurse is providing discharge instructions for a client at four weeks postpartum. The client should contact the provider for which of the following client findings.
Scanned, non-odorous white vaginal discharge
Uterine cramping during breast-feeding
Sore nipple with cracks in fissures
Decrease response with sexual activity
Sore nipples with cracks and fissures
A nurse is providing discharge teaching for a non-lactating client with shut the following instruction should the nurse include in the teaching
We are supportive bra continuously for the first 72 hours
Pump your breast every four hours to relieve discomfort
Use breast shells throughout the day to decrease milk supply
Apply warm, compresses until milk. Suppression occurs.
Where’s a supportive bra continuously for the for 72 hours?
A nurse is providing discharge instructions to a postpartum client following a cesarean birth. The client reports leaking urine every time they sneeze or cough, which of the following intervention, should the nurse suggest.
Set ups
Pelvic tilt exercise
Keagle exercises
Abdominal crunches
Keagle exercises
A nurse is providing care to four clients on the post partum unit which of the following client is at greatest risk for developing a postpartum infection
A client who has an episiotomy that is erthematous Anna has extended into a third-degree laceration
A client who does not wash their hands between perineal care and breast-feedind
A client who is not breast-feeding and is using measures to suppress lactation
Ta client who has a cesarean section that as well approximated with no drainage
A client who does not wash their hands between perineal care and breast-feeding
What is thrombophlebitis
Thrombus that is associated with inflammation
A patient who is deep vein thrombosis is at greatest risk for what
Pulmonary embolism
What is a risk factor for deep vein thrombosis and pulmonary embolism
Pregnancy, cesarean, birth and mobility, obesity, smoking greater age than 35
Expected, finding in define thrombosis
Like pain and tenderness
Unilateral, swelling warmth and redness
Heart and vein
How do you prevent deep vein thrombosis
Compression socks
Early ambulation
Elevate legs while sitting
Avoid crossing legs
If you have a deep vein, thrombosis, what should you do?
Facilitate bedrest, an elevation of clients extremity
Administer continuous, warm compresses
Do not massage affected limb
Measure leg circumference, 
Administer anticoagulants
What are two anticoagulants used to prevent clots
Heparin and warfarin
Use birth control when using warfarin
When using an anticoagulant, what is client education
Avoid taking aspirin
Use electric razor
Avoid alcohol
Brush teeth gently
Avoid rubbing legs
What is a pulmonary embolus?
Fragments of entire class dislodges, it moves into circulation
Moves into pulmonary artery in lodges in Long, including the vessels in obstructing blood flow
What is idiopathic thrombosis cytopenia Purpera? ITP.
Coagulopathy that is an autoimmune disorder in which the lifespan of platelets is decreased by antiplatelet be anybody’s
Result in severe hemorrhage, following cesarean
What is disseminated intravascular coagulation DIC
Coagulopathy in which clotting an anti-clotting mechanisms of her at the same time
At risk for both internal and external bleeding
When are coagulopathy suspected
 When the usual measures to stimulate uterine contractions, fail to stop vaginal bleeding
Respecters for DIC
Abruptio placenta, fetal death in utero
Expected findings in coagulopathy’s
Unusual, spontaneous, bleeding from guns and nose
Excessive bleeding
Oozing trickling Blood flow from incision
For a DIC what should you focus on?
Removing underlying cause removal of dead fetus, or placental abruption
What is considered a postpartum hemorrhage in a vaginal birth
Client loses more than 500 mL of blood
What is considered a postpartum hemorrhage in a cesarean birth
Client loses more than 1000 mL of blood
What is a risk factor for postpartum hemorrhage?
Uterine atony
Prolonged labor
Ruptured uterus
Precipitous delivery
Administration of Meg sulfate
Retained placenta
Expected finding in postpartum hemorrhage
Increase of change in local pattern
Return to previous stage large clots in lochia
Foggy uterus
Blood clots larger than a quarter
Perineal pets, adjuration in 15 minutes or less
What do you do if a patient is having a postpartum hemorrhage
Firmly massage the uterus fundus
Assess source of bleeding
Assess lochia color
Assessed for bladder distention
Initiate IV fluids to replace fluid volume loss
Provide oxygen
Elevate clients legs
What medication do you give a patient as in postpartum hemorrhage
 Oxytocin to promote uterine contractions
Meythlergonvine and misoprostol to control postpartum hemorrhage
What is uterine atony?
Uterine add any results from the inability of the uterine muscle to contract adequately after birth. This can lead to postpartum hemorrhage.
Findings and uterine atony
Increase vaginal bleeding
Heeter is larger and buggy
What are you do for uterine atony?
Find manual compression or manual exploration of the uterine cavity for retain placental fragments
When are you allowed to Xpress cloths that have accumulated in the uterus?
Only after the uterus is firmly contracted it is critical, not to Xpress clots prior to the uterus becoming firmly contracted, because pushing on it on contracted uterus, invert the uterus
What is subinvolution of the uterus
Evolution is when the uterus remains in large with continued
Lochia discharge, and can result in postpartum hemorrhage
Therapeutic procedures for subinvolution of uterus
DNC performed by the provider to remove retained placenta fragments, or to breed placental insertion site
What is inversion of the uterus?
Uterus is turning inside out of the uterus and can be partial or incomplete. It’s an emergency situation.
Expected finding an inversion of the uterus
Pain in lower abdomen
What is a complete inversion of the uterus?
Funniest, presenting as a mass in the vagina
What is a prolapse in version of the uterus?
Large red rounded mass that protrudes 20 to 30 cm outside the introitus
What is incomplete inversion of the uterus?
Evidence by the palpation of a smooth mass throughout the dilated cervix
What should you do if there’s an inversion of the uterus?
Manually replacement of the uterus into the uterine cavity and repositioning of the uterus by the provider
What should you stop administering if there is an version of the uterus
Oxytocin
What does retained placenta
Placenta fragments remain in the uterus and prevent the uterus from contracting a placenta that has not been delivered. Within 30 minutes of birth is retain placenta.
What is the diagnostic procedure for retained placenta?
Manuel separation removal of placenta
D&C
What is a hematoma
Collection of clotted blood within tissues that can appear as a bulging bluish mass
What is the first sign of a hematoma?
Pain
Under says, caring for a client who is postpartum nurse should identify which of the following findings as an early indicator of hypovolemia caused by hemorrhage
Increased pulse in decreasing blood pressure
Dizziness in increasing respiratory rate
Cool clammy skin and Paul mucous membranes
Altered mental status in level of consciousness
Increasing pulse and decreasing blood pressure
A nurse educator on the post partum unit is reviewing risk factors for postpartum hemorrhage with a group of nurses, which of the following factors should the nurse include in the teaching(select)
Precipitous delivery
Obesity
Inversion of the uterus
Oligohydramnios
Retain placental fragments
Precipitous delivery
Inversion of the uterus
Retain placental fragments 
A nurse on the post partum unit is assessing a client who is being admitted with a suspected deep vein thrombosis which of the following clinical findings should the nurse expect(select)
Calf tenderness to palpation
Mottling of the affected extremity
Elevated temperature
Area of warmth
Report of nausea
Calf tenderness to palpation
Elevator temp
Area of warm
A nurse is planning care for a client who is postpartum and is Thrombophylebitis which of the following nursing intervention should the nurse include in the plan of care
Apply cold compresses to the effect of extremity
Massage the affected extremity
Hola the client to ambulate
Measure the lake circumference
Measure the leg circumference
A nurse is caring for a client who has disseminated intravascular coagulation, which of the following antepartum complications with the nurse understand it’s a risk factor for this complication
Preeclampsia
Thrombophlebitis
Placenta previa
Hyperemisis gravidarum
Preeclampsia
When do postpartum infections occur?
 Up to 28 days, following childbirth or spontaneous abortion
 What is a postpartum infection classified as
Fever of 104 or higher for the first 24 hours or two days during the first 10 days of postpartum period
What is uterine infection referred to?
Endometriosis
When does endometritis usually begin?
Begins third to fourth postpartum day
Physical findings in endometritis
Uterine tenderness and enlargement
Dark profuse lochia
Loki that is either mail order us or Purlant
Pelvic pain
Loss of appetite
Medication’s for endometriosis
Clindamycin
What is mastitis?
Infection of the breast involving interlope you look connective tissue that usually intro literally
When mastitis occur
During the first six weeks of breast-feeding, but can occur any time during breast-feeding
 Expected findings in mastitis
Painful or tender, localized hard mass in reddened area usually in one breast
Influenza like manifestations
Play an education for mastitis
Maintain cleanliness of brass with frequent changes of breast pads
Allow nipples to air dry
Proper infant positioning in latching on technique
Completely empty breast with each feeding
Use ice pack, or warm pack
Continue breast-feeding frequently especially on affected side
Manually expressed breastmilk
Werewolf, reading bra with no underwire
A nurse on the post partum unit is caring for four clients which of the following client. Should the nurse recognizes the greatest risk for development of postpartum infection.
A client who experience of precipitous labor less than three hours induration
A client who has premature rupture of membranes in prolong labor
A client who delivered a large for gestational age infant
A client who had a buggy uterus that was not well contracted
A client who had premature rupture of membranes in a prolong labor
A nurse is teaching a client who is breast-feeding and has mastitis which of the following responses should the nurse make
Limit the amount of time, the infant nurses on each breast
Nurse the infant only on the unaffected breast until resolved
Completely empty each breast at each feeding or use a pump
Wear a tight fitting bra until lactation has deceased
Completely empty each breast at each feeding or use a pump
A nurse is reviewing discharge, teaching with a client who has a urinary tract infection, which of the following statements by the client indicates an understanding of the teaching (select)
I will perform perineal care and apply a peroneal pad in a back to front direction
I will drink grape juice to make mayor in More acidic
I will drink large amount of fluids to flush the bacteria from a urinary track
I will go back to breast-feeding after I have finished taking the antibiotic
I will take Tylenol for any discomfort
I will drink large amounts of fluid flush out the bacteria from my urinary track
I will take Tylenol for any discomfort
A nurse is caring for a client who has mastitis, which of the following is the typical causative agent of mastitis
Staphylococcus aureus
Chlamydia trachomatis
Klebsiella pneumonia
Clostridium Perfringens 
Staphylococcus aureus
A nurse is discussing risk factors for urinary track infection with a newly licensed nurse, which of the following conditions to the nurse include in the teaching
Epidural anesthesia
Urinary bladder catheterization
Frequent pelvic examination
History of UTIs
Vaginal birth
Epidural anesthesia
Urinary bladder catheterization
Frequent pelvic examination
History of UTIs
Postpartum blues can occur in up to what percentage of clients during the first few days after birth
85%
How long does postpartum blues last?
Few days after birth, continues up to 10 days
What is postpartum blues characterized by?
Mood swings, tearfulness, insomnia, lack of appetite, and feeling let down
When does postpartum depression occur?
Within 12 months of delivery
When does postpartum psychosis develop
Within the first 2 to 3 weeks of postpartum
Respecters for postpartum depression
Hormonal changes
Rapid decline and estrogen and progesterone
Decrease social support system
Anxiety about assuming new role
Unintended pregnancy
Expected findings and postpartum blues
Feeling of sadness
Lack of appetite
Sleep pattern disturbance
Feeling inadequate
Crying easily
Anxiety
Expected findings and postpartum depression
 Feeling guilt
Fatigue persisting beyond a reasonable amount of time
Feeling Lost
Intense mood swings
Flat affect
Irritability
Rejection of infant
Persistent, feeling of sadness
Expected findings and postpartum psychosis
Pronounce sadness
Disorientation
Confusion
Paranoia
Hallucinations or delusions of self harm or harming infant
Does postpartum depression resolve on its own
No, usually does not resolved without intervention
Nursing care of postpartum depression
Monitor interaction between client an infant
Encourage bonding activity
Reinforce that feeling down is normal and self-limitin
Encouraged client to communicate feelings, validate an address, personal complex
Ask Lane if they have any thoughts of self harm
Care after discharge for postpartum depression
Plenty of rest and nap with the infant nabs
Remember the importance of taking time out for self
Follow up visits
A nurse is assessing a postpartum client, who is exhibiting tearfulness, insomnia, lack of appetite, and feeling let down which of the following conditions are associated with this manifestations
Postpartum fatigue
Postpartum psychosis
Let it go phase
Postpartum blues
Postpartum blues
A nurse is caring for a postpartum client, who delivered the third infant two days ago, which of the following manifestations should indicate postpartum depression(select)
Fatigue
Insomnia
Euphoria
Flat affect
Delusions
Fatigue, insomnia, flat affect
A nurse is assessing a client who has postpartum depression. The nurse should expect which of the following manifestations(select)
Paranoia that they’re infant will be harmed
Concerns about lack of income to pay bills
Anxiety about assuming a new role as a parent
Rapid decline an estrogen and progesterone
Feeling of inadequacy with a new role as a parent
Concerns about lack of income to pay bills
Anxiety about assuming a new role as a parent
Rapid decline an estrogen and progesterone
Feeling of inadequacy with a new role as a parent
A nurse is caring for a client who is postpartum psychosis, which of the following action should the nurse prioritize
Reinforce the need to take antipsychotics as prescribed
Ask the client if they have thoughts of harming themselves or their infant
Manager of the infant for indications of failure to thrive
Review the clients medical record for history of bipolar disorder
Ask the client if they have thoughts of harming, themselves or their infant
