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NURS 3800 > Postpartum > Flashcards

Postpartum Flashcards

0
Q

When does the maternal recovery stage start? How long does it last?

A

Starts with the delivery of the placenta and lasts from 1-4 hr

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1
Q

Main goal during immediate postpartum period

A

Prevent postpartum hemorrhage

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2
Q

When should parent-newborn binding begin to occur?

A

During fourth stage of labor

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3
Q

When does postpartum period begin? When does it end? How long dies it last?

A

Begins after the delivery of the placenta and ends when the body returns to the prepregnant state. This process takes approximately 6 weeks.

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4
Q

Greatest risk during postpartum period

A

Hemorrhage, shock, infection

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5
Q

What coordinates and strengthens uterine contractions?

A

Oxytocin

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6
Q

What does breast feeding do to oxytocin?

A

Stimulates the release of endogenous oxytocin from pituitary gland

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7
Q

Uncomfortable uterine cramping is referred to as….

A

Afterpains

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8
Q

What does a firm and contracted uterus prevent?

A

Excessive bleeding and hemorrhage

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9
Q

After delivery of placenta what do hormones do?

A

Estrogen, progesterone, and placental enzyme insulinase decrease resulting in a decreased blood glucose, estrogen, and progesterone levels

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10
Q

What is decreased estrogen associated with

A

Breast engorgement, diaphoresis, and diuresis of excess extra cellular fluid accumulated during pregnancy

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11
Q

What does decreased estrogen diminish

A

Vaginal lubrication. Local dryness and intercourse discomfort may persist until ovarian function returns and mensturation resumes

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12
Q

What does a decreased progesterone result in?

A

Increase in muscle tone throughout the body

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13
Q

What does decreased placental enzyme insulinase result in?

A

Reversal of diabetogenic effects of pregnancy, which lowers blood glucose levels immediately in the puerperium

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14
Q

Nursing goals for the postpartum women

A

Prevent infections, hemorrhage and engorgement
Comfort and rest
Safety in care for infant
Provide knowledge about self care and infant care

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15
Q

Where is fundus 6-12 hours after delivery

A

Midline, at umbilicus (or just above)

Should go down 1fb per day postpartum

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16
Q

If uterus is displaced and deviated after birth what should your first nursing action be

A

Ask her to void

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17
Q

What should temp be after 1st 24 hours

A

Back to normal

Can raise to 100 degrees and it be normal up until 24 hrs postpartum

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18
Q

What happens to estrogen and progesterone after delivery of placenta

A

Decreases

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19
Q

How does infant sucking help with milk production

A

Provides stimulus for hormone release

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20
Q

What are the three different stages of lochia and when will you see these

A

Rubra- 3-4 days after birth
Serosa- 3-10 days after birth
Alba- 10-14 (could be longer)

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21
Q

What could it mean if a postpartum woman is having heavy amounts of bright red bleeding

A

Too much activity

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22
Q

When does the postpartum period begin

A

After birth of the placenta

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23
Q

What does lochia typically begin as

A

Rubra

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24
Q

Does cardiac output quickly return to non pregnant values after birth

A

No, due to the increasing amount of venous return there is an increase in stroke volume

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25
Q

Does the postpartum woman commonly experience tachycardia or bradycardia

A

Bradycardia

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26
Q

Why is bradycardia normal in the postpartum woman

A

There is an increase in fluid and with each pump of the heart it is pushing out a lot more blood so it does not have to pump as much

Pulse will be lower

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27
Q

Is profuse diaphoresis (sweating) common or uncommon in early postpartum

A

Common

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28
Q

The uterus returns to its normal size through a process called

A

Involution

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29
Q

After pain refers to

A

The uterine contractions that occur after birth

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30
Q

What is engorgement

A

Swelling of the breast tissue that occurs 2-4 days after birth

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31
Q

What are the three phases fathers go through

A

Expectations, reality, and mastery

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32
Q

What is a normal pulse for the postpartum mother

A

40-60

Anything higher is considered tachycardia

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33
Q

What could tachycardia indicate

A

Hemorrhage

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34
Q

What should postpartum blood pressure be

A

That of a normal adult

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35
Q

What if blood pressure is too high?

Too low?

A

Too high- preeclampsia

Too low- hemorrhage (fluid loss)

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36
Q

Where is the fundus at directly after delivery

A

Midway between symphysis pubis and umbilicus

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37
Q

Why is the fundus higher 6-12 hours after delivery thaN it is directly after delivery?

A

Right after delivery there is so much oxytocin that it drastically contracts uterus and 6-12 hours later there is not that much oxytocin so it doesn’t contract it as much

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38
Q

What are the three things you want a postpartum woman to be aware of with her lochia

A

If it has an odor= infection

Check amount and color

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39
Q

What causes after pains

A

Release of oxytocin

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40
Q

What happens with after pains the more deliveries you have

A

They get worse with each child

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41
Q

What can stretching of the uterus due to after pains

A

Make them worse

42
Q

Why is a women hungry after delivery

A

It takes as many calories to labor as it does to run a marathon

43
Q

What are the things a postpartum women can and cannot eat

A

No restrictions. Can eat whatever she wants

44
Q

When will a women be VERY thirsty

A

After delivery and when she is breast feeding

45
Q

What contributes to a postpartum women’s constipation

A

She is in pain and does not want to push to have a bowel movement

46
Q

What can you do to help with her constipation

A

Give her stool softener, ice pack for the pain, fluids, and a litacam spray to numb the area

47
Q

How much blood is normally lost during a vaginal birth?

C-section?

A

Vaginal- 500cc

C-section- 1000cc

48
Q

What can estrogen do to the blood

A

Increase clotting

Important to ambulate postpartum to decrease chances of blood clots

49
Q

What can you do to help a women who does not want to breast feed

A

Tell her to stop stimulating nipple, use ice packs, wear a tight fitting bra

50
Q

What happens to estrogen and progesterone after delivery of placenta

A

Decrease

51
Q

What hormone triggers milk production

A

Prolactin

52
Q

Where is prolactin released from

A

Anterior pituitary

53
Q

What hormone triggers let down

A

Oxytocin

54
Q

Where is oxytocin made

A

Posterior pituitary

55
Q

What is the first fluid available to the newborn

A

Colostrum

56
Q

When is breast milk usually produced

A

In 3 days of delivery

57
Q

What does colostrum help with

A

EVERYTHING!

Helps with breaking up the Meconium in the baby so it can pass

58
Q

Can a women with inverted nipples breast feed

A

Yes

59
Q

What can you do to help a women get her nipples to turn the right way out

A

Place baby on nipple; the sucking could pull it out

Breast pump will usually do the same

60
Q

What can you suggest for a breast feeding mom that wants to continue to breast feed but says that her nipples are so cracked it is painful

A

Nipple shields

61
Q

What will you see with engorged breast?

A

Taut, shiny, tender, warm

62
Q

What could happen if you don’t do anything to engorged breast?

A

Mastitis

63
Q

Where is a good place to release some of engorgement of breast?

A

Standing in warm shower and massage breast to let some of engorgement out

64
Q

What happens to linea negra?

A

Fades but never goes away

65
Q

What are some postpartal abdominal wall changes?

A

Always some separation of rectus abdominus but it is the degree to which it happens which we are concerned about

66
Q

What is weight loss from

A

Lose fluids, baby, placenta

67
Q

When a mom who had a C/S is breast feeding what is something that might be helpful?

A

Pillow between baby and incision when breast feeding

68
Q

Do you bleed or ovulate first?

A

Ovulate, so you can become pregnant again so you must be careful

69
Q

Uncomfortable uterine pains that occur intermittently during first two or three days postpartum

A

Afterpains

70
Q

Who are after pains more common in

A

Multiparous woman

71
Q

Uterus that is not well contracted and feels soft when palpated

A

Boggy uterus

72
Q

A process by which parents form an emotional relationship with their infant over time

A

Bonding

73
Q

Fluid in breast during pregnancy and into early postpartal period; rich in antibodies, high in protein, and acts as laxative for new born

A

Colostrum

74
Q

Separation of two rectus muscles along median line of abdominal wall

A

Diastasis recti

75
Q

Face-to-face position in which parents and infants face are approximately 20 centimeters apart and on the same plane

A

En face

76
Q

Swelling of breast tissue

A

Engorgement

77
Q

How long does primary engorgement usually last? When does it reach a peak?

A

Primary engorgement usually lasts 48 hours and reaches a peak between 3rd and 5th days postpartum

78
Q

A fathers absorption, preoccupation, and interest in his infant

A

Engrossment

79
Q

Dome-shaped upper portion of uterus between points of insertion of Fallopian tubes

A

Fundus

80
Q

Client compliant of sharp calf pain when leg is extended and client moves foot in a direction of dorsiflexion, such as walking or stretching legs

A

Homan’s sign

81
Q

What is Homan’s sign a early sign of

A

Thrombophlebitis

82
Q

Reduction in size of the uterus after delivery to its pre-pregnant state

A

Involution

83
Q

Release of breast milk caused by contraction of milk glands in response to natural release of oxytocin

A

Let-down reflex

84
Q

Thin, clear, yellow to white vaginal discharge that follows Lochia serosa, from approx 11 days to 3-6 weeks postpartum

A

Lochia alba

85
Q

Red, menstrual-like vaginal discharge, from birth to three days postpartum

A

Lochia Rubra

86
Q

Serous, pinkish-brown vaginal discharge that follows Lochia Rubra until approx 10 days postpartum

A

Lochia serosa

87
Q

A maternal adjustment reaction accompanied by irritability, anxiety, a mild let-down feeling usually occurring between 2nd and 3rd postpartum day through 1st to 2nd week postpartum

A

Postpartum blues

88
Q

Period starting after third stage of labor and ending with a return of uterus to pre-pregnant state at six weeks postpartum

A

Puerperium

89
Q

If breast feeding exclusively menstruation delayed until when?

A

At least 3 months

90
Q

What seems to suppress ovulation

A

Prolactin

91
Q

If not breast feeding, menstruation _______

A

6-10 weeks

92
Q

Is breast feeding a reliable form of contraception?

A

Only for 3 months when exclusively breast feeding

93
Q

Should you bring breast to baby or baby to breast?

A

Baby to breast!

94
Q

Time immediately after birth when the client needs sleep, depends on others to meet her needs, and relives the events surrounding the birth process

A

Taking-in phase

95
Q

Second phase of maternal adaption characterized by dependent and independent maternal behavior

A

Taking-hold phase

96
Q

The third stage of maternal adaption and is when the woman establishes relationships with other people

A

Letting-go phase

97
Q

What are the three stages to the maternal psychological adaptation

A
  1. Taking-in phase
  2. Taking-hold phase
  3. Letting -go phase
98
Q

What are the three stages of father or partner attachment

A

1 expectations
2 reality
3 mastery

99
Q

Preconceptions of what home life may be like with newborn

A

Expectations

100
Q

Happens when father realizes that their expectations in stage 1 are not realistic

A

Reality

101
Q

The father makes a conscious decision to take control and be the center of his newborns life regardless of his preparedness

A

Mastery

102
Q

What does external cervix look like after a pregnancy

A

Jagged slit-like opening, often described as a fish mouth

NURS 3800 (19 decks)

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