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families > ob chapter 17 > Flashcards

ob chapter 17 Flashcards

1
Q

What is the postpartum period (puerperium)?

A

The 6-week period after childbirth involving maternal physical and psychological changes.

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2
Q

What are the two types of changes during the postpartum period?

A

Retrogressive: Involution of the uterus and vagina. Progressive: Lactation, menstrual cycle restoration, and beginning the parenting role.

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3
Q

How can postpartum physical care impact a birthing parent?

A

It can influence their long-term health and recovery.

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4
Q

What is the Baby-Friendly Initiative, and how does it relate to postpartum care?

A

A set of strategies promoting breastfeeding and infant-parent bonding, such as skin-to-skin contact and rooming-in.

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5
Q

What is parental attachment bonding?

A

A process where a parent successfully links with their newborn, facilitated by early skin-to-skin contact.

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6
Q

When should skin-to-skin contact occur after birth?

A

Ideally within the first hour, even after cesarean delivery, as long as the parent and baby are stable.

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7
Q

What is the en face position, and why is it important?

A

When a parent looks directly at their newborn’s face with eye contact, signaling the beginning of effective attachment.

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8
Q

What is engrossment in parental bonding?

A

A sign of active parental bonding where the parent is highly focused on their newborn.

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9
Q

How can nurses support family bonding postpartum?

A

Encourage skin-to-skin contact, rooming-in, and sibling/family visitation.

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10
Q

Why might a birthing parent feel overlooked or forgotten postpartum?

A

They may feel less important after birth compared to the attention received during pregnancy and labor.

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11
Q

What is disillusionment in new parents?

A

The realization that parenting is different from expectations; nurses should reassure parents that this is normal.

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12
Q

What are postpartum blues, and how common are they?

A

Temporary feelings of sadness, tearfulness, irritability, or feeling let down, affecting up to 50% of postpartum individuals.

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13
Q

What is a possible cause of postpartum blues?

A

Hormonal changes.

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14
Q

How can postpartum blues be alleviated?

A

Breastfeeding can help counteract mood changes.

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15
Q

What is involution of the uterus?

A

A process where the uterus returns to its pregestational size and seals off the placental site to prevent bleeding.

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16
Q

How long does uterine involution take?

A

Approximately 6 weeks.

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17
Q

Where is the fundus located immediately after birth?

A

Halfway between the umbilicus and the symphysis pubis.

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18
Q

Where is the fundus one hour after birth?

A

It rises to the level of the umbilicus and remains there for about 24 hours.

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19
Q

How much does the fundus decrease in height daily?

A

1 cm (or one fingerbreadth) per day.

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20
Q

How does breastfeeding affect uterine involution?

A

It accelerates involution because oxytocin, released during breastfeeding, stimulates uterine contractions.

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21
Q

What is a boggy uterus, and why is it a concern?

A

A soft, relaxed uterus that increases the risk of postpartum hemorrhage.

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22
Q

What is uterine atony, and when is the highest risk?

A

When the uterus fails to contract properly, leading to rapid blood loss; highest risk is within the first hour postpartum.

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23
Q

How should the fundus be assessed?

A

Assess fundal height after bladder emptying for accuracy. A full bladder can push the uterus upward, increasing bleeding risk.

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24
Q

How should a well-contracted uterus feel?

A

Firm and grapefruit-like in size and tenseness.

25
Q

What is lochia?

A

A vaginal discharge consisting of blood, fragments of decidua, WBCs, mucus, and bacteria, similar to menstrual flow.

26
Q

Why does lochia occur?

A

The necrotic uterine lining is shed following birth.

27
Q

How does the cervix change after birth?

A

The internal os closes, but the external os remains slightly open and appears slitlike or stellate (star-shaped) instead of round.

28
Q

How does the vagina change postpartum?

A

It becomes soft, with few rugae, and its diameter is wider than normal.

29
Q

How does the perineum change after birth?

A

It becomes edematous and tender due to birth pressure.

30
Q

What comfort measures can help with perineal discomfort?

A

Ice packs, warm packs, a gentle pillow, or a doughnut pad for sitting.

31
Q

What medications can be used for perineal pain?

A

Acetaminophen or ibuprofen, as discussed with

32
Q

Why do postpartum patients experience diaphoresis and diuresis?

A

To rid the body of excess fluid from pregnancy.

33
Q

How does the bladder change postpartum?

A

It has a transient loss of tone, making it harder for the patient to sense when they need to void.

34
Q

Why is it important to assess the abdomen for bladder distention postpartum?

A

A full bladder can displace the uterus, preventing contractions and increasing the risk of postpartum hemorrhage.

35
Q

How can the uterine position help determine bladder fullness?

A

If the uterus is displaced and not contracting well, the bladder may be full.

36
Q

When does blood volume return to prepregnancy levels?

A

By the first or second week postpartum due to diuresis and blood loss.

37
Q

How does pregnancy-related varicosities change postpartum?

A

Varicose veins usually recede after birth.

38
Q

Is bilateral ankle edema normal postpartum?

A

Yes, but it should not progress above the knees.

39
Q

What dietary recommendations help with postpartum constipation?

A

High-fiber foods, fruits, and adequate fluids.

40
Q

Why might stool softeners be needed postpartum?

A

Because bowel movements may be slow due to relaxin, and hemorrhoids/episiotomy sutures can make passing stool painful.

41
Q

What skin change is common postpartum?

A

Striae gravidarum (stretch marks) on the abdomen.

42
Q

What is diastasis recti, and how can it be treated?

A

Separation of the abdominal muscles due to overstretching; can be treated with modified abdominal exercises or surgery if severe.

43
Q

What triggers Lactogenesis II at birth?

A

The delivery of the placenta, which causes a drop in progesterone and pregnancy hormones.

44
Q

What is Lactogenesis II also known as?

A

Engorgement or when the “milk has come in.”

45
Q

When does Lactogenesis II occur?

A

From birth to 5–10 days postpartum.

46
Q

What is the milk called during Lactogenesis II?

A

Transitional milk.

47
Q

What happens to the breasts in the first 2 days postpartum?

A

They show little change from pregnancy because colostrum may have already been secreted.

48
Q

What happens to the breasts on day 3 postpartum?

A

They become full, tense, or tender as milk forms.

49
Q

When does menstrual flow return for a non-breastfeeding parent?

A

6 to 10 weeks postpartum.

50
Q

When does menstrual flow return for a breastfeeding parent?

A

3 to 4 months or more (or sometimes not until after lactation ends).

51
Q

Can a breastfeeding person ovulate before their period returns?

A

Yes, ovulation can occur before menstruation returns, meaning pregnancy is still possible.

52
Q

What are the postpartum warning signs for respiratory issues?

A

Chest pain or difficulty breathing.

53
Q

What are the neurologic postpartum warning signs?

A

Seizures, persistent headaches, or visual changes.

54
Q

What are the mental health postpartum warning signs?

A

Thoughts of self-harm or harming others.

55
Q

What are the infection-related postpartum warning signs?

A

Fever (100.4°F or higher), redness/edema of lower extremities, or poor incision healing.

56
Q

What are the postpartum hemorrhage warning signs?

A

Soaking through one pad/hour or passing clots larger than a quarter.

57
Q

When should a postpartum patient call 911?

A

Chest pain, difficulty breathing, seizures, or thoughts of harming self/others.

58
Q

When should a postpartum patient call their healthcare provider?

A

Persistent headache, fever, excessive bleeding, swelling/redness in legs, or incision not healing.

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