OB ch 12 - post partum woman Flashcards
what does a post partum cervix look like as compared to a nullipara cervix
slightly open with a small slit
how does the cardiovascular system change during pregnancy and how does it return to normal post partum
increased blood volume, increased circulation, increased clotting factors
heart rate slows down, blood clots faster
what are some ways the body rids itself of excess fluid from excess blood volume
skin, urinary tract, blood loss
what happens to the blood post partum and what is the woman at risk for because of this
clotting - Deep Vein Thrombosis(DVT)
what are symptoms of thrombophebitis
redness, swelling, warmth, pain
what happens to the GI system and what symptoms might the woman have
decreased peristalsis, decreased bowel tone
-constipation
what are some treatments for constipation
fluid, stool softener, exercise, fiber
what is the main concern and what should the nurse assess for in the immediate post partum period
hemorrhage - assess for uterine atony
how would you assess for hemorrhage post partum
VS(low BP, tachycardia)
boggy uterus
bleeding
how often would you assess for hemorrhage immediately post partum
every 15 minutes
what is the most common cause of hemorrhage
uterus not contracting
how much blood loss is typical for a vaginal birth
300-500 mL
how much blood loss is typical for a c section
500-1000 mL
How does the nurse determine the amount of blood loss by looking at hg and hct results
subtract 1 from hg
subtract 2 from hct
for every 250 mL
why are UTI’s so common post partum and what are the symptoms of this
they just had lots of foreign stuff up there
-painful perineum and urination
what is the benefit of Kegel exercises
increase tone and enhance sexual excitement
how would you instruct a new mom to use the peri bottle
warm water - front to back
every time you go to bathroom
what is the average weight loss immediately post partum
12-14 lbs
how long will it take to lose the rest of the “baby weight”
6 months
describe the 3 phases of lochia - what might be going on if it does not go in order
lochia rubra - moderate, red fleshy odor, 1st 3-4 days
lochia serosa-day 4-10, pinkish
lochia alba-after day 10 - white/pale yellow
-probably a hemorrhage
describe the amount of lochia on a pad.
scant, little, moderate, heavy
what is considered too much blood
fill a pad in 1 hr
what is important to note when assessing a pad
clot size - HOW LONG PAD WAS IN
what are afterpains and what is causing these
pain after birth - uterus remains contracted
what increases afterpains
breastfeeding, multiple children
what should the nurse do if the fundus is soft and boggy
fundal massage
know where the fundus should be immediately post partum and in the following days until it disappears
slightly above belly button - each day one finger breadth lower
what are some other treatments for perinea pain
ice packs
what is a priority assessment to any patient that has received an opioid
respiratory assessment
what additional medication should be kept on hand if a patient is receiving opioid medications
naloxone - narcane
what are common side effects of opioids
dizziness, nausea, vomiting, constipation
what is the name of the first breasts secretions
colostrum
why is colostrum important
antibody rich
when does colostrum start and end
right after birth-3rd day post partum
when does the milk “come in” and the breasts have a possibility to become engorged
3rd day
what are good signs of maternal infant bonding
call by name, eye contact, talking to, smiling
what is en face position
face to face with baby
what are concerning signs that maternal infant bonding might not be taking place
don’t talk, turn away, don’t call by name
