OB ch 12 - post partum woman Flashcards

1
Q

what does a post partum cervix look like as compared to a nullipara cervix

A

slightly open with a small slit

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2
Q

how does the cardiovascular system change during pregnancy and how does it return to normal post partum

A

increased blood volume, increased circulation, increased clotting factors

heart rate slows down, blood clots faster

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3
Q

what are some ways the body rids itself of excess fluid from excess blood volume

A

skin, urinary tract, blood loss

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4
Q

what happens to the blood post partum and what is the woman at risk for because of this

A

clotting - Deep Vein Thrombosis(DVT)

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5
Q

what are symptoms of thrombophebitis

A

redness, swelling, warmth, pain

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6
Q

what happens to the GI system and what symptoms might the woman have

A

decreased peristalsis, decreased bowel tone

-constipation

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7
Q

what are some treatments for constipation

A

fluid, stool softener, exercise, fiber

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8
Q

what is the main concern and what should the nurse assess for in the immediate post partum period

A

hemorrhage - assess for uterine atony

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9
Q

how would you assess for hemorrhage post partum

A

VS(low BP, tachycardia)
boggy uterus
bleeding

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10
Q

how often would you assess for hemorrhage immediately post partum

A

every 15 minutes

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11
Q

what is the most common cause of hemorrhage

A

uterus not contracting

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12
Q

how much blood loss is typical for a vaginal birth

A

300-500 mL

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13
Q

how much blood loss is typical for a c section

A

500-1000 mL

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14
Q

How does the nurse determine the amount of blood loss by looking at hg and hct results

A

subtract 1 from hg
subtract 2 from hct
for every 250 mL

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15
Q

why are UTI’s so common post partum and what are the symptoms of this

A

they just had lots of foreign stuff up there

-painful perineum and urination

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16
Q

what is the benefit of Kegel exercises

A

increase tone and enhance sexual excitement

17
Q

how would you instruct a new mom to use the peri bottle

A

warm water - front to back

every time you go to bathroom

18
Q

what is the average weight loss immediately post partum

19
Q

how long will it take to lose the rest of the “baby weight”

20
Q

describe the 3 phases of lochia - what might be going on if it does not go in order

A

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

21
Q

describe the amount of lochia on a pad.

A

scant, little, moderate, heavy

22
Q

what is considered too much blood

A

fill a pad in 1 hr

23
Q

what is important to note when assessing a pad

A

clot size - HOW LONG PAD WAS IN

24
Q

what are afterpains and what is causing these

A

pain after birth - uterus remains contracted

25
what increases afterpains
breastfeeding, multiple children
26
what should the nurse do if the fundus is soft and boggy
fundal massage
27
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
28
what are some other treatments for perinea pain
ice packs
29
what is a priority assessment to any patient that has received an opioid
respiratory assessment
30
what additional medication should be kept on hand if a patient is receiving opioid medications
naloxone - narcane
31
what are common side effects of opioids
dizziness, nausea, vomiting, constipation
32
what is the name of the first breasts secretions
colostrum
33
why is colostrum important
antibody rich
34
when does colostrum start and end
right after birth-3rd day post partum
35
when does the milk "come in" and the breasts have a possibility to become engorged
3rd day
36
what are good signs of maternal infant bonding
call by name, eye contact, talking to, smiling
37
what is en face position
face to face with baby
38
what are concerning signs that maternal infant bonding might not be taking place
don't talk, turn away, don't call by name