Post Partem

Question 0

Endometrium healing

Answer 0

2 layers separate
inner becomes new endometrium.
Outer cast off

Question 1

Pitocin

Answer 1

Usually in first liter postpartum
Stimulates contraction to expel placenta
Emptying bladder helps
Palpate after infusion stops for firmness

Question 2

Outer layer composition

Answer 2

Blood fragments, mucus, bacteria , clots

Question 3

Lochia assessment

Answer 3

Color
Amount- no more than 1 an hour
Presence of clots- good thing

Question 4

Lochia rubra

Answer 4

Bright red and first couple days

Question 5

Serosa

Answer 5

Until 12th day

Brownish

Question 6

Alba

Answer 6

After 12th day

Clear

Question 7

Blood loss

Answer 7

300-500mL vaginal birth

500-1000mL C section

Question 8

Blood loss protocol

Answer 8

C section is NPO until bowel sounds return
High fall risk
Mean Arterial pressure over 60

Question 9

Mean arterial pressure

Answer 9

1/3 systolic

2/3 diastolic

Question 10

Perfusion changes

Answer 10

Increased blood to heart because decrease to uterus
Fibrinogen and WBC increase
DVT risk

Question 11

Perfusion interventions

Answer 11

Incentive spirometery
Deep breathing
Assess exit location

Question 12

Perfusion assessments

Answer 12

Cap refill
Pulse will decrease because higher stroke volume
HGB, Fe, HCT
DVT
Dangle for orthostatic

Question 13

Urinary elimination

Answer 13

Incontinence not normal
Decrease in tone and sense to void
Diuresis expected

Question 14

Constipation

Answer 14

Progesterone decreases peristalsis
PAIN
Medication
Rectal protrusions

Question 15

Constipation interventions

Answer 15

Assess bowel sounds
Stool softeners
Comfort

Question 16

Postpartum assessment

Answer 16

BUBBLE-HE
Respirations
Fall risk
Homans sign/DVT
Labs
Bladder

Question 17

Postpartum labs

Answer 17

HCT, HGB, WBC, PLT, FBR, SG

Question 18

Postpartum vitals

Answer 18

Decrease HR, and RR

Slight Increase in temp

Question 19

Postpartum breasts

Answer 19

True milk 3-4 days with engorgement

Question 20

Breast feeding breast care

Answer 20

Encourage PT/Child to breast feed
Warm compress/shower
Lactation consult/teach
Lanolin on nipples
Wash daily with no soap

Question 21

Bottle feeding breast

Answer 21

Cold compress

Face away from shower

Question 22

Pericare interventions

Answer 22

Ice pack
Badet
Sitz bath
Epifoam
Witch Hazel

Question 23

Involution

Answer 23

Uterus returns to pregestational size
Contracts below umbilicus initially
Rises to umbilicus at 24 hr
Finger a day decrease