Physiologic Changes and Physical Assessment Flashcards
decreased BP after delivery meanings (2)
-physiological adaption to decreased intrapelvic pressure
-also can indicate PPH
othrostatic hypotension post delivery is….
common for the first few hours PP
elevated BP post delivery….
may indicate preeclampsia
a slow heart heart post delivery is called and caused by….
-puerperal bradycardia; 50-70BPM
-common for 6-10 days post delivery because of decreased strain on the heart, decreased blood volume, and increased stoke volume
tachycardia post delivery….
result of PPH or prolonged labor
how does the resp system adapt during pregnancy?
-increasing minute ventilation; primarily an increase in tidal volume with normal RR
FRC and when does it return to normal post delivery
-functional residual capacity (refers to the amount of air the lungs can take)
-returns to normal within 1-2 weeks
urinary changes PPH included (4) - and what does this put mothers are risk for (2)
-increased bladder capacity
-possible urinary retention due to edema of the tissues surrounding the urethra
-decreased sensitivity to bladder filling and fluid pressure
-increase urinary output for 12-24 hour
-excessive bladder distention/residual urine
-increased risk of UTI
why are mothers at increased risk for constipation post delivery? (2)
-lack of muscle tone and slow motility from progesterone
-concerns for opening episiotomy
common blood loss amount for vaginal delivery
200-500 ml
common blood loss for c-section delivery
700-1000 ml
hemoglobin to blood loss ratio
3 point drop for every 500ml of blood loss
how long does it take for H&H to normal post delivery?
2-6 weeks
WBCs post delivery…
elevate and may increase to 30,000 in the days after delivery without indication of infection but a WBC increase of 30% in 6 hours may indicate infection
what is ursine involution?
the process of the uterus returning to pre pregnancy state
how long does it take for the placenta site to heal in the uterus post delivery?
6-7 weeks
non pregnant uterus weight/capacity
70-100g; capacity 5ml
how many weeks does it take for the uterus to return to pre pregnancy weight?
3
describe how uterine involution occurs (4 steps)
-estrogen and progesterone levels drop dramatically, causing cells of uterus to atrophy
-autolysis occurs, preteolytic enzymes (break down protein) are release and macrophages mirage to uterus
-spongy layer of decidua sloughs off as lochia
-basal layer of decidua separates into two layers, outer layer becomes necrotic and sloughs off and the in layer is the base for the endometrium
lochia
tissue sloughed by the uterus
rubra
reddish in color w clots in the first 1-3 days after birth
serosa
after rubra, pink lochia for 3-10 days PP
alba
after rubra and serosa, yellow whitish mucus lochia seen for 10-14 (or longer) PP
cervix dilation PP
stays dilated for the first week when it should again be at 1cm
vagina PP
may be bruised PP, by 3rd week rugae (folds) are seen again in the vaginal walls
pelvic floor muscles PP
regain their tone 6 weeks PP, legal exercises help this process
return to menses non breastfeeding mothers
7-9 weeks PP
return of menses in breastfeeding mothers
2-18 months
wound care for cesarean?
surgery-strips or staples and then covered with a sterile bandage; ice pack applied 15 mins at time to control pain and swelling in the 1st 24 hours; bandage is usually removed at 24 hours and wound is left open to air or covered with light sterile dressing; woman can usually shower at 24 hours; check site routinely
wound care for episiotomy/lacerations
checked for signs of infections, hematoma or separation; ice pack is applied for 15 mins at a time in the 1st 24 hours for swelling and pain; after 24 hours sitz baths for 20 mins 2-4 times daily; caution woman to tighten buttocks when sitting to avoid stress on suture lines.
