Postnatal Physiology, Care, Assessment & Support (W/S14)

Question 1

How often should vital signs be checked post birth?

Answer 1

Every 15mins for the first hour

Question 2

What are the terms used to describe changes in lochia?

Answer 2

Lochia rubra (red) - heavy, may have small clots

Lochia serosa (pink) - moderate to small amount

Lochia alba (white) - gradually disappearing

*blood loss >6 weeks is not unusual

Question 3

What advice can you give for perineal healing?

Answer 3

Diclofenac suppository
Keep it clean and dry
Ice for 10mins per hour
Pelvic floor exercises
Rest
Manual support when opening bowels

Question 4

What’s involved in micturition (urinary) assessment?

Answer 4

Record frequency and volume of voids

Question 4

What’s involved in micturition (urinary) assessment?

Answer 4

Record frequency and volume of voids
2 consecutive voids of 300-600mls
Experiencing any pain or discomfort?
Constant stream?
Does she feel post void bladder emptiness?

Question 5

Does cardiac output increase or decrease immediately after birth?

Answer 5

Increases 60-80%

• Bood is returned to systemic circulation from the uterus as it contracts
• Relief of inferior vena cava compression allows venous return to maternal heart

Question 6

How many weeks postpartum does cardiac output return to non-pregnant levels?

Answer 6

2-4 weeks but it remains elevated for longer if breastfeeding

Question 7

What are the 6 principles of safe sleeping?

Answer 7

1. On back, not tummy or side
2. Face uncovered
3. Avoid tobacco smoke before and after birth
4. Safe sleeping environment
5. In parents’ room for the first 6-12 months
6. Breastfeeding reduces risk of SIDS

Question 8

Where is oxytocin released from?

Answer 8

Posterior pituitary

Question 9

After 1 week, where would you expect the uterus to be?

Answer 9

Midway between the umbilicus and symphysis

Question 10

What is oxytocin responsible for?

Answer 10

Myometrial contraction (involution of uterus)
Ejection of milk during lactation

Question 11

A drop in levels of ______ following the birth of the placenta allows ________ to stimulate milk synthesis.

Answer 11

A drop in levels of PROGESTERONE following the birth of the placenta allows PROLACTIN to stimulate milk synthesis.

Question 12

How many mls of blood is considered to be a PPH?

Answer 12

500mls (vaginal birth) or any amount that’s deteriorating to her health

Question 13

What are the normal limits for neonatal vital signs?

Answer 13

Temp: 36.5-37.3
Resp: 30-60
HR: 110-160
Oxygen: 96+