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CMC(EINC) > [Module 5] Postpartum > Flashcards

[Module 5] Postpartum Flashcards

1
Q

Is the six-week period starting with
childbirth during which the reproductive
organs undergo physical and physiological
changes

A

NORMAL PUERPERIUM

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2
Q

NORMAL PUERPERIUM is characterized mainly by the anabolic activity of?

A

LACTATION & catabolic
activity of the INVOLUTIONARY PROCESS

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3
Q

marks the start of of the return of
the reproductive organs to their pre-pregnant
state

A

Involution

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4
Q

is the breaking down of muscle
proteins, connective tissue, collagen, and
elastin, which are then excreted in the urine

A

Autolysis

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5
Q

The placental site starts to heal without
scarring. This process is called

A

Exfoliation

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6
Q

new endometrium is formed ——- (before or after)
delivery, except the placental site.

A

3weeks after

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7
Q

▪ The placental site is healed in ____

A

6weeks

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8
Q

vaginal flow after delivery consisting of
blood from the placental site, mucus and shreds of
decidua, epithelial cells and bacteria;

A

Lochia

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9
Q

▪ A perineal pad, fully soaked, can contain
about ____of blood.

A

60-80ml

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10
Q

3 types of Lochia

A

Rubra
Serosa
Alba

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11
Q

Day 1-3, red to bright red Lochia

A

Rubra

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12
Q

Day 4-10; pinkish to brownish; scanty Lochia

A

Serosa

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13
Q

Day 10-14; whitish-yellow, creamy, slight lochia

A

Alba

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14
Q

Weight of the uterus
After delivery—
1 week after—
2weeks after—
at the end of the puerperium—

A

1000g(2.2lbs)

500g

350g

2oz

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15
Q

discomfort secondary to
contraction of the uterus.

A

afterpains

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16
Q

multipara experience less afterpains than primiparas

A

False

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17
Q

Lochia Saturation of pad within 15-30minutes indicate what?

A

Hemorrhage

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18
Q

breastfeeding and oral contraceptives affects the amount of lochia

A

False

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19
Q

What causes the lochia abnormality wherein there are retained products?

A

Excessive lochia amount, bright red after day 3
✓Offensive odor
✓Pieces of membrane of placenta

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20
Q

Puerperal Infection/ Sepsis causes what complications?

A

✓ Offensive odor with pyrexia
✓ Scanty lochia with pyrexia
✓ Putrid odor

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21
Q

Subinvolution of the Uterus causes what problems?

A

✓ Large, bulky uterus
✓ Brown and profuse lochia
✓ Lochia beyond 3 weeks

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22
Q

. CERVIX
a. Bruised and with tears immediately after delivery,
flabby, closes slowly.
b. Also undergo involution
▪ After Delivery- admits a hand
▪ One week after- internal os closed and admits 1 to 2
fingers.
▪ Never fully returns to a pre-pregnant state.

A

Read carefully and understand

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23
Q

VAGINA
❑ After Delivery: edematous, bruised, and thin-walled
d/t lower estrogen levels; few rugae, may have small
lacerations.
❑ Smooth for3-4 weeks; vaginal rugae reappear at 4
weeks; returns to pre-pregnancy state by 6-8 weeks

A

Read and understand

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24
Q

what happens to the cervix one week after?

A

internal os closes and admits 1-2fingers

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25
Q

the vagina is smooth during _ to _ weeks, after that. vaginal rugae reappears at _ weeks, and return to pre pregnancy state by _ to _ weeks

A
  1. 3-4 weeks
  2. 4 weeks
  3. 6-8 weeks
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26
Q

________ mothers: Ovulation resumes after __ to __weeks, menstruation after _____ mothers: menstruation is less predictable, it may be delayed for __ to __months. However ovulation may occur even without the first menstruation.

A
  1. Non-lactating
  2. 4-6 weeks
  3. lactating
  4. 2-18months
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27
Q

The use of breastfeeding as the sole means of contraception by delaying ovulation due to lactation is unreliable

A

Keep in mind

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28
Q

The best position for assessing episiotomies

A

Side Lying Position

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29
Q

Presence of hematoma on the perineum is possible

A

True

30
Q

a tense and painful mass of blood
located in the connective tissue beneath the skin that needs to
be drained

A

Hematoma

31
Q

Ice bag application to reduce edema and discomfort during
first 24h after the episiotomy of laceration repair

A
32
Q

after 24hr post delivery, what is the best thing to do for the perineum ?

A
  • moist heat with warm sitz bath
33
Q

when does the pelvic floor regains it tone?

A

by the end of the puerperium

34
Q

. After delivery: ___to___ increase in blood volume is_________ to the general circulation, causing sudden
_______.

A
  1. 30-50percent
  2. shunted or redirected back
  3. overloading
35
Q

In the cardiovascular system, Blood volume starts returning to pre-pregnant state ___ to __ weeks.

A

4-6 weeks

36
Q
  1. Blood volume starts returning to pre-pregnant state ____ weeks.
  2. HCT usually returns to the pre-pregnant state by — weeks.
  3. HGB & RBC drop by the (1st,2nd,3rd,4th) postpartum day.
  4. RBC increases, especially if labor is prolonged. (This is false, correct it)
  5. Varicosities inregress. (correct the sentence)
  6. Clotting factors are activated, keeping levels above the pre-pregnant
    state during the 1st week.
  7. The rise in platelets, fibrinogen and factor 8 with the trauma in
    labor, immobility during pp, possible sepsis predispose to
    thromboembolic complications e.q pulmonary embolism
A
  1. 4-6 weeks
  2. 4-6 weeks
  3. 4th day
  4. WBC
  5. regress
  6. 8.
37
Q

The mother’s appetite will return to normal immediately after delivery, hunger will start how many hours during post delivery?

A

1-2 hours

38
Q

first memses

A

anovulontary

39
Q

The mother may experience constipation; roughage and exercises
may relieve. Bowel habits/pattern should remain unchanged
after vaginal delivery, with first bowel movement normally occuring in?

A

2-3 days

40
Q

The puerpera needs added CHON & calories to replace the looses
during the process of involution.
o ____calories and ____calories added if lactating.
o Iron and folic acid supplementation should be continue for ___
months after birth.

A

2500, 500, 3

41
Q

Marked diuresis begins after 12hrs of delivery up to 5th
day; daily output may average _______in the first
2-3 days
5. Dilatation of the ureters subsides in a few week

A

3L(3000ml)

42
Q

what fades in the integ system?

A

chloasma, linea nigra

43
Q

Temperature: normal to slight elevation – fatigue,
stress and excitement of labor but does not reach 38’C
❑ Day 1 elevation: likely because of ____
❑ Day 2 elevation and normal in Day 3: likely because of
__________
❑ Day2 and for at least 2 consecutive days: danger signs
of __________

A

Dehydration
Breast Engorgement
Puerperal Asepsis

44
Q

A heart rate greater than 100bpm should be evaluated
for possible causes such as

A

Infection, Fever, Pain, Anxiety, Dehydration

45
Q

the increase immediately after delivery d/t
_____ from labor stress goes down during the
puerperium.

A

epinephrine

46
Q

Slightly bradycardia: ______bpm; may persist for _____
days

A

50-70bp

7-10 days

47
Q

The presence of tachycardia, tachypnea, and
hypotension should make the nurse suspect _______lead to _____

A

Hypovolemia- Shock

48
Q

B/P usually return to normal after ____ of delivery

A

6 hours

49
Q

Causes of B/P elevation

A

o Oxytocin administration
o PIH
o Essential hypertension
o Anxiety

50
Q

normal limit of respiration 16-24

A
51
Q

what depresses maternal and newborn respirations?

A

Narcotics, The use of Mg SO4 in PIH (Pregnancy-Induced
Hypertension)

52
Q

to ensure safety to the mother and child, what do you always need to have if there is a decrease in respi?

A

antagonistic drugs

53
Q

antagonistic drugs include what?

A

Narcotic- Narcan (newborn)
▪ Mg SO4- Calcium Gluconate (mother)

54
Q

The infant sucking stimulate the production of ____
(6-10oz) of milk by Day 4.
▪ By the end of puerperium, the increase in milk was up to
______day

A

200-300ml, 600ml

55
Q

danger of postpartum blues

A

suicidal or infanticidal ideation

56
Q

Is a complication characterized as intense neuralgia or
cramp-like pains extending down to one or both legs cause by
pressure as the fetal head begins to descend into the pelvis; pain
may continue after delivery if the nerve injured.

A

obstetrical neuropathy

57
Q

most common nerve injuries

A

Lateral Femoral Cutaneous Neuropathy, Femoral Neuropathy

58
Q

Immediate weight loss after delivery, presenting the combined
weight of the infant, placenta and amniotic fluid which is

A

12-15lbs

59
Q

By the ______week after delivery, the puerpera will have
returned to approx. her pre-pregnant state weight if she has
gained weight the average of 22-28 lbs.,; most women however,
return to pre-pregnant weight _____ after delivery.

A

6-8, 6months

60
Q

Weight loss should be done slowly around ______ per week, so the
mother will feel better and the weight will be more likely to stay
off

A

1lb

61
Q

in 3mo ths after birth, vitamins and minerals are essental for the health of the mother, what are these?

A

folic acid, Vit C, Iron

62
Q

what day does the uterine fundus is no longer palpabel?

A

10th day

63
Q

what day does the uterine fundus is no longer palpabel?

A

10th day

64
Q

Rubins maternal role attainment

A

A process of “binding-in” (being attached to the child) and
“maternal role identity” (seeing oneself in the role and
having a sense of comfort about it) .

65
Q

The process of maternal role attainment has 3 adjustment
phases what are these

A

taking in
taking hold
letting go

66
Q

also known as
the Rhythm Method – this is the female natural family
planning method.

A

ovulation prediction method

67
Q

estrogen and progestin
▪ Prevent pregnancy by stopping ovulation by suppressing the
production of FSH and LH.
▪ Most effective reversible method.

A

COC - Combined Oral Contraceptives

68
Q

contain only progestin, commonly
termed as “minipill” also called POP or “Progestin-Only Pills

A

Progestin-only Contraceptives:

69
Q

side effects of ocp and coc

A

Nausea (common in first 3 months)
✓ Mild headaches/ tender breasts
✓ Spotting between periods (most common in the first 3 months)
✓ Moodiness
✓ Slight weight ga

70
Q

COCs have more disadvantages because of the estrogen effects. High
risk for:

A

k for:
a. Thrombus formation
b. Thrombophlebitis
c. Pulmonary Embolism
d. Breast/Cervical cancer, HTN and Respiratory problems

71
Q

Teach and emphasize the need to report danger signs: calf pain(leg _______);
severe headache (HTN); chest pain (_______); heavy bleeding (lead to
e. anemia.
Report any signs of pregnancy; stop the pill
f. Increase intake of folic acid and Vit D & C

A

thrombophlebitis, Pulmonary embolism

72
Q

Teach and emphasize the need to report danger signs: calf pain(leg _______);
severe headache (HTN); chest pain (_______); heavy bleeding (lead to
e. anemia.
Report any signs of pregnancy; stop the pill
f. Increase intake of folic acid and Vit D & C

A

thrombophlebitis, Pulmonary embolism

CMC(EINC) (8 decks)

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