OB - Module 7

Question 1

When does involution begin?

Answer 1

Immediately after birth to control bleeding and return organs to normal size

Question 2

What stimulates contractions in the mother?

Answer 2

Oxytocin

Question 3

3 stages of lochia

Answer 3

Rubra(1-3 days), Serosa (4-10), Alba (up to 6 weeks)

Question 4

How long does the vagina take to heal?

Answer 4

6 weeks. does not return to pre-pregnancy size. Painful intercourse for 4-6 months

Question 5

Volume for Post partum hemorrhage

Answer 5

500ml Vaginal, 1000mL Cesarean. Before 24 hours (early), After 24 hours (late)

Question 6

What are the most common causes of Postpartum hemmorhage?

Answer 6

Uterine atony and trauma

Question 7

Management of uterine atony (boggy fundus)

Answer 7

Fundal massage and empty bladder

Question 8

placenta accreta

Answer 8

placenta grows into uterine wall causing continuous bleeding

Question 9

What medications are given for postpartum hemorrhage?

Answer 9

Pitocin, methergine, and prostaglandin

Question 10

First vital signs for hemorrhage

Answer 10

Tachycardia, reduced blood pressure

Question 11

Laceration

Answer 11

Fundus is firm and in expected position, but bleeding is continued.

Question 12

Signs of hypovolemic shock

Answer 12

Tachycardia, pale cool skin, decreased pulse pressure, increased respirations

Question 13

What causes subinvolution of the uterus?

Answer 13

Retained placental pieces and infection

Question 14

Normal ways the postpartum woman gets rid of fluids

Answer 14

Diuresis and Diaphoresis

Question 15

What increases to protect the mother from hemorrhage?

Answer 15

Fibrinogen and Clotting factor

Question 16

How much urine output could a postpartum mother have?

Answer 16

3000ml per day is not uncommon

Question 17

SVT/DVT management

Answer 17

Bedrest, elevated legs, analgesics, anticoagulants

Question 18

Sign of SVT

Answer 18

Obvious inflammation. reddening, swelling. Diagnosed with patient’s symptoms.

Question 19

Sign of DVT

Answer 19

Pain on ambulation, diagnosed with doppler

Question 20

Blood values for postpartum

Answer 20

Increased WBCs and Neutrophils

Low hematocrit

Question 21

How do the muscles look?

Answer 21

Stretched and decreased tone

Question 22

How does the skin look?

Answer 22

hyperpigmentation (dark skin spots), stretch marks, and hair loss for 3-4 months

Question 23

When does ovulation/menstruation begin again?

Answer 23

Non breast feeding: 7-9 weeks
Breast feeding: 12 weeks - 18 months
Still need to use contraceptives

Question 24

Metritis

Answer 24

Infection of the lining of the uterus

Question 25

Endometritis

Answer 25

Infection of the endometrium

Question 26

Endomyometritis

Answer 26

Infection of muscle and inner lining

Question 27

Endoparametritis

Answer 27

Infection that involves the surrounding tissues

Question 28

Mastitis

Answer 28

Inflammation of breast tissue after 2-3 weeks. To treat, decompress the breasts (massage, breast feeding, and increase fluids).

Question 29

Normal WBC count for Postpartum

Answer 29

25000-30000. Greater than this indicates infection