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N352: Practice of Nursing I > OB Module 1: Part 1 - Postpartum > Flashcards

OB Module 1: Part 1 - Postpartum Flashcards

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1
Q

When do all babies get full assessments (at the very least)?

A

Immediate assessment by nurse and doc at birth, and then again by doc before discharge

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2
Q

What are the 4 areas of the OB Unit?

A

Labor and Delivery

Postpartum

The Nursery

Neonatal Intensive Care Unit (NICU)

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3
Q

Birth is a life event for a woman where she is …

A

in a very vulnerable point in her life

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4
Q

It is important that the OB nurse by ____ of how different women cope with extreme pain

A

non-judgmental

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5
Q

Post partum women need to ___ their birth experiences ____ so that they can do what?

A

Post partum women need to recount their birth experiences verbally so that they can start to put these experiences into perspective and get on with the work of taking in their infant and mothering

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6
Q

The more ___ the birth, the more they need to recover from

A

traumatic

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7
Q

Everytime an infant is taken to a mother what must be done?

A

Sequential numbered ID bracelets are checked

The infant has 2 on and the mother has one while she designates another person to have the fourth bracelet

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8
Q

What assessments are included in postpartum care?

A

Physical assessments

Interactions w/ and care of infant

Support systems available

Pain Level and coping strategies

Educational needs

VS and BP

BUBBLE Assessment

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9
Q

BUBBLE Assessment

A

B - Breasts
U - Uterus/Fundus
B - Belly
B- Bottom
L - Lochia
E - Edema/Homans

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10
Q

What are we looking at in the first B of BUBBLE

A

Breasts for filling, nipple status and engorgement (rare)

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11
Q

What are we looking at in the U of BUBBLE

A

Uterus/Fundus in relation to the umbilicus

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12
Q

What are we looking at in the second B of BUBBLE

A

Belly - Abdominal incisions, bowel sounds, distention, elimination, voiding, and bowels in general

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13
Q

What are we looking at in the third B of BUBBLE

A

Bottom - check perineum for aswelling, ecchymosis, hematomas, lacerations, episiotomies and the status of repairs, hemorrhoids

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14
Q

What are we looking at in the L of BUBBLE

A

Lochia vaginal flow

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15
Q

What are we looking at in the E of BUBBLE

A

Edema - Edema and Homans sign

if the policy is to check Homans, some places do not like at Lourdes Hospital

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16
Q

What are two important considerations regarding VS and BP in reference to a pregnant woman’s post partum circulating blood?

A
  1. VS and BP reflect hemodynamic status, but unlike a nonpregnant person, the pregnant woman can lose 30% OF CIRCULATING BLOOD before there are perceivable changes in VS
  2. A woman can lose 50% before there are significant changes. Women who are anemic prior to labor will be affected with smaller loses!

Anemia

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17
Q

Preeclampsia

A

A potentially life threatening complication of pregnancy

Blood pressure elevations related to this that START in the post partum period

*Elevations in BP are unusual

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18
Q

What BP and higher is significant in the mother and should trigger initiation of additional and ongoing assessments?

A

140/90 and greater

*Elevations in BP in this group are unusual

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19
Q

What sort of temperature changes are concerning in the post partum period and what are not?

A

Elevations could be infection, but LOW GRADE FEVER changes are common when milk “comes in” or is secondary to dehydration in the immediate post partum period

Temperatures above 100.4 are indicative of infection

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20
Q

Endometritis

A

infection of the uterus often secondary to an infection that develops in the uterus during labor (chorioamnionitis).

If a womans water was broken for >24 hours the risk of developing this infection increases

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21
Q

What infection is Endometritis often secondary to?

A

Chorioamnionitis

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22
Q

In the post partum period, elevations in pulse and temperature rates could be related to ___ ___ or ___-

A

blood loss or infection

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23
Q

Shortness of Breath and Syncope are indicators of what in the post partum period?

A

Significant blood loss

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24
Q

What is included in the group of post partum lab work?

A

H&H

Review of Rubella Status and administering the vaccine if negative or equivocal

Review of Rh status and administration of Rhogam if the mother is Rh negative and infant is rh positive

Review of hepatitis status and immunization of the infant if HepB positive

Some lab values differ in pregnancy!

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25
Q

What is done if a Rubella status comes back as negative or equivocal for a post partum woman?

A

She is given the vaccine, but because it is a live vaccine it is important that she NOT GET PREGNANT FOR THE NEXT 3 MONTHS

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26
Q

What is done if the post partum woman comes back as Hep B positive?

A

The infant must be immunized immediately

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27
Q

The post partum period starts at what time and continues for how long?

A

Starts at the delivery of the placenta and continues for approximately 6 weeks as the reproductive organs return to their normal non pregnant state

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28
Q

In addition to undergoing significant physical recovery what else must the new mother do?

A

Put her birth experience into perspective and transition into the role of caregiver for her new infant

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29
Q

___ relating to self care and infant care are important components of the post partum care plan!

A

Education

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30
Q

What are the immediate post partum changes that occur in the woman?

A

Uterine and Cervical Involution

Lochia Flow

decrease in Vaginal distention

Breast changes

urinary changes

GI changes

Cardiovascular changes

Endocrine changes

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31
Q

Uterine Involution

A

Process by which the uterus is transformed from pregnant back/collapses back to the non pregnant state

Period is characterized by restoration of ovarian function in order to prepare for any new pregnancies

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32
Q

Cervical Involution

A

shrinkage of the cervix back to a pre pregnancy state

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33
Q

Lochia

A

Vaginal discharge after giving birth, containing blood mucus and uterine tissue

Continues about 4-6 weeks post partum

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34
Q

Every day in 2017, about 810 women died from, ____ causes related to pregnancy and childbirth

A

preventable

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35
Q

Between 2000 and 2017, the maternal mortality ratio (MMR) dropped by about 38% ___, but the MMR rates are increasing in ___

A

worldwide; the U.S.

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36
Q

94% of all maternal deaths occur in what countries?

A

Low and lower middle income countries

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37
Q

MMR

A

Maternal Mortality Ratio

Number of maternal deaths per 100,000 live births

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38
Q

What group faces a higher risk of complications and death as a result of pregnancy when compared to other women?

A

Young Adolescents (ages 10-14)

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39
Q

Skilled care ___, ___, and ___ childbirth can save the lives of women and newborns

A

before, during, AND after

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40
Q

What are some common reasons for pregnancy related deaths in the US (2011-2016)?

A

Hemorrhage, 11.0%.

Infection or sepsis, 12.5%.

Amniotic fluid embolism, 5.6%.

Thrombotic pulmonary or other embolism, 9.0%.

Hypertensive disorders of pregnancy, 6.9%

Anesthesia complications, 0.3%.

Cerebrovascular accidents, 7.7%.

Cardiomyopathy, 11.0%.

Other cardiovascular conditions, 15.7%.

Other noncardiovascular medical conditions, 13.9%.

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41
Q

Any pregnant woman is in a ___ state, leading to high clot risk

A

hypercoagulable

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42
Q

Why is cardiomyopathy related pregnancy deaths on the rise?

A

Because of many women in the US being heavy set during pregnancy

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43
Q

Amniotic Fluid Embolism

A

Clot that forms after amniotic fluid is swept up into maternal circulation

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44
Q

Uterine Involution starts when and continues through when?

A

starts in delivery but continues through the post partum period

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45
Q

After Cramps

A

The uterus continues to contract after delivery. There are dilated blood vessels flow through the muscle fibers of the uterus, so the uterus will contract in a “tourniquet like effect”. These contractions are the after cramps

More noticeable the more pregnancies a woman has

The more contractions = more after cramps felt too

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46
Q

What is the number 1 cause of maternal death in the world and accounts for 27% of all maternal deaths worldwide?

A

Postpartum hemorrhage

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47
Q

Immediately after expulsion of the placenta, the top of the fundus is …

A

in the midline and approximately halfway between the symphysis pubic and the umbilicus

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48
Q

After 6-12 hours post partum, where is the fundus?

A

the highest point of the uterus, the fundus, is usually located at the umbilicus

Feels like a grapefruit in the abdomen

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49
Q

The height of the fundus after 6-12 hours post partum decreases…

A

about one finger breadth (about 1 cm) each day back to its normal position

It will feel hard like a baseball

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50
Q

If the uterus is above the umbilicus after 6-12 hours, be concerned that it is not what?

A

well contracts and blood flow may increase

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51
Q

The more distended the uterus has been during pregnancy, the more…

A

difficult it is for it to contract effectively after delivery

Because of this women who have multiple infants and those that have large infants ARE AT INCREASED RISK FOR HEMORRHAGE

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52
Q

A ___ ___ can interfere with effective post partum uterus contraction

A

distended bladder

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53
Q

What does it mean if the fundus is pushed to the right and is above the umbilicus?

A

The bladder is full (and making it compete for space)

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54
Q

Like the uterus, the ___ and ___ involute after delivery

A

the cervix and vagina

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55
Q

Why do the cervix and vagina have to involute after birth?

A

they dilated to allow passage of the infant and need to return to pre pregnancy state

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56
Q

Why is it so important the cervix close?

A

to prevent infection having access to the uterine cavity

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57
Q

How long does cervical and uterine involution take?

A

process takes up to several weeks to comp[lete

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58
Q

Kegal Exercises

A

exercises to assist with restoring vaginal tone

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59
Q

Vaginal flow after delivery is usually representative of what?

A

the shedding of the uterine lining and the oozing from the site of placental implantation

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60
Q

Atony

A

lack of tone

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61
Q

Excessive post partum bleeding can come from…

A

Uterine atony

Unrepaired cervical, vaginal or perineal lacerations

Retained placental fragments (lead to bad uterine contraction/involution)

Vaginal or Vulvular Hematomas

Coagulopathies

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62
Q

types of Lochia

A

Lochia Rubra

Lochia Serousa

Lochia Alba

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63
Q

Lochia Rubra

A

Initial lochia that is red in color

Occurs 1-3 days post pregnancy

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64
Q

What does brighter red or darker mahogany colored Lochia Rubra Mean?

A

The brighter red the flow, the fresher the bleeding

Darker more mahogany colored bleeding means older bleeding that collected in the vagina and uterus and was expressed now (not necessarily bad)

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65
Q

What kind of lochia flow is common 1-3 days after delivery with position changes?

A

large amounts of very dark flow

66
Q

Lochia Serousa

A

a serousy and pinkish brown color vaginal discharge

Occurs 4-10 days post delivery

67
Q

Lochia Alba

A

A yellowy white color lochia

Has a distinctive fleshy odor

Occurs 11 days to 6 weeks post delivery

It is a NORMAL DISCHARGE

68
Q

Lochia is often accompanied by ___ ___

A

blood clots

69
Q

What are the five different amounts of documented lochia measurement?

A

Scant
Light
Moderate
Heavy
Excessive

70
Q

What amount of lochia is scant

A

less than 2.5 cm on the pad

71
Q

What amount of lochia is light

A

less than 10 cm on the pad but more than 2.5 cm

72
Q

What amount of lochia is moderate

A

greater than 10 cm on the pad

73
Q

What amount of lochia is heavy

A

saturating a pad every 2 hours

74
Q

What amount of lochia is excessive

A

saturating a pad every 15 minutes and/or pooling of blood under the buttocks

75
Q

Breast changes in the post partum period can happen ___ or ___ the woman intends to breastfeed

A

whether or not

76
Q

For the first __ to ___ days after birth, breasts secrete ___

A

1-3 days; colostrum

77
Q

Colostrum

A

a dense yellowish fluid rich in protein, fat, and antibodies

Secreted by the breasts for the first 1-3 days post birth

78
Q

Between what time period will mature milk start to “come in”

A

between the 2nd and 5th day

79
Q

When the mature milk “comes in” how may the breasts feel?

A

May feel hard and full (potentially engorged).

When the breasts are full they may even feel lumpy

Milk in the ducts may feel like cottage cheese in a bag

80
Q

Nipple Trauma

A

Trauma occurring to breastfeeding mothers who are not doing preventative measures

The nipples blister and crack which impedes feeding because of discomfort and can create an entry port for bacteria and leave the woman at risk for developing mastitits

81
Q

What things can a breastfeeding mother be educated on to prevent nipple trauma?

A

Making sure the infant latches well every time (the most important measure)

Changing start side (to equalize pressure of suction)

Changing positions

Do not wipe off after secretions

Air exposure after feeding

82
Q

The breastfeeding mother can breastfeed how many times a day and for up to how long?

A

Could go 8-12 times a day each at up to an hour at a time

83
Q

The best prevention and treatment for breast engorgement in the breastfeeding mother is ___ ___

A

frequent breastfeeding

84
Q

For the non nursing mother, prevention of engorgement is important too, what can they do to prevent engorgement?

A

Instruct to wear a snug fitting bra immediately after delivery and to continue wearing it

She can also use ice pack and raw cabbage leaves lining the bra to impede milk production

Do not have the breasts stimulated as well

85
Q

Milk production is what kind of system?

A

A supply and demand system

We want frequent breastfeeding to stimulate milk production and establish a supply in the breastfeeding mother while having a snug bra, ice, leaves, and no stimulation in the non breastfeeding mom to stop production

86
Q

What are the urinary changes that occur in post partum?

A

Increased diuresis because of reduced estrogen

Increased space available in the pelvis

Potential for urinary retention, especially in vaginal deliveries related to swelling and birth trauma

87
Q

A post partum woman should void by ___ hours and at least ___ cc

A

8 hours and at least 150 ccs

88
Q

If a post partum mother is unable to void, she should be …

A

straight catheterized

89
Q

GI changes in the post partum woman include ___ motility because of decreased ____

A

increased motility because of decreased progesterone

90
Q

Another GI change in a post partum woman is decreased ___ and ___ of the stomach and bowel

A

decreased pressure and displacement of the stomach and bowel

91
Q

C-Section patient’s will have ___ motility initially, thus making ___ ___ ___ a common practice

A

C section patients will have decreased motility initially, thus making gradually resuming feedings a common practice

92
Q

Why is there a significant drop in estrogen and placenta post partum?

A

These extra hormones were made by the placenta which is now gone

93
Q

Diastasis Recti Abdominis

A

A separation of the rectus muscles of the abdomen common after pregnancy

94
Q

Why do we want a post partum mom to avoid aggravating exercise routines?

A

There is diastasis recti abdominis occurring which can cause herniation issues

95
Q

Cardiovascular changes in the post-partum mother include…

A
  1. Blood loss during delivery
  2. Diuresis and Diaphoresis in the first 3 days
  3. potential for shock
  4. Diverting blood from the placentae
  5. Rapid reduction in uterine size allowing the return of blood flow systematically
  6. Continuation of the hypercoagulable state
96
Q

Why is there potential for shock in a post partum woman?

A

shock potential is related to blood loss in delivery

97
Q

How much blood is diverted back to systemic circulation from the placenta after delivery?

A

500-750 cc

98
Q

Many of the mother’s post partum cardiovascular changes are due to what?

A

The fact she took on a lot of fluid which now needs to leave the body

99
Q

What are the 3 major endocrine changes in the post partum woman?

A
  1. Oxytocin increases (from contractions and breastfeeding)
  2. Decreased estrogen, progesterone, and placental enzyme insulinase with the passing of the placenta
  3. Prolactin level increases
100
Q

Oxytocin

A

Hormone released from the pituitary gland

It coordinates uterine contractions but is also the “Love” hormone and stimulates breast feeding and milk release

It is released for amourous attraction but also biochemically primes the mother to fall in love with the baby

101
Q

What hormones increase with breastfeeding?

A

Prolactin and Oxytocin

102
Q

Average blood loss with a vaginal delivery is ___ ccs or less

A

500

103
Q

Average blood loss with C section delivery is ___ ccs or less

A

1000

104
Q

When are post partum hemorrhages considered early? When are they considered late? Which is more common?

A

early - within 24 hours of delivery

late - after 24 hours but can occur up to 6 weeks later

Early partum hemorrhages are more common

105
Q

Why is it important the the mother very gradually resumes her daily activities over the course of several weeks?

A

so that she is not at risk for a post partum hemorrhage

106
Q

Women who have already made the transition in roles with a prior pregnancy must…

A

take in and expand their role as a parent

107
Q

Women who are assuming the role of the mother for the first time…

A

have very significant role changes

complex role strain can occur

108
Q

Role adaptation as a new mother will include…

A

Accepting role as mother

Changing relationship dynamic with partner

changing relationship with extended family

“Bonding” to infant

Body image changes

109
Q

What are the 3 major phases of role adaptation for the new mothers?

A
  1. taking in
  2. taking Hold
  3. Letting go
110
Q

Taking In Phase of role adaptation

A

First couple of days

Passive dependent behaviors as she relies on other for help and guidance

Will repeat the birth story over and over

111
Q

Taking Hold Phase of role adaptation

A

Lasts 2-10 days to several weeks

Asserts her independence as the primary caretaker of her infant

May verbalize fatigue, insecurity in skills, needs for nurturing and acceptance

Optimal time for teaching!!!!

Prone to depression

Commonly discharged at this stage

112
Q

Letting Go Phase of role adaptation

A

She assumes her position at home and adjusts to her role

Focus is on the forward movement of her family unit

Reestablishes her relationship with her partner and may resume intimacy

Still prone to fatigue and depression

113
Q

4 Stages a Woman Progresses through to establish a maternal identity

A
  1. Commitment
  2. Acquaintance/Attachment
  3. Moving toward
  4. Achievement of a maternal identity
114
Q

Commitment Stage of Maternal Identity

A

Stage 1

Attachment to the unborn baby, and preparation for delivery and motherhood during pregnancy

115
Q

Acquaintance/Attachment Stage of Maternal Identity

A

Stage 2

Acquaintance/Attachment to the infant, learning to care for the infant, and physical restoration during the first 2-6 weeks following birth

116
Q

Moving Toward stage of Maternal Identity

A

Stage 3

Moving toward a new normal

117
Q

Achievement of a Maternal Identity stage of Maternal Identity

A

Stage 4

Achieves maternal identity through redefining self to incorporate motherhood (around 4 months).

The mother feels self confident and competent in her mothering and expresses love for and pleasure interacting with her infant

118
Q

Ways to Promote Infant Bonding

A

Allow contact

Allow mom to undress the infant (take in baby fully)

Encourage “en face” positioning

Have mom recognize infant as a unique individual

Have mom recognize infant characteristics with different family members

Have mom touch, hold, and maintain proximity to infant

119
Q

En Face Positoning

A

Mother puts face directly in front of baby for eye to eye contact

120
Q

Behaviors to watch for an hope to see between mother and infant?

A
  1. responds to cues from infant and provides care
  2. Smiles at and talks to infant
  3. Communicates pride in infant
  4. Assigns meaning to the infants behavior and views them positively
121
Q

Potentially pathological signs to watch for between mother and infant?

A
  1. Apathy A(turns away from infant, does not seek proximity)
  2. Disgusts in infant bodily functions, methodical care, and ignores infant
  3. Views infants behaviors as deliberatively uncooperative or disruptive

4.Expresses disappointment in the infant, does not talk about the infants unique features

  1. Handles infant roughly
  2. Lack of preparation for the infant
122
Q

Engrossment

A

Process of the partner that is characterized by seven behaviors - this differs slightly from the moms process

  1. Visual Awareness of Newborn
  2. Tactile Awareness of Newborn
  3. Perception of the newborn as perfect
  4. Strong attraction to the newborn
  5. Awareness of distinct features of the newborn
  6. Extreme Elation
  7. Increased sense of self esteem
123
Q

Visual Awareness of the Newborn during Engrossment of the Partner

A

The father perceives the newborn as attractive, pretty, or beautiful

124
Q

Tactile Awareness of the Newborn during Engrossment of the Partner

A

the father or partner has a desire to touch or hold the newborn and considers this activity to be pleasurable

Mother to infant contact is just as important as father to infant contact in first few hours

125
Q

Perception of the newborn as perfect during engrossment of the partner

A

the father or partner does not “see” any imperfections

126
Q

Strong attraction to the newborn during engrossment of the partner

A

the father or partner focuses all attention on the newborn when he is in the room

127
Q

Awareness of distinct features of the newborn during engrossment of the partner

A

the father or partner can distinguish his newborn from others in the nursery

128
Q

Extreme elation during engrossment of the partner

A

the father or partner feels a “high” after the birth of his child

“I never expected the intensity of how I feel about him/her”

129
Q

Increased sense of self esteem during engrossment of the partner?

A

the father or partner feels proud, “bigger”, more mature, and older after the birth of their child

130
Q

Common Complications of the Post Partum Period

A

Hemorrhage

Infection

Thromboembolic Disease

Postpartum Psychiatric Disorders

131
Q

What are the risk factors for the common complications of the post partum period?

A

Over distention of uterus due to large baby, multiple gestation, multiparity

Rapid or prolonged labor

Oxytocin induction of labor

Precipitous induction of labor

Precipitous delivery, cesarean section (3 hours or less)

Prolonged or premature ROM

Urinary catheterization (always done in C Sections)

132
Q

What are the 6 factors associated with development of Mastitis?

A

Milk stasis

Promotion of access/multiplication of bacteria

Breast/nipple trauma

obstruction of ducts

change in number of feedings/failure to empty breasts

lowered maternal defenses

133
Q

What contributes to milk stasis?

A

failure to change infant position for lobe emptying

failure to alternate breasts when feeding

poor suck

poor letdown

134
Q

What contributes to the promotion of access/multiplication of bacteria causing mastitis?

A

poor hand washing

improper breast hygiene

failure to air dry breasts after feeding

use of plastic lined breast pads that trap moisture

135
Q

What contributes to breast/nipple trauma that causes mastitis?

A

poor latch

incorrect positioning

aggressive pumping

failure to rotate position on the nipple

136
Q

What contributes to obstruction of the ducts which can cause mastitis?

A

restrictive clothing

constrictive bra

underwire bra

137
Q

What contributes to the change in number of feedings/failure to empty the breasts?

A

attempted weaning

missed feedings

prolonged sleeping, including sleeping through the night

feeding primarily from one side because of nipple soreness

138
Q

What contributes to lowered maternal defenses

A

fatigue

stress

139
Q

S/S of Hemorrhage complications in the Post Partum Woman

A

Vaginal bleeding

Persistent bleeding in the presence of a firmly contracted uterus

Rise in the level of the fundus in the abdomen, uterine atony, “boggy” uterus

Abnormal clots

Unusual pelvic discomfort or backache

Increased pulse, decreased BP, lightheadedness, syncope, SOB

Hematoma formation or shiny bulging skin in the perineal area

Decreased level of consciousness

Lowered hemoglobin and hematocrit results

140
Q

Is a lemon sized clot normal in the first few hours after delivery?

A

Yes a clot this large may be delivered after a few hours, but anything larger or more frequent means a poorly contracted uterus

141
Q

S/S of Infection complications in the post partum woman?

A

fever

purulent discharge from vagina or incision

erythema at incision site

increased WBCs

burning during urination

redness/pain in breast about fourth postpartum week

142
Q

S/S of Blood clots in the post partum woman?

A

positive Homans sign

skin color changes

pain

tenderness

swelling in lower extremities

143
Q

S/S of Depression in post partum woman?

A

overwhelming sadness

low self esteem

lack of desire to care for the child

144
Q

It is important to keep in mind what things about WBC levels in post partum?

A

WBCs above 20 have a cause (infection), but an increase of WBC after birth for a bit is normal

145
Q

Where are blood clots commonly forming in the post partum woman?

A

In the pelvis, thighs, or calves

146
Q

Postpartum blues usually subside after…

A

2 weeks

147
Q

Factors associated with increased risk of thromboembolic disease in the post partum woman

A

C Section

Inactivity

Obesity

Cigarette Smoking

Previous thromboembolic disease

Trauma to the extremity (may be related to positioning during labor and delivery)

Varicose veins

Diabetes

Advanced maternal age

Inherited thromboembolic disorders

Multiparity

Anemia

148
Q

Why do C Sections make a woman more prone to thromboembolic disease?

A

It makes them more hypercoagulable on top of the state they are in in pregnancy, and they are more inactive and confined to bed

149
Q

Most women (___%) experience a transient period of ___ depressive symptoms in the first ___ weeks after delivery

A

most women (80%) experience a transient period of mild depressive symptoms in the first two weeks after delivery\

This is post partum blues

150
Q

About ___% of women will experience ___ symptoms of depression that usually set in later in the post partum period. This is called __ __ depression

A

about 15% of women will experience severe symptoms of depression that usually set in later in the post partum period. this is called post partum depression

151
Q

Post Partum Psychosis

A

A small percentage of woman develop this more severe psych issue

It requires a period of in hospital evaluation, stabilization, and treatment

152
Q

Observe the new mother for ___ signs or depression, listen for feelings of ___ and __ ___

A

observe the new mother for objective signs of depression, listen for feelings of failure and self accusation

153
Q

If the mother feels overwhelming feelings of sadness or inability to care for the infant what should the nurse do?

A

Provide a list of support organizations in the community

154
Q

Women with post partum depression usually need…

A

to be on medication for 6 months and often benefit from therapy

155
Q

What puts a woman at increased risk for post partum depression?

A

A history of depression in the past

156
Q

When is post partum depression more severe?

A

In first time mothers, rather than women who have had children before

157
Q

Primiparas

A

A woman who has given birth to 1 child or who is giving birth for the first time

158
Q

Multiparas

A

A woman who has had 2 or more pregnancies resulting in viable offspring

159
Q

What observations may be made in a woman with post partum depression, especially a first time mother?

A

episodic tearfulness

Note if mother feels overwhelmed

inability to cope

fatigue

anxiety

irritability

oversensitivity

160
Q

What are some factors that influence (positively or negatively) a woman’s success in physical healing and role changes during the post partum period?

A

General health and comfort level

Physical strain her labor created

her perceptions of her birth experience

relationship with her partner

relationship with her mother

social support available to her

her ability to rest in the first few weeks

nutrition

N352: Practice of Nursing I (14 decks)

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