ob chapter 17 Flashcards
What is the postpartum period (puerperium)?
The 6-week period after childbirth involving maternal physical and psychological changes.
What are the two types of changes during the postpartum period?
Retrogressive: Involution of the uterus and vagina. Progressive: Lactation, menstrual cycle restoration, and beginning the parenting role.
How can postpartum physical care impact a birthing parent?
It can influence their long-term health and recovery.
What is the Baby-Friendly Initiative, and how does it relate to postpartum care?
A set of strategies promoting breastfeeding and infant-parent bonding, such as skin-to-skin contact and rooming-in.
What is parental attachment bonding?
A process where a parent successfully links with their newborn, facilitated by early skin-to-skin contact.
When should skin-to-skin contact occur after birth?
Ideally within the first hour, even after cesarean delivery, as long as the parent and baby are stable.
What is the en face position, and why is it important?
When a parent looks directly at their newborn’s face with eye contact, signaling the beginning of effective attachment.
What is engrossment in parental bonding?
A sign of active parental bonding where the parent is highly focused on their newborn.
How can nurses support family bonding postpartum?
Encourage skin-to-skin contact, rooming-in, and sibling/family visitation.
Why might a birthing parent feel overlooked or forgotten postpartum?
They may feel less important after birth compared to the attention received during pregnancy and labor.
What is disillusionment in new parents?
The realization that parenting is different from expectations; nurses should reassure parents that this is normal.
What are postpartum blues, and how common are they?
Temporary feelings of sadness, tearfulness, irritability, or feeling let down, affecting up to 50% of postpartum individuals.
What is a possible cause of postpartum blues?
Hormonal changes.
How can postpartum blues be alleviated?
Breastfeeding can help counteract mood changes.
What is involution of the uterus?
A process where the uterus returns to its pregestational size and seals off the placental site to prevent bleeding.
How long does uterine involution take?
Approximately 6 weeks.
Where is the fundus located immediately after birth?
Halfway between the umbilicus and the symphysis pubis.
Where is the fundus one hour after birth?
It rises to the level of the umbilicus and remains there for about 24 hours.
How much does the fundus decrease in height daily?
1 cm (or one fingerbreadth) per day.
How does breastfeeding affect uterine involution?
It accelerates involution because oxytocin, released during breastfeeding, stimulates uterine contractions.
What is a boggy uterus, and why is it a concern?
A soft, relaxed uterus that increases the risk of postpartum hemorrhage.
What is uterine atony, and when is the highest risk?
When the uterus fails to contract properly, leading to rapid blood loss; highest risk is within the first hour postpartum.
How should the fundus be assessed?
Assess fundal height after bladder emptying for accuracy. A full bladder can push the uterus upward, increasing bleeding risk.
How should a well-contracted uterus feel?
Firm and grapefruit-like in size and tenseness.
What is lochia?
A vaginal discharge consisting of blood, fragments of decidua, WBCs, mucus, and bacteria, similar to menstrual flow.
Why does lochia occur?
The necrotic uterine lining is shed following birth.
How does the cervix change after birth?
The internal os closes, but the external os remains slightly open and appears slitlike or stellate (star-shaped) instead of round.
How does the vagina change postpartum?
It becomes soft, with few rugae, and its diameter is wider than normal.
How does the perineum change after birth?
It becomes edematous and tender due to birth pressure.
What comfort measures can help with perineal discomfort?
Ice packs, warm packs, a gentle pillow, or a doughnut pad for sitting.
What medications can be used for perineal pain?
Acetaminophen or ibuprofen, as discussed with
Why do postpartum patients experience diaphoresis and diuresis?
To rid the body of excess fluid from pregnancy.
How does the bladder change postpartum?
It has a transient loss of tone, making it harder for the patient to sense when they need to void.
Why is it important to assess the abdomen for bladder distention postpartum?
A full bladder can displace the uterus, preventing contractions and increasing the risk of postpartum hemorrhage.
How can the uterine position help determine bladder fullness?
If the uterus is displaced and not contracting well, the bladder may be full.
When does blood volume return to prepregnancy levels?
By the first or second week postpartum due to diuresis and blood loss.
How does pregnancy-related varicosities change postpartum?
Varicose veins usually recede after birth.
Is bilateral ankle edema normal postpartum?
Yes, but it should not progress above the knees.
What dietary recommendations help with postpartum constipation?
High-fiber foods, fruits, and adequate fluids.
Why might stool softeners be needed postpartum?
Because bowel movements may be slow due to relaxin, and hemorrhoids/episiotomy sutures can make passing stool painful.
What skin change is common postpartum?
Striae gravidarum (stretch marks) on the abdomen.
What is diastasis recti, and how can it be treated?
Separation of the abdominal muscles due to overstretching; can be treated with modified abdominal exercises or surgery if severe.
What triggers Lactogenesis II at birth?
The delivery of the placenta, which causes a drop in progesterone and pregnancy hormones.
What is Lactogenesis II also known as?
Engorgement or when the “milk has come in.”
When does Lactogenesis II occur?
From birth to 5–10 days postpartum.
What is the milk called during Lactogenesis II?
Transitional milk.
What happens to the breasts in the first 2 days postpartum?
They show little change from pregnancy because colostrum may have already been secreted.
What happens to the breasts on day 3 postpartum?
They become full, tense, or tender as milk forms.
When does menstrual flow return for a non-breastfeeding parent?
6 to 10 weeks postpartum.
When does menstrual flow return for a breastfeeding parent?
3 to 4 months or more (or sometimes not until after lactation ends).
Can a breastfeeding person ovulate before their period returns?
Yes, ovulation can occur before menstruation returns, meaning pregnancy is still possible.
What are the postpartum warning signs for respiratory issues?
Chest pain or difficulty breathing.
What are the neurologic postpartum warning signs?
Seizures, persistent headaches, or visual changes.
What are the mental health postpartum warning signs?
Thoughts of self-harm or harming others.
What are the infection-related postpartum warning signs?
Fever (100.4°F or higher), redness/edema of lower extremities, or poor incision healing.
What are the postpartum hemorrhage warning signs?
Soaking through one pad/hour or passing clots larger than a quarter.
When should a postpartum patient call 911?
Chest pain, difficulty breathing, seizures, or thoughts of harming self/others.
When should a postpartum patient call their healthcare provider?
Persistent headache, fever, excessive bleeding, swelling/redness in legs, or incision not healing.
