Postpartum Flashcards
What is
Uterine involution
Uterine stony
Uterine inversion
Uterine subinvolution
The return of the uterus to its pre-pregnant size
The failure of uterus to contract even after fundal rub
Uterus turn partially or entirely inside out
Uterus isn’t decreasing in size
PP focus assessment
BUBBLE HEB
Breasts- engorgement, nipple, milk production
Uterus- fundal height, consistency & location
Bladder function- voiding or catheter
Lochia- color, odor, consistency, and amount
Episiotomy/ laceration - edema, ecchymosis
Hemorrhoids
Emotional/education needs
Bonding
What body part do you compare when measuring the fundal height (postpartum)
The umbilicus
What do these fundal tone indicate
Boggy
Tenderness
Boggy- atony- needs to be massaged
Tenderness- infections
What is Lochia
Vaginal discharge
What are the different stages of Lochia (3)
Rubra
Serosa
Alba
What are the characteristics of Rubra
Time frame
Expected findings
1-3 days
Moderate to light bleeding
Fleshy odor
What are some characteristics of serosa
Time frame
Expected findings
4-10 days
Light- scant bleeding
Fleshy odor
What are some characteristics of alba
Time frame
Expected findings
Yellow-white color
Scant-none bleeding
Fleshy odor
What are some abnormal findings of Lochia (5)
Heavy bleeding
Foul odor
Placenta fragments
Large clots
Bright red bleeding
How much blood loss is it considered for a hemorrhage
Vaginal delivery
C section
More than 500
More than 1000
What are some inteventions to prevent DVT
Early ambulations
Walking to the bathroom
SCD or compression socks
What is the timeframe for this PP Hemorrhages
Early (Primary)
Late (secondary)
1-24 hours early delivery
24hrs- 6 wks
What are some s/s of hypovolemia (6)
Tachycardia
Hypotension
Pale,
Clammy
Anxious
Confused
What are some s/s of hemorrhagic shock (7)
Blue lips/fingernails,
Decrease urine output
Excessive sweating
Chest pain
Shallow breathing
Hypotension
Confusion
What are some s/s of PP hemorrhage caused by uterine atony
Boggy fundus
Steady or sudden saturated pad -15 mins
What are s/s of PP hemorrhage caused by the laceration (3)
Continuous trickledown
Bleeding in spurts
Bleeding in of a contracted fundus
What some s/s of PP hemorrhage caused by hematoma (5)
Swollen, bruised perineum
intense pain
Pressure on vagina, urethra, or bladder
Possible urinary retention, or displacement
Pallor, tachycardia, and hypotension
What are some nursing interventions for PP hemorrhage
FUNDAL massage
Get IV assess
Vital signs
O2
Ice, pain meds
Oxytocin
Notify physician
What does oxytocin do
Stimulates uterine muscle to contract
What does Methylergonovine maleate used for
To stimulate contractions
What are some contradictions for Methylergonovine maleate
Hypertension
What does carboprost tromethamine do
Stimulates contractions
What is a contraindication for carboprost tromethamine
Asthma
What are some risk factors for uterine inversion (6)
Excessive fundul massages
Retention of placenta
Short cords
Uterine atony
Excessive traction on cord
Prolonged labor
What some nursing interventions for uterine inversion (3)
Stop oxytocin immediately
Give terbutaline, antibiotics
Monitor for hypovolemic shock
What are some nursing interventions for PP infections (4)
VS
Labs
Analgesics, antibiotics
Warm compresses
What are some s/s of endometriosis (5)
Fever, tachycardia, excessive uterine tenderness
Lochia regressing stages
Foul smelling Lochia
Sore,cracked, bleeding nipples
What is a Homan sign?
Pain with moving calf
