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WH707 > Module 9 Unit A study guide > Flashcards

Module 9 Unit A study guide Flashcards

1
Q

What causes afterbirth pain

A

Relaxing and re-contracting of the uterus

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2
Q

Which client is most likely to experience strong afterbirth pains

A

Clients whose uterus was greatly distended
Polyhydramnios
Large infant
Multiple babies
Breastfeeding

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3
Q

Afterbirth pains are

A

more noticeable in births where the uterus was overdistended

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4
Q

Lochia rubra

A

consists of:
blood
decidual
trophoblastic debris

glow generally lasts 3-4 days and pales, becoming pink or brown

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5
Q

Lochia serosa

A

Consists of:
Blood
serum
leukocytes
tissue debris

generally occurs around day 3 or 4 after childbirth

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6
Q

Lochia Alba

A

Occurs in most women after day 10
can continue up to 6 weeks after childbirth

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7
Q

what should Lochia smell like

A

Should smell like a normal menstrual cycle unless an infection is present

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8
Q

what is the mechanism that causes diaphoresis and diuresis in the early postpartum period?

A

Loss of increased blood volume associated with pregnancy

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9
Q

what occurs in the urinary system postpartum

A

fluid loss through perspiration and increased urinary output accounts for weight loss post partum

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10
Q

When does kidney function returns to normal postpartum

A

1 month

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11
Q

When is bladder tone restored postpartum

A

5-7 days after childbirth

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12
Q

How will menstrual cycle be after childbirth

A

first menstrual cycle to be heavier than normal

and the volume of subsequent cycles will return to prepregnant levels within 3-4 cycls

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13
Q

Describe ovarian function postpartum

A

The first flow is heavier, with within 3 - 4 cycles returns to normal

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14
Q

When does ovulation occurs postpartum

A

within the first month for 70% nonlactating women, it returns within 12 weeks after birth.

Breastfeeding women take longer to resume ovulation

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15
Q

At 4 days PP where should you feel the uterine fundus

A

4 fingerbreath below umbilicus

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16
Q

Healing at the placental site takes about

A

6 weeks

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17
Q

swelling and increased vascularity of the vagina will be decreased by

A

3-4 weeks

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18
Q

Right after birth the maternal cardiovascular system instability is due to what factors

A

blood loss
autotransfusion of fluid from losing placenta
extracellular fluid

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19
Q

During the first postpartum week, women lose approximately how many pounds of water weight

A

5

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20
Q

When will the placental totally regenerate

A

6 weeks

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21
Q

Swelling and increased vascularity of the vagina normally decrease by how many weeks postpartum

A

3-4 weeks

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22
Q

Where is the uterine fundus normally located 4 days post-delivery

A

two fingerbreadths below the umbilicus

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23
Q

What is taking hold

A

strives for independence and autonomy in hr new role

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24
Q

When does stabilization of Hgb and Hct typically occurs

A

24-48 hours after birth

25
Q

How long will it take for hemoglobin and hematocrit to reach prepregnant level

A

4-6 weeks

26
Q

what happens to stroke volume and cardiac output in the FIRST HOUR

A

increase by almost 80%

27
Q

How long does it take for maternal blood volume to return to pre pregnant levels

A

2 weeks

28
Q

How long does the hypercoagulable state of pregnancy continue

A

first few weeks

29
Q

Mechanism of fibrinolysis

A

Decreased during pregnancy and in the first few weeks postpartum which puts our clients at risk for thromboembolism

30
Q

When does fibrinolysis begin to normalize

A

24-48 hours

31
Q

when does full normalization of coagulation factors occur

A

4-6 weeks

32
Q

When does platelets normalize

A

12 weeks

33
Q

Note regarding cardiovascular system

A

Physically, with the removal of the gravid uterus the inferior vena cava no longer has to share a space with the gravid uterus and coupled with the return of the extracellular fluid to the maternal circulation, there is

  1. Increase in stroke volume and cardiac output by almost 80% in the first 1 hour
  2. Causing a simultaneous decrease in maternal heart rate (rationale: each pump of the heart is now more effective and sends more oxygenated blood to the body so the heart rate can slow down without losing oxygenation to the body.
34
Q

Clinical takeaway regarding cardiovascular system postpartum

A

There is an increased risk for cardiovascular adverse events in the postpartum period. If the client has risk factors such as preexisting cardiac disease, hypertension or preeclampsia, the dramatic fluid shifts may lead to complications , like pulmonary edema, cardiac failure and death.

35
Q

How long does it takes for the maternal blood volume to return to pre-pregnant levels

A

2 weeks

36
Q

Note regarding respiratory system

A

The respiratory system quickly return to a nonpregnant respiratory function following the birth of the baby and placenta

The reduction of intra-abdominal pressure allows for normal diaphragm excursion and a rapid return of normal residual air volume

The loss of placenta progesterone leads to the immediate return of many normal nonpregnant respiratory parameters. These changes lead to the rapid resolution of pregnancy dyspnea and shortness of breath

37
Q

Respiratory clinical pearls

A

Post partum client reports of shortness of breath and/or chest pain should be taken very seriously with prompt evaluation considering the increased risk of cardiovascular thromboembolic events in the postpartum period.

38
Q

when does diuresis starts PP

A

within 12 hours

39
Q

How long does profuse diaphoresis occurs

A

especially at night, in the first 2-3 days after birth

40
Q

Which narcotic is not recommended in breastfeeding clients

A

Codeine

41
Q

Why is Vitamin K given to new born babies

A

helps the newborn’s clot appropriately

42
Q

Some factors to help reduce the risk of SIDS

A

Pacifier use….can help decrease SIDS

Keep the room at least 5 degree warmer then the rest of house (overheating can increase SIDS

Avoid any exposure to secondhand smoke (Secondhand smoke is an important SIDS risk factor

43
Q

When does Physiologic jaundice peaks

A

about 3-7 days after birth

44
Q

How common is jaundice in term infants

A

50-60%

45
Q

How common is jaundice in preterm infants

A

80%

46
Q

What are some red flags that could signal that jaundiced appearing baby is not normal

A

Jaundice appears 24-48 hours after birth

Jaundice that is worsening extending to the lower half of body (the lower on the baby’s body the jaundice is the higher the serum level generally is

Fetus behavioral changes

47
Q

Can the uterus be palpable at 2 weeks PP

A

No….it is a pelvic organ at 2 weeks.

48
Q

when does vaginal swelling and vascularity decrease

A

3-4 weeks

49
Q

when does vaginal rugae reappears

A

3-4 weeks

49
Q

how longs does carefully repaired lacerations or episiotomies usually heal

A

within 2-3 weeks, but could take longer depending on the extent of the repair

50
Q

when does bowel movement return PP

A

3 days PP

51
Q

when does the fundus begins to descent into the pelvic pp

A

after 24 hours

52
Q

what are normal WBC value during the first 10 - 12 days PP

A

20,000-25,000

53
Q

when does respirations return to normal PP

A

6-8 weeks

54
Q

when does hemorrhoids decrease in size

A

6 weeks

55
Q

How long does it takes for the uterus to return to original size

A

full 6 weeks

56
Q

what is involution

A

end of the puerperium

57
Q

what is the puerperium

A

interval between birth of the newborn and the return of the reproductive organs to their normal nonpregnant state

58
Q

how long does puerperium last

A

3-6 weeks

WH707 (24 decks)

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