Postpartum Flashcards
What is the most productive cardiac change postpartum?
diuresis
Decreases extravascular fluid and weight
respiratory changes postpartum
Increased respiratory rate due to fever or pain
Decreased respiratory rate due to respiratory compromise
What’s the most common neural complaint postpartum?
Headache
Due to fluid shift after birth, leakage of CSF from epidural
treatment for leakage of CSF from epidural
Blood patch
if headache is pregnancy related what is the treatment option?
Acetaminophen
Caffeine
how to suppress lactation
Compression wrap
Cold compress
Cabbage leaves
No warm water on breasts
Anti-inflammatory meds
Intervention for insufficient milk amount
Increase fluids to 2 L per day
intervention for sore nipples
Lanolin cream
Let dry open to air
intervention for plugged ducts
frequent nursing
Change positions
Manual warm massage
Pumping
mastitis
Infection of breast tissue
sx of mastitis
sudden onset fever around 101
Chills
Red, painful, sore
Treatment for mastitis
warm compress, analgesics
7–10 days of antibiotics (PCN)
Supportive bra without underwire
Complete emptying
Report flu like symptoms
Engorgement
venous stasis in breasts
Overfilled with milk
Does engorgement mostly occur in one or both breasts
both
Gradual onset
treatment for engorgement
Don’t miss feedings
Pumping
Warm compress
Cabbage leaves
Cold application between feedings
Diastasis rectus abdominous
Abdominal muscles separate till our room for large uterus
interventions for after pains
Rest prone
Motrin/ibuprofen
When should ibuprofen or Motrin not be given
platelet count less than 70,000
Preeclampsia
involution
Pre-pregnancy state of uterus
Decreases weight
endometritis
Infection of lining of the uterus
sx endometritis
Tender
104° fever
Chills
Foul smelling lochia
treatment for endometritis
Broad-spectrum antibiotic, such clindamycin and gentamycin
at what rate does involution occur
One finger breaths per day
Fundus decreases 1 cm per day
what color hair is oddly common for postpartum hemorrhage
Redheads
Bowel changes postpartum
sluggish due to progesterone, decreased tone, anesthesia, hemorrhoids, fear of tearing
Stool softeners!
does the bladder capacity increase or decrease during pregnancy?
Increase
Lochia
Vaginal discharge, blood, mucus, atrophied cells
Uterine debris
Lochia rubra
2–4 days postpartum
Red
Lochia serosa
4–10 days postpartum
Pink
Lochia alba
10–20 days postpartum
White
how is total blood loss measured?
Weighing pads
1 g equals 1 mL
what measurement classifies a hemorrhage risk
Saturating one pad within one hour
Causes of postpartum hemorrhage
boggy uterus
lacerations, episiotomy
Retained placental fragments
Hematoma
Uterine prolapse, rupture
Decreased platelets
sx postpartum hemorrhage
Excessive bright, red bleeding
Abnormal clots
Increased HR , temp
Decreased BP, LOC
treatment for postpartum hemorrhage
oxytocin
Uterine massage
Frequent voiding/catheter
Hemabate/carboprost
Misoprotol
Methergine
which medication should not be used with high blood pressure
Methergine, can cause rebound, hypertension
Which medication has a side effect of extreme diarrhea
Carboprost
T/F a diaphragm needs to be refitted for birth control after having a baby
True
what location of pain can also relate to gas pain?
Right shoulder pain
Homans sign
sign of thrombophlebitis
Dorsiflex foot to assess
“taking in”
1-2 days PP
focused on herself and her needs
“taking hold”
2-3 days PP
ready to help others and assume control of body
postpartum blues
Resolves naturally in 10–14 days
Mood swings, sad then happy
Episodic tearfulness with no cause
Postpartum depression
Considered a mood disorder after four weeks
risk factors of postpartum depression
First pregnancy
History of depression
Lack of support
Adolescent
History of abuse
postpartum psychosis
Insomnia, confusion, delusions, illogical, thinking
What’s the first line treatment for postpartum depression and psychosis
seek referral order
Cognitive behavioral therapy
en face
by mom, direct eye contact close to face
engrossment
Done by partner, absorption and interest
T/F, heavy lifting, frequent stair, climbing, and strenuous activity can be done right after delivery
False
when can sexual activity be resumed postpartum
4–6 weeks
episiotomy/laceration should be healed
discharge criteria
Rubella- non immune or equivocal, must receive vaccine
RhoGAM
Able to avoid and pass flatus
No difficulty with foods or fluids
abnormal expected Postpartum changes
low-grade fever
Profuse night sweats
Intense shivering one hour after
