POST-Partum Flashcards
- Natural proces that involves uterus return to its PRE-PREGNANCY state
- Regeneration of uterine epithelium
Involution
Uterine weight begins to
decrease in weight.
1000grams - 60grams in 6 weeks.
Fundal height should be in
pelvic cavity after 6 weeks.
Cervix goes back to prepregnant state in
6 weeks.
which one closes sooner?
Internal os or external os?
internal Cervix os
prevent infection.
VAgina adaptations post partum
- prepregnant by 6-8 wekks
- localized dryness
perineum post partum
- painful, edeatous, and bruised
- sitz bath helps
- pelvic floor dysfunction
- PFMT: pelvic floor muscle training
What type of cardiovascular activity REQUIRES ATTENTION
TACHYCARDIA >100 BPM
(ABNORMAL)
Bradycardia is normal
WBC remain
high for 1-6 days
Normal functions begin
1-3 weeks
Endocrine Post partum:
if mom is NOT BREASTFEEDING what happens
Within 2 weeks:
* Estrogen INCREASES
* Prolactin DECREASES
Endocrine Post partum:
if mom IS BREASTFEEDING what happens
Estrogen and Prolactin both REMAIN LOW.
most placental hormones are gone within a
week.
A mom is constipated POST PARTUM
- this is normal.
- increase fluid intake
- INCREASE diets.
When inspecting abdomen the nurse should do what first
AUSCULTATE BOWEL SOUNDS first!!! then palpate fundus.
Urinary system Post partum
- large amounts of fluids.
- diuresis in 12 hrs
- 3000 mL/day (normal)!!! (due to trauma)
Normal pee for person is 30/mL/hr
Sexual health POST PARTUM
4-6 weeks.
Contraceptions after POST PARTUM to be used
Progestin ONLY!!
bc it has no effect on breastmilk.
Combined contraceptions can be started until
6 weeks.
What stimulates Milk production
- Prolactin
- Oxytocin
- skin to skin
- supply and demand
- breast crawl.
Is enfoged breast an infection?
NO!!
just large collection of milk and not feeding baby soon enough.
How to supress lactation (milk production) for HIV, DRUGS, still birth, etc resons.
- cessation
- tight support bra 24 hrs/day
- ice packs on breast
- avoid breast stimulation
- avoid warmth on breasts
is breastfeeding a TOTAL RELIABLE METHOD of contraception?
No…
Unless:
1. Exclusively breastfeeds
2. no PMS since birth
3. infant < 6 monts
Bubble- EE for postpartum ASSESSMENT
B: BREASTS
U: UTERUS
B: BOWELS
B: BLADDER
L: LOCHIA
E: EPISIOTOMY/ lacerations/C-Section
E: extremities
Emotional status
Discharge assessment
describe and docment if it is NOT colostrum (creamy yellow) or Foremilk (bluish white)
fundal should go down how many cm per day?
1 cm per day.
Uterus should NOT be
boggy or displaced.
what can cause URINARY RETENTION
1 cause epidural
(medications)
WHat are most common causes for CONSTIPATION
HIGH iron (due to prenatal vitamin)
vaginal discharge that occurs AFTER birth
LOCHIA
LOCHIA CONTINUES for how long AFTER BIRTH
4-8 weeks.
Lochia for the first 3-4 day after birth.
Lochia rubra
Lochia that is PINK-BROWN and is expelled 3-10 days POSTPARTUM
LOCHIA SEROSA
LOCHIA on final stage
Can last 10-14 days or 3-6 weeks.
lochia ALBA
THINGS TO REPORT with Lochia
- foul smelling = infection
- Large clots= poor uterine involution, retained placental fragments.
Assess Lochia pads used.
WHat is considered large or heavy lochia
Saturating 1 or more pads per hr.
1in - 4in stain on pad (10mL-25mL
Episiotomy in perineum area should be assesed every
8 hrs.
(lithotomy or side-side position)
REEDA
score chart for healing of Episiotomy in perineum
REEDA is considered heel with what score
0= healed
1-5= moderate healed
6-10 mild healed
11-15 not healed.
REEDA is for
- REdness
- Edema
- Ecchymosis (bruising)
- Discharge
- Approximation
- Large area, swollen, bluish skin
- Severe pain
- Redness, swelling
- Purulent drainage
- NO noticeable BLEEDING
Hematomas
(blood outside the vessel)
- A boggy or relaxed uterus
- Failure of uterus to contract
- excessive clots
- bloddy red flow
UTERINE ATONY
WHAT causes uterine atony
- full bladder
- overdistension of uterus
- retention of placental fragments
- Inducing labor with Oxytocin
What is the number one cause of postpartum hemorrhage
uterine atony
- TRICKLING or STEADY STREAM of red blood
- excessive bleeding w/ FIRM fundus.
LACERATIONS
S/S for VTE
- tightness
- redness
- aching
- edema
- warmth
- BILLATERALLY
- low grade fever..
To prevent VTE/ DVT POSTPARTUM what would the nurse have the pt do
ambulation
compressing socks
report abnormal findings
Nutrition should
increase for mom.
no sodas
IF mom is RH Neg and baby is RH POS what should be the NEXT step?
administer mom. RhoGAM within 72 hrs of delivery.
Women receive 2 doses of RhoGam .. when is this
28 weeks gestation
and
72 hrs after birth.
- need consent
- Blood product so get consent and b careful with Jehovas witnesses.
do PP mood changes (baby blues) interfere with ability to care for SELF AND INFANT?
NO.
