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Unit 4 > Post partum > Flashcards

Post partum Flashcards

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1
Q

What is sub involution?

A

Uterus is not returning to pre pregnancy size within 14 days.

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2
Q

What is involution?

A

Uterus returning to pre pregnancy size within 14 days.

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3
Q

What is normal rate of uterus shrinking postpartum?

A

1 cm/daily (one finger breadth daily)
Descent is documented in relation to umbilicus. If U-1 means fundus at 1 cm below umbilicus

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4
Q

What is lochia?

A

Discharge postpartum

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5
Q

What is lochia rubra?

A

First 3 days -dark red or brown red
Educate:—-If soaking more than one pad an hour-that is a problem–

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6
Q

What is lochia serosa?

A

Day 4-10
Red, pink, brown tinged

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7
Q

What is lochia alba?

A

Day 11-21
Light color

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8
Q

What is average blood loss for vaginal and C-Section births?

A

vag-500 cc
CS-1000 cc

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9
Q

What urine changes occur postpartum days 2-5?

A

Increase in urine output.
All the excess plasma volume of pregnancy is leaving.

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10
Q

What is a woman at in increased risk for in post partum period?

A

Thrombus formation (highest at 2 week mark)
This is because her body has an increased ability to form clots during normal pregnancy. High levels of clotting factors in blood.
Educate:—Signs of DVT (warm, red, pain, edema) and importance of mobility–

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11
Q

What is diastasis recti?

A

Separation of rectus muscles of abdomen.

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12
Q

Suggestions for mom who has no rubella antibodies.

A

Rubella vax recommended after childbirth (never given during pregnancy) to prevent problems in future pregnancies.

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13
Q

What vaccine should all mom’s receive in third trimester?

A

TdAP-will give baby antibodies at birth

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14
Q

What are some things that could prevent uterus from contracting postpartum?

A

Clots-NEVER expel clots from boggy uterus. Massage until firm first-then expel clots.
Full bladder

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15
Q

What should uterus feel like 24 hours postpartum?

A

Firm grapefruit around umbilicus

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16
Q

Management of boggy uterus.

A

Massage (Firm circles while stabilizing bottom of uterus)
Find cause
Express clots
Empty bladder
Oxytocin
Methergine (IM) 0.2mg—-watch for hypertension—-
Cytotec
Hemabate (refrigerated, Deep IM)

17
Q

Major side effect of methergine.

A

Hypertension

18
Q

Prevention steps of thrombus formation.

A

Ambulate early and often.
ROM exercises
Compression devices
Stay hydrated

19
Q

What is puerperal infection?

A

Bacterial infection of genital tract within 42 days postpartum

20
Q

What is normal elevated WBC range Post partum?

A

14-16K
–If extremely high (20K and above) make sure no underlying infection–

21
Q

What are some signs of distended bladder or urinary retention?

A

Displaced fundus
Excess lochia
Retention:
Frequent voiding but small amount

22
Q

When are RhoGam shots needed?

A

Negative blood type (mom)
or O blood type

23
Q

What is minimum output per hour until concerning?

A

30 mL/hour

24
Q

What is the taking in phase postpartum?

A

First stage
Mom focused on self
Passive and dependent

25
Q

What is taking hold phase?

A

Second stage
Attention on NB
More independent (starts taking care of herself…(showers, makeup, get dressed and taking care of baby)
—Best time for education–

26
Q

What is letting go phase?

A

Third stage
Process disappointments with labor and delivery, look of baby
Relinquish her previous life before this new role

27
Q

Bleeding in uterus will present as…

A

Clots
Need massage, maybe Pitocin
IV fluids, careful monitoring

28
Q

What medications is given for severe postpartum hemorrhage/hypovolemic shock?

A

Methergine (IM or PO) 0.2 mg
Can give IV in emergency situations but must be given slowly while monitoring BP
Raises BP
–Side effects: hypertension, N/V, diarrhea–
Hemabate

29
Q

What is treatment for DVT?

A

Heat, elevate, anticoags, hydrate
—No massage–

30
Q
A

Unit 4 (4 decks)

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