Post Partem Flashcards
Endometrium healing
2 layers separate
inner becomes new endometrium.
Outer cast off
Pitocin
Usually in first liter postpartum
Stimulates contraction to expel placenta
Emptying bladder helps
Palpate after infusion stops for firmness
Outer layer composition
Blood fragments, mucus, bacteria , clots
Lochia assessment
Color
Amount- no more than 1 an hour
Presence of clots- good thing
Lochia rubra
Bright red and first couple days
Serosa
Until 12th day
Brownish
Alba
After 12th day
Clear
Blood loss
300-500mL vaginal birth
500-1000mL C section
Blood loss protocol
C section is NPO until bowel sounds return
High fall risk
Mean Arterial pressure over 60
Mean arterial pressure
1/3 systolic
2/3 diastolic
Perfusion changes
Increased blood to heart because decrease to uterus
Fibrinogen and WBC increase
DVT risk
Perfusion interventions
Incentive spirometery
Deep breathing
Assess exit location
Perfusion assessments
Cap refill Pulse will decrease because higher stroke volume HGB, Fe, HCT DVT Dangle for orthostatic
Urinary elimination
Incontinence not normal
Decrease in tone and sense to void
Diuresis expected
Constipation
Progesterone decreases peristalsis
PAIN
Medication
Rectal protrusions
Constipation interventions
Assess bowel sounds
Stool softeners
Comfort
Postpartum assessment
BUBBLE-HE Respirations Fall risk Homans sign/DVT Labs Bladder
Postpartum labs
HCT, HGB, WBC, PLT, FBR, SG
Postpartum vitals
Decrease HR, and RR
Slight Increase in temp
Postpartum breasts
True milk 3-4 days with engorgement
Breast feeding breast care
Encourage PT/Child to breast feed Warm compress/shower Lactation consult/teach Lanolin on nipples Wash daily with no soap
Bottle feeding breast
Cold compress
Face away from shower
Pericare interventions
Ice pack Badet Sitz bath Epifoam Witch Hazel
Involution
Uterus returns to pregestational size
Contracts below umbilicus initially
Rises to umbilicus at 24 hr
Finger a day decrease
