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OB > Mod 5 > Flashcards

Mod 5 Flashcards

1
Q

After the first hour delivery how often are vitals performed?

A

Q15 min

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2
Q

Defined the postpartum period.

A

The critical transition period for women, newborn, and family both physiologically and psychologically

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3
Q

Define puerperium.

A

A.k.a. postpartum, the period after delivery of the placenta, lasting for six weeks

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4
Q

What is the pain go for a woman in the postpartum period?

A

0-2

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5
Q

Is a blood pressure change in the postpartum period?

A

Falls in the first 2 days

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6
Q

Do respirations change in the postpartum period?

A

No

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7
Q

Does the pulse change in the postpartum period?

A

Yes 40-80 bpm, puerperal bradycardia

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8
Q

Does the mothers temperature change in the postpartum period?

A

Slight elevation in the first 24 hr, normal afterwards

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9
Q

What happens to the cervix in the postpartum period?

A

It begins to close, and now appears as a jagged slit like opening that is not the same as it was before delivery

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10
Q

What happens to the vagina in the postpartum period?

A

Eventual thickening and return of rugae

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11
Q

Define a boggy uterus.

A

Not firm, soft

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12
Q

Define involution.

A

Contraction of muscle fibers, the contraction of the uterus to stop bleeding after birth. Regeneration of the uterine epithelium

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13
Q

Define lochia.

A

Vaginal discharge after delivery consisting of a superficial layers of the uterus is sloughed off. Consists of lochia rubra, serosa, alba

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14
Q

Define afterpains during the postpartum period.

A

Painful uterine contractions after delivery that help in involution of the uterus, more painful with multiparas. (Uterus is bigger and more stretched each time = has to contract more so more pain.)

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15
Q

How does fundal height decrease in the postpartum period?

A

It should decrease one finger birth per postpartum day.

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16
Q

What initiates milk production in the mother during the postpartum period?

A

Prolactin released from the anterior pituitary

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17
Q

What initiates milk let down in the postpartum mother?

A

Oxytocin released from posterior pituitary

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18
Q

What provides continue stimulation for prolactin and oxytocin release in the postpartum mother?

A

The infant sucking

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19
Q

If a mother states that she is not producing milk, what should you do?

A

Encourage her to nurse and latch the baby, sucking will stimulate milk production and let down.

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20
Q

Two or false afterbirth the cervix returns to its pre-pregnancy state?

A

False

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21
Q

What happened to the mothers white blood cell count in the postpartum period?

A

Wbc increases during labor and remains elevated 4 to 6 days after birth

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22
Q

What is the average blood loss with a vaginal birth?

A

500mL

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23
Q

What is the average blood loss with a cesarean birth?

A

1000 mL

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24
Q

What happens to glomerular filtration rate and renal flow in the postpartum period?

A

Increases

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25
Q

When must a woman urinate by after delivery?

A

Within 6 hrs

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26
Q

What urinary system problem is common with epidurals?

A

Decrease bladder tone and sensation due to regional Anastasia, leads to diminish sensation of the bladder and pressure due to swelling

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27
Q

What are four causes of postpartum diuresis?

A
  • Large amounts of intravenous fluid given during labor
  • Decreasing anti-diuretic effect of oxytocin as its level declines
  • Build up and retention of extra fluids during pregnancy
  • Decrease in production of aldosterone, a hormone that decreases sodium retention and increases urine production
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28
Q

What is a common G.I. system problem in the postpartum mother?

A

Constipation due to fear of straining affecting the perineum, administer stool softeners

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29
Q

How long is diaphoresis common for in the postpartum mother?

A

Approximately one week postpartum

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30
Q

In the postpartum assessment the breasts are at assessed for what?

A

Size, contour, and engorgement, if they’re soft or hard, tender or nontender. If the mother is secreting clostridium. Also how the baby breast-feeds

31
Q

In the postpartum assessment the uterus is assessed for what?

A

Height of fundus, one fingerbirth below umbilicus or deviated to right, firmness

32
Q

In the postpartum assessment the bladder is assessed for what?

A

Time of last Voiding, and complete bladder emptying, was there a foley before or after surgery (void after Cathy removal?)

33
Q

In the postpartum assessment the bowels are assessed for what?

A

Assess of the mother has had a bowel movement, has bowel sounds, is passing gas, and that there is no distention

34
Q

In the postpartum assessment the lochia is assessed for what?

A

Amount, color, odor

35
Q

In the postpartum assessment the Episiotomy and perineum are assessed for what?

A

That the perineum is intact, if there is any bruising, lacerations, or a hematoma

36
Q

In the postpartum assessment the extremities are assessed for what?

A

there is no edema, no warmth or tenderness to the calf

37
Q

True or false in the postpartum assessment emotional status should also be assessed

A

True

38
Q

what time is typical for the establishment of lactation?

A

4 to 5 days after childbirth

39
Q

Define breast engorgement

A

Process of swelling of the breast tissue due to an increase in blood and lymph supply as a precursor to lactation

40
Q

Is the mother has chosen to breast-feed how do you help her with Breast engorgement.

A

Help relieve by frequent emptying, warm showers and compresses before feeding, cold compresses after feeding

41
Q

If the mother has chosen not to breast-feed how do you help with breast engorgement.

A

Tight supportive bra, ice, avoid breast stimulation

42
Q

True or false during the first 24 hours postpartum, a slight elevation in temperature is considered normal?

A

True

43
Q

After the birth of the baby where is the uterus located?

A

It should be approximately two fingerbirths below the umbilicus.

44
Q

True or false any type of nipple stimulation will cause the uterus to contract?

A

True

45
Q

In charting The assessment of the fundus what does U/U mean?

A

The uterus is over or above the umbilicus

46
Q

When chart in the assessment of the fundus what does +1/U stand for

A

The uterus is one fingerbirth above the umbilicus, this is an unusual finding.

47
Q

When charting the assessment of the fundus what does -1/U mean?

A

Uterus is below the umbilicus, this is normal for the first day postpartum

48
Q

Define decidua basalis

A

The lining of the uterus that is present during pregnancy, it must be shed to form a new endometrial lining, this happens for 4-8 weeks post delivery.

49
Q

What color is lochia initially?

A

Bright red and consists of blood and fibrinous products, decidual cells, and red and white blood cells

50
Q

At any stage lochia should have what smell?

A

Fleshy/earthy

51
Q

An offensive odor of lochia usually indicates what?

A

An infection such as endometriosis

52
Q

What are the three stages of lochia flow in order?

A

Lochia rubra, lochia serosa, lochia alba

53
Q

Define lochia rubra

A

Deep red mixture of mucous, tissue, debris and blood. Occurs for the first 3-4 days after birth

54
Q

Define lochia serosa

A

Pinkish brown discharge and is expelled 3-10 days after birth

55
Q

Define Lochia alba

A

Creamy white or light brown discharge, occurs from day 10-14 and can last 3-6 weeks postpartum

56
Q

What are the parameters for light bleeding

A

Less than 4 in

57
Q

What are the parameters for moderate bleeding

A

Less than 6 in

58
Q

What is the acronym for the assessment of an episiotomy/laceration/ perineum?

A 
R
E
E
D
A
59
Q

What does the R stand for in REEDA?

A

R- redness

60
Q

What does the first E stand for in REEDA?

A

E- edema

61
Q

What does the second E stand for in REEDA?

A

Ecchymosis

62
Q

What does the D stand for in REEDA?

A

Discharge, drainage

63
Q

What does A stand for in REEDA?

A

Approximation

64
Q

When a client ambulated for the first time after birth what should you inform them to do?

A

To call you before they get up so you can help them, because they may faint.

65
Q

Peri self care after birth involves what?

A

A squirt bottle with warm water.

66
Q

How long is ice given for the perineum after vag births?

A

6-8 but ideally 24hrs followed by heat

67
Q

True or false checking for homans Sign is controversial because you can dislodge a DVT in the process?

A

True

68
Q

What are 4 of the 7 assessment areas for the emotional assessment of the postpartum patient?

A
  • interactions with family
  • level of independence
  • energy levels
  • eye contact with infant
  • posture and comfort level with infant
  • sleep and rest patterns
  • be alert for mood swings, irritability, or crying episodes
69
Q

Define postpartum blues.

A

Transient emotional disturbances

70
Q

What are postpartum blues characterized by?

A

Anxiety, irritability, insomnia, crying, loss of appetite, sadness

71
Q

When do the symptoms of postpartum blues usually begin?

A

2 -4 days after child birth

72
Q

When do symptoms of postpartum blues usually resolve?

A

By day 8

73
Q

Postpartum blues typically resolve with…?

A

Restorative sleep

74
Q

Define engrocement

A

Strong feelings of attachment by a parent towards the newborn

OB (4 decks)

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