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NURS 326 > Postpartum > Flashcards

Postpartum Flashcards

1
Q

Postpartum

A

After delivery for 6 wks

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2
Q

Involution

A

Return of the uterus to pre-pregnant state

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3
Q

Lochia

A

Shed uterine epithelial cells

vag bleeding

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4
Q

Lochia

Rubra

A

Dark red and consists mainly of blood and trophoblastic debris; Bloody, dy 1-3

norm

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5
Q

Lochia

Serosa

A

consists of old blood, serum, leukocytes, and tissue debris; Pinkish/brown, dy 4-10

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6
Q

Lochia

Alba

A

Lochia alba consists of leukocytes,
decidua, epithelial cells, mucus, serum, and bacteria. White/Cream, dy 11-21

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7
Q

Amount of Lochia

Scant

A

< 2.5 cm

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8
Q

Amount of Lochia

Light

A

< 10 cm

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9
Q

Amount of Lochia

Moderate

A

> 10 cm

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10
Q

Amount of Lochia

Heavy

A

1 pad w/in 2hrs

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11
Q

Amount of Lochia

Excessive

A

pad is saturated in 15 mins

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12
Q

What will we assess?

A

VS
Pain
Breast
Uterus
Bladder
Bowel
Lochia
DVT
Episiotomy
Emo. Attach
Bonding
Feeding

BUBBLEDEP

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13
Q

**How often do we assess? **

A

Q15 mins: 1st hour
Q30 mins: 2nd hour
Q4 hrs: first 24 hours
Q8 hrs: after 2 hours
Always on indication !, temp may be elevated ( > 100.4) 1st 24 hrs (dehyration), BP >= 140/90 = danger sign

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14
Q

PP Immunizations

A

Rho GAM (- mom, + baby)
Tdap ( if not gotten in 2 yrs)
Rubella, Varicella in non-immune

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15
Q

Maternal Adaptation

A

Taking In: dependent on others ( 24-48hrs, desires sleep, needs nurturing)
Taking Hold: Increasing autonomy ( confidence in infant care, may feel inadequate, don’t take over, praise effort)
Letting Go: adapts to new parenthood (separation of newborn form self, confidence in caretaking)

Promote early skin to skin + rooming in

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16
Q

Newborn Attachment

A

prolonged eye contact, mutual gazing
tracking parent face
holding fingers
“enterainment” - dancing w/ voice
synchrony - infant cues + parent respone

17
Q

Family Adaptions: Pospaturm Blues

A

Normal, occur 1-2 wks pp
unexplained tearfulness, feeling down, decrease appetite

18
Q

PP Psychological changes: Postpartum Psychosis

A

**Medical Emergency **
Psych admission for treatment
Self harm/ infant harm risk

19
Q

PP Depression

A

Requires intervention
Therapy, meds, diet, exercise, sleep,
Zulresso: expensive, 60 hrs IV dose

20
Q

Discharge Education

A

Increase fluids, fiber, stool softeners
rest periods
no heavy lifting
no tampons, no douching, no tub for 6 wks
no sex 6 wks
flu appt: 6 wks ( 1 wks for c/s)
* newborn visit w/in 1-2 days

S/S DVT

21
Q

Breasts

A

Inspect
colostrum: early milk -> mature milk by about 72 - 96 hours after birth
Engorgement/ Mastitis
* relief: tight bra, cool compress, no stim, cabbage

22
Q

Not Breastfeeding ?

A

Risk for engorgement
* occurs 3-4 day PP, resolves in 1-2 days AFTER milk comes

23
Q

Uterus

A

Funal Height, firm, midline
* @ umbilicus after delivery, 1 FB above the umbilicus, etc
* 1-2 cm/dy
Displaced up + right = void
Boggy = uterine atony = PPH
* life threatening, massage fundus
Myometrium contractions: After pains
* d/t increase oxytocin

24
Q

Postpartum Hemorrhage

A

Risk Factors: Grandmulti, overdistention of uterus, precipitous labor, prolonged labor, retained placenta, placenta previa/abruptio, operative procedures

PPH= leading causes of maternal mortality
Causes: ( 4 T’s = Tone, Tissue, Trauma, Thrombus)
Uterine atony, vag. lac, Cervix lac., Hematoma, retained placental fragment, full bladder
90% PPH due to uterine atony
Blood loss greater than
* 500 cc vag birth, or 1000 cc c/s

Early PPH: 1st 24hrs
Late PPH: 24 HRS -> 12 wks

25
Q

S/S of Postpartum Hemorrhage

A

boggy uterus, blood gushm > 1 pad/ 15 mins, severe perineal pain, tachycardic
CALL MD IF UTERUS DOES NOT FIRM UP

26
Q

PPH Meds

A
  1. Oxytocin 20 units IM/IV
  2. Methylergomovine Maleate 0.2 mg IM, follwed by tablets ever 4-6 hours
    ( Preeclampsia or BP !!! > 140/90, hold call MD)
  3. Hembate, prostin 15 M 250 mg IM
    ( contra: Asthma, keep in fridge)

Side Effect of Meth: stomach upset/ diarrhea/ nausea
Med are given after

NURS 326 (17 decks)

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