postpartum

Question 1

post partum period is also called as

Answer 1

puerperium

Question 2

period immediately after birth & extending for 6 - 8 wks after delivery
mother’s body returns to its pre-pregnant state

Answer 2

post partum period

Question 3

Phases of puerperium

Answer 3

taking in
taking hold
letting go

Question 4

it is also called as dependent phase

Answer 4

taking in phase

Question 5

First 3 days post partum
Focus on self, not infant, on her own needs for sleep and rest
Passive, dependent and can’t make decisions
Need to discuss labor experiences
Sense of wonderment when looking at the neonate

Answer 5

taking in phase

Question 6

also called the dependent-independent phase

Answer 6

taking hold phase

Question 7

from 3rd to 10th day postpartum
focus on infant
active, independent and can make decisions
initiates self care activities, focus on bowels, bladder and breastfeeding
responds to instruction about infant care and self care
may express lack of confidence in caring for the neonate

Answer 7

taking hold phase

Question 8

also called the interdependent phase

Answer 8

letting go phase

Question 9

10 days to 6 weeks postpartum
readjustment
mother may feel deep loss over separation of baby from her body
wanting to feel safe and secure yet wanting to make decisions
finally redefines her new role
see self as separate from infant
gives up fantasized image of her child and accepts real one

Answer 9

letting go phase

Question 10

postpartum maternal concerns and feelings include

Answer 10

abandonment
disappointment
postpartal blues
post partum depression
post partum psychosis

Question 11

mother may feel confused by a sensation very close to jealousy
shared responsibility for infant care can help alleviate these feelings

Answer 11

abandonment

Question 12

difficult for mother to feel positive immediately about a child who does not meet their expectations

Answer 12

disappointment

Question 13

postpartal blues other name

Answer 13

baby blues

Question 14

show up 3 to 4 days after birth and may last few weeks after delivery
50% of women experience some feelings of overwhelming sadness
mood swings, sudden crying episodes, irritability, anxiety, loneliness
feeling of happiness and love for newborn may be accompanied by feelings of helplessness, sadness and anxiety

Answer 14

postpartal blues

Question 15

moderate to severe depression in a woman after she has given birth
may occur soon after delivery or up to a year later

Answer 15

postpartum depression

Question 16

Irritability
changes in appetite
feeling of worthlessness or guilt
feeling withdrawn or unconnected
lack of pleasure or interest in most or all activities

Answer 16

postpartum depression

Question 17

rare compared to postpartum anxiety or depression
requires immediate attention, especially if with suicide thoughts or harms herself or baby

Answer 17

postpartum psychosis

Question 18

Symptoms
Hallucinations (hearing, sight, touch, etc)
Delusion (false, bizarre beliefs, which are not reality-based)
Drastic mood swings
Disorganization of speech (incoherence)
Disorganization of behavior (extremely inappropriate dress)
Extreme restlessness
Anger and agitation

Answer 18

postpartum psychosis

Question 19

occurs 1-12 days after birth
incidence: 70%

Answer 19

pospartal blues

Question 20

occurs 1-12 months after birth
incidence: 10%

Answer 20

postpartum depression

Question 21

occurs within 1 month after birth
incidence: 1-2%

Answer 21

postpartum psyhosis

Question 22

rapid decrease in uterine size as it returns to the nonpregnant state
weight decreases

Answer 22

uterine involution

Question 23

by __ days postpartum, uterus cannot be palpated abdominally

Answer 23

10 days

Question 24

flaccid fundus indicates __ and should be massaged until firm

Answer 24

uterine atony

Question 25

tender fundus indicates

Answer 25

infection

Question 26

during uterine involution, fundic height decreases about __ per day

Answer 26

1cm

Question 27

uterine discharge consists of blood from placental site and debris from decidua

Answer 27

lochia

Question 28

3-4 days after birth bright/dark red may have small clots flow similar to heavy menstrual period

Answer 28

lochia rubra

Question 29

pinkish/brown loss 4-12 days flow moderate to small amount

Answer 29

lochia serosa

Question 30

yellow/white discharge 12 days - 3 weeks gradually reducing/disappearing

Answer 30

lochia alba

Question 31

complete cervical involution may take

Answer 31

3 – 4months

Question 32

permanent change cause by childbirth – the cervical os becomes

Answer 32

slit-like or elongated

Question 33

rugae in the vagina reappear by __ after giving birth

Answer 33

3 – 4 weeks

Question 34

__ is present at time of delivery

Answer 34

colostrum

Question 35

breast milk is produced by __

Answer 35

3rd or 4th day

Question 36

sucking of newborn triggers release of

Answer 36

OXYTOCIN

Question 37

it causes milk letdown and contraction of the uterus

Answer 37

oxytocin

Question 38

menses resume in non-breastfeeding mothers

Answer 38

within 8 weeks

Question 39

menses resume in breastfeeding mothers

Answer 39

3-4 months

Question 40

striae gravidarum do not disappear and assumes a __ appearance

Answer 40

silvery white

Question 41

Linea nigra will be barely detectable in __ time

Answer 41

6 weeks

Question 42

women are usually very hungry after delivery due to

Answer 42

lack of food during labor

Question 43

constipation occurs due to

Answer 43

decreased intestinal muscle tone perineal discomfort pain from episiotomy hemorrhage laceration

Question 44

diuresis begins within the__ of delivery

Answer 44

first 12 hours

Question 45

sexual activity may resume 3-4 weeks after delivery if

Answer 45

bleeding has stopped perineum is healed it does not cause pain

Question 46

Occurs as a result of contraction of the uterus Are more common in multiparas, those with overdistended uterus, breastfeeding mothers & clients treated with oxytocin

Answer 46

after birth pains

Question 47

apply __ to the perineum during first 24 hours to reduce swelling

Answer 47

iced napkin

Question 48

expose to nipples to air __after feeding

Answer 48

10 – 20 minutes

Question 49

bleeding 500 ml or more following delivery

Answer 49

postpartum hemorrhage

Question 50

During the 1st 24 hours after delivery Caused by uterine atony, lacerations or inversion of the uterus

Answer 50

early postpartum hemorrhage

Question 51

After the 1st 24 hours after delivery Caused by retained placental fragments

Answer 51

late postpartum hemorrhage

Question 52

inability of myometrium to contract and constrict blood vessels, resulting in open sinuses at site of placental separation cause of 80 – 90% of early hemorrhage

Answer 52

uterine atony

Question 53

large babies are called

Answer 53

macrosomia

Question 54

medications to stimulate uterine contractions

Answer 54

IM Methergine and IM or IV Oxytocin

Question 55

surgical removal of the uterus

Answer 55

hysterectomy

Question 56

uterus remains large, and soft at 4 to 6 weeks postpartum incomplete return of uterus to its prepregnant size and shape Lochia is still present

Answer 56

subinvolution

Question 57

infection of the urinary bladder burning pain on urination

Answer 57

cystitis

Question 58

localized collection of blood into tissues of the reproductive sac after delivery severe pain, pressure in perineal area with discolored skin

Answer 58

vulvar hematoma

Question 59

inflammation of breast as a result of infection seen in breastfeeding mothers 2-3 weeks after delivery but may occur anytime during lactation

Answer 59

mastitis

Question 60

passage of thrombus, often originating in one of the uterine or pelvic veins, into the lungs, where it disrupts circulation of blood Dyspnea, tachypnea, tachycardia, cough, rales, hemoptysis, pleuritic chest pain, feeling of impending doom

Answer 60

pulmonary embolism

Question 61

what to administer to patient with pulmonary embolism

Answer 61

Give O2, head elevated, monitor VS, streptokinase, and anticoagulants as prescribed

Question 62

formation of a clot in vessel wall due to inflammation of vessel wall partial obstruction of vessel can occur increased blood-clotting factors

Answer 62

thrombophlebitis