Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Postnatal > Postnatal woman > Flashcards

Postnatal woman Flashcards

1
Q

MBAUBBLES

A 
Post natal assessment 
Mind 
Breasts 
Abdomen 
Uterus
Bowels 
Bladder 
Legs and loss 
Episiotomy 
Support
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Mind

A

Assess-
Emotional- feelings
Physical- pain
Bonding/attachment

Also education- take home brochures websites

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What women should be carefully monitored in PN ax

A 
CS
Episiotomy 
Pre eclampsia 
Assisted birth 
Epidural
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What symptoms need further investigation if found

A 
Swelling 
Uterus not involuting 
Headaches 
High BP
Visual disturbances
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Breasts

A 
Looking for 
Symmetry
Tenderness 
Swelling
Redness
Pain 
Attachment 
Ask- full, tender, soft, firm
Nipples 
Palp

Also education- expressing, signs of infection, discuss on demand, reassure first attachment might be painful, tender milk trying to come in, how to express, changing sides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Abdomen

A

Diastasis recti
Separation of abdominal muscles more than 2 cm

Advice- refer to physio, limits, safety, supportive bands, high fibre, mobility, pain mx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Signs and symptoms of diastasis recti

A

Palpable
Back pain
Bladder issues
More common in grand multi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Uterus

A 
Ax the uterus is contracted, tender, bilateral
Monitoring blood loss 
Pain level- tender on palp? 
Location below umbilical 
Involution
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

When is it normal to have increased loss

A 
Assisted birth 
CS
Prolonged labour
Grand multi
Full bladder
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Aims of postnatal care

A 
Support attachment /bonding
Support into transition into parenthood 
Observe risk of PPH and infection 
Education- attachment, SIDS, sick baby signs, PPH, bf, pelvic floor exercises 
Dvt prevent
Good maternal child relationships
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Causes of PPH

A 
Four Ts
Tissue (retained)
Trauma (tear)
Tone (uterus)
Thrombin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

When does a secondary PPH occur

A

24 hrs to 6 weeks postpartum period

Caused by four Ts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Education: how monitor for PPH

A 
Pads to monitor loss
Colour 
Consistency
Amount
Resources 
Or do hb
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Normal bladder freq and vol

A 
Void post VB - 1-2 hrs
Max tolerance 6 hrs 
8 times in 24 hrs 
Normal bladder vol is 200-400
Postpartum is a large void 
Every 3 hrs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Why must we wait 6 hrs post epidural VB or 12 hrs epidural CS to remove IDC?

A

Sensation must return so we can ensure they are retaining fluid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Risk factors for bladder retention

A 
Epidural
Should dystocia
Prolonged 2nd
Forceps
CS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Bladder concerns

A 
Small and freq
Uterus higher than last checked
Feels full
No sensation when going
Incontinent
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Void questions

A

Colour
Amount
Pain
Odour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Urinary incontinent mx

A

Fluid intake increase
Early ambulatory
Mobility
Warm shower

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Bowel

A 
Questions 
Info 
Assist 
Hemorrhoids 
Further investigation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Bladder

A 
Discuss freq
Vol
IDC
Risks 
Concerns 
Ask
Mx for incontinence
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Education: bowels

A 
Fibre and diet
Pressure on perineum to protect wounds 
Hemmorrhoids common 
Constipation common first 2 days
Early ambulation aids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Bowel assessment questions

A 
Constipation?
Urge?
Normal for them
Amount
Consistency 
Colour
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

How could you offer to assist constipation

A

Fibre supps
Stool softener
Reassure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Pharmalogical mx for hemorrhoids

A

Paracetamol
Cold compressors
Topical ointment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Further investigation of bowels

A 
Long period of time 
Abdomen discomfort 
On continence 
Swilled hemorrhoids 
Bleeding
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Loss/legs

A

Lochia changes

Conditions of L&L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Three types of lochia

A

Rebra
Serosa
Alba

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Lochia rubra

A 
DAY 1-3 
Blood
Amnion
Chorion
Decidual cells
Vernix
Languo
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Lochia serosa

A 
DAY 4-10
Blood
Wound excudate 
Erythromycin 
Leucocytes
Cervical mucous 
Microorganisms
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Lochia alba

A 
DAY 11-21
Leukocytes 
Decidual cells
Bacteria
Epithelial cells
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Life threatening conditions to do with loss and legs

A

Haematoma & abbess formation
Infection- sepsis
Pulmonary embolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

S&S pulmonary embolism

A

SOB- blood clot that enters lungs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Episiotomy

A 
Assess- visual
Pain
Swelling or excudate 
Mx for pain 
Perineal care 
Referrals 3rd 4th
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Perineal ax

A

Visual- swelling, gaping, bulging, bruising, discharge, odour, bleeding, healing tissue
May not need to visualise- ask if pain/tender or swelling or excudate
Pass urine without sting?
Pain relief?
Infection- excudate, temp, heat

36
Q

Management for perineal pain

A

Ice
Analgesia
Hygiene

37
Q

Educate; perineal care

A 
Empt bladder fully and often 
Ice packs
Mobilise 
High fibre
Stool softeners 
Refer to gyany or obst if 3/4
38
Q

Support

A 
Mental health
PND
Ax supportive network 
Access to services 
Domestic violence 
Signs and symptoms 
Puerperal psychosis
Resources
39
Q

Assess for PND

A 
Supportive network 
Mental history 
Access
Violence 
Secure housing
40
Q

Signs of maternal mental illness

A 
Disinterested 
No binding 
Left in cot
Mood
Sleep disturbance 
Overwhelmed 
Family reports
41
Q

Puerperal psychosis signs

A 
Manic or depressive 
Euphoria 
Grandiose 
Delusions 
Hallucinations
42
Q

Main Physiological changes in peurperium

A

Involution
Decreased blood vol
Muscle and ligaments return
Secrete milk and establish lactation

43
Q

Physiological change systems

A 
Cvs
Resp
renal
Gastrointestinal
Endocrine
44
Q

Following delivery of placenta what hormones decrease

A

HPL
HCG
Oestrogen- 7 days
Progesterone -24-48hrs

45
Q

Prolactin is secrete by the – and — during pregnancy

A

Anterior pituitary gland

Increases

46
Q

Why does the decrease in oestrogen stimulate bf

A

Because oestrogen antagonises prolactin and it’s reduced after birth

47
Q

Oxytocin is produced by the – and stored in the –

A

Hypothalamus

Posterior pituitary gland

48
Q

Role of oxytocin

A

Stimulates electrical and contractile activity and acts on myomere kin of uterus, assisting in ejection of milk and uterine involution

49
Q

Uterine involution

A

Free placenta birth
Contracts causing apposition of uterine walls
Haemostasis controlled by contraction
Blood clotting activateda fibrogen and platelets
Oxytocin leads to contractions and further retraction

50
Q

By day 7 uterus has

A

Halved to 500g, by end of puerperium 60g

51
Q

After pains

A

Intense
Diminish 4-7 days
Increase dying bf bc oxytocin helps release milk but also increases contractions

52
Q

Decidua

A

Uterine lining

53
Q

Physiological steps of uterine involution

A

Vasoconstriction- muscle fibres squeeze off BV where placenta sep - ischaemia
Auto lysis - auto digestion of muscle fires by enzymes
Phagocytosis - removes excess fibres and tissue

54
Q

Rate of involution.

A 
1cm per day
Should always progress not digress 
Below umbi
Day21- should return to pelvic cavity 
No longer palpable above Punic bone
55
Q

Decidua is shed as

A

Lochia

56
Q

Endometrium

A

Mucous lining
Innermost layer
Regeneration occurs rapidly - basal layer in 10 days

57
Q

Changes in cervix

A 
Immediately- soft and vascular
Rapidly converts to PPS firm 
Shortens 
Firmer
Internal os closed 2 week
External os open for some months
58
Q

Decreased progesterone after

A

Recovers normal

Muscle tone

59
Q

Cardiovascular changes

A 
BV loss (haemodilution no longer req)
Diuresis- oestrogen 
CO, SV increase- return of blood to maternal system 
BP maybe Lower 
Decrease in cardiac workload 
Dec circulatory vol
02 demands dec return to normal
Blood co2 levels return to norm
Clotting factors increase fibrinogen
Haemoglobin increase
60
Q

Respiratory changes

A

Because Decrease size of uterus, decrease excess tissue and circulating fluid
= dec in pressure of maternal lungs- able to fully inflate inc basal lobes

61
Q

GIT changes

A

Return:
Tone smooth muscle- dec progesterone
Carb metabolism- appetite increase, heart burn dec, constipation dec
Insulin- 48hrs-6wks bc dec oestrogen

62
Q

Renal changes

A 
Less need for renal bf
Progesterone dec= less renal dilation 
Size and shape return 
Bladder displaced, urethra stretched 
Loss of tone in bladder
63
Q

Loss of tone in bladder + bruised urethra + Diuresis =

A

Become over full and distended = retention

64
Q

Describe head to toe approach of PN ax

A

See notes

65
Q

Bp reruns to pre pregnant state - hrs after

A

24

66
Q

Abdominal musculature

A

Ax of long muscles of abdomen PN to identify diastasis rectis abdominis

67
Q

Direct combs test

A

Test for Rhesus factor

Fetus checked for need of anti d by cord blood

68
Q

Cligh howers test

A

Test for Rhesus factor

Tests number for feral cells in maternal system

69
Q

3 categories of thromboembolism

A 
Superficial thrombophlebitis (veins) 
Deep vein thrombosis (calves thighs) 
Pulmonary emboli (chest pain tachy)
70
Q

Superficial thrombophlebitis

A

Superficial veins

Mx
Supportive bandage
Elevate

71
Q

Deep vein thrombosis

A

Deep veins of calf and thigh
One side
Pain redness swelling one leg

72
Q

Pulmonary emboli

A 
Sob 
Chest pain
Dyspnoea
Cough
Crackles 
Hypo
73
Q

Why is thromboembolism more likely to occur in puerperium

A

Large diuresis

Resolution of haemodilution

74
Q

Muscles of perineum

A

Series of longitudinal and round structures
Deep layer PII
Superficial layer TIV
Circle layer

75
Q

Deep layer of perineum

A

PII
Puboccocygeus
Illiococcygeus
Ischiococcygeus

76
Q

Superficial layer of perineum

A

TIV
Transverse perineal muscle
Ischocavanus
Vulvocavanous

77
Q

Circle layer perineum

A

Assists with opening and closing orrifices

78
Q

Ax of perineal healing

A 
Asking about pain
Passing urine 
Bowels 
Examine 
Educate
79
Q

Perineal care -HIPPS

A 
Hygiene
Ice
Pelvic floor exercises 
Pain relief 
Support
80
Q

Pharmalogical consideration for 3/4 deg

A 
Analgesics 
Anti inflam
Oral abs 
With stool softeners and bulking agents 
Ibuprofen pest choice with rectal disclofenac (epis)
81
Q

Long term morbidities perineal trauma

A 
Infection
Haemorrhage
Fistula
Haematoma 
Incontinence   
Pain
82
Q

Pain relief for CS

A 
PCA 
Epidural
NSAIDs
Narcotics 
If IV infusion- freq  observe resp, sedation, pain
83
Q

Wound care CS

A

Observe for bleeding, discharge, infection, pain, redness, separation/ dihiscence, heat, swelling
Remove sutures as ordered

84
Q

Wound drainage

A

Record amount type
Remove as ordered
IDC removal not before 12 hrs of top up epidural
Record first voids post removal

85
Q

Complications of CS

A

PPH
Infection- wound, endometrium, IVT, UTI from IDC
Thromboembolism- less mobility more blood lose
Epidural- hypotension Duran tap (dura punctured - headache unrelieved by meds)

Postnatal (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions