Postpartum

Question 0

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

Answer 0

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

Question 1

Main goal during immediate postpartum period

Answer 1

Prevent postpartum hemorrhage

Question 2

When should parent-newborn binding begin to occur?

Answer 2

During fourth stage of labor

Question 3

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

Answer 3

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

Question 4

Greatest risk during postpartum period

Answer 4

Hemorrhage, shock, infection

Question 5

What coordinates and strengthens uterine contractions?

Answer 5

Oxytocin

Question 6

What does breast feeding do to oxytocin?

Answer 6

Stimulates the release of endogenous oxytocin from pituitary gland

Question 7

Uncomfortable uterine cramping is referred to as….

Answer 7

Afterpains

Question 8

What does a firm and contracted uterus prevent?

Answer 8

Excessive bleeding and hemorrhage

Question 9

After delivery of placenta what do hormones do?

Answer 9

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

Question 10

What is decreased estrogen associated with

Answer 10

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

Question 11

What does decreased estrogen diminish

Answer 11

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

Question 12

What does a decreased progesterone result in?

Answer 12

Increase in muscle tone throughout the body

Question 13

What does decreased placental enzyme insulinase result in?

Answer 13

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

Question 14

Nursing goals for the postpartum women

Answer 14

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

Question 15

Where is fundus 6-12 hours after delivery

Answer 15

Midline, at umbilicus (or just above)

Should go down 1fb per day postpartum

Question 16

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

Answer 16

Ask her to void

Question 17

What should temp be after 1st 24 hours

Answer 17

Back to normal

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

Question 18

What happens to estrogen and progesterone after delivery of placenta

Answer 18

Decreases

Question 19

How does infant sucking help with milk production

Answer 19

Provides stimulus for hormone release

Question 20

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

Answer 20

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

Question 21

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

Answer 21

Too much activity

Question 22

When does the postpartum period begin

Answer 22

After birth of the placenta

Question 23

What does lochia typically begin as

Answer 23

Rubra

Question 24

Does cardiac output quickly return to non pregnant values after birth

Answer 24

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

Question 25

Does the postpartum woman commonly experience tachycardia or bradycardia

Answer 25

Bradycardia

Question 26

Why is bradycardia normal in the postpartum woman

Answer 26

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

Question 27

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

Answer 27

Common

Question 28

The uterus returns to its normal size through a process called

Answer 28

Involution

Question 29

After pain refers to

Answer 29

The uterine contractions that occur after birth

Question 30

What is engorgement

Answer 30

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

Question 31

What are the three phases fathers go through

Answer 31

Expectations, reality, and mastery

Question 32

What is a normal pulse for the postpartum mother

Answer 32

40-60 Anything higher is considered tachycardia

Question 33

What could tachycardia indicate

Answer 33

Hemorrhage

Question 34

What should postpartum blood pressure be

Answer 34

That of a normal adult

Question 35

What if blood pressure is too high? | Too low?

Answer 35

Too high- preeclampsia Too low- hemorrhage (fluid loss)

Question 36

Where is the fundus at directly after delivery

Answer 36

Midway between symphysis pubis and umbilicus

Question 37

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

Answer 37

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

Question 38

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

Answer 38

If it has an odor= infection | Check amount and color

Question 39

What causes after pains

Answer 39

Release of oxytocin

Question 40

What happens with after pains the more deliveries you have

Answer 40

They get worse with each child

Question 41

What can stretching of the uterus due to after pains

Answer 41

Make them worse

Question 42

Why is a women hungry after delivery

Answer 42

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

Question 43

What are the things a postpartum women can and cannot eat

Answer 43

No restrictions. Can eat whatever she wants

Question 44

When will a women be VERY thirsty

Answer 44

After delivery and when she is breast feeding

Question 45

What contributes to a postpartum women's constipation

Answer 45

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

Question 46

What can you do to help with her constipation

Answer 46

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

Question 47

How much blood is normally lost during a vaginal birth? | C-section?

Answer 47

Vaginal- 500cc | C-section- 1000cc

Question 48

What can estrogen do to the blood

Answer 48

Increase clotting Important to ambulate postpartum to decrease chances of blood clots

Question 49

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

Answer 49

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

Question 50

What happens to estrogen and progesterone after delivery of placenta

Answer 50

Decrease

Question 51

What hormone triggers milk production

Answer 51

Prolactin

Question 52

Where is prolactin released from

Answer 52

Anterior pituitary

Question 53

What hormone triggers let down

Answer 53

Oxytocin

Question 54

Where is oxytocin made

Answer 54

Posterior pituitary

Question 55

What is the first fluid available to the newborn

Answer 55

Colostrum

Question 56

When is breast milk usually produced

Answer 56

In 3 days of delivery

Question 57

What does colostrum help with

Answer 57

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

Question 58

Can a women with inverted nipples breast feed

Answer 58

Yes

Question 59

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

Answer 59

Place baby on nipple; the sucking could pull it out | Breast pump will usually do the same

Question 60

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

Answer 60

Nipple shields

Question 61

What will you see with engorged breast?

Answer 61

Taut, shiny, tender, warm

Question 62

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

Answer 62

Mastitis

Question 63

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

Answer 63

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

Question 64

What happens to linea negra?

Answer 64

Fades but never goes away

Question 65

What are some postpartal abdominal wall changes?

Answer 65

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

Question 66

What is weight loss from

Answer 66

Lose fluids, baby, placenta

Question 67

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

Answer 67

Pillow between baby and incision when breast feeding

Question 68

Do you bleed or ovulate first?

Answer 68

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

Question 69

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

Answer 69

Afterpains

Question 70

Who are after pains more common in

Answer 70

Multiparous woman

Question 71

Uterus that is not well contracted and feels soft when palpated

Answer 71

Boggy uterus

Question 72

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

Answer 72

Bonding

Question 73

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

Answer 73

Colostrum

Question 74

Separation of two rectus muscles along median line of abdominal wall

Answer 74

Diastasis recti

Question 75

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

Answer 75

En face

Question 76

Swelling of breast tissue

Answer 76

Engorgement

Question 77

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

Answer 77

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

Question 78

A fathers absorption, preoccupation, and interest in his infant

Answer 78

Engrossment

Question 79

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

Answer 79

Fundus

Question 80

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

Answer 80

Homan's sign

Question 81

What is Homan's sign a early sign of

Answer 81

Thrombophlebitis

Question 82

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

Answer 82

Involution

Question 83

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

Answer 83

Let-down reflex

Question 84

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

Answer 84

Lochia alba

Question 85

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

Answer 85

Lochia Rubra

Question 86

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

Answer 86

Lochia serosa

Question 87

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

Answer 87

Postpartum blues

Question 88

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

Answer 88

Puerperium

Question 89

If breast feeding exclusively menstruation delayed until when?

Answer 89

At least 3 months

Question 90

What seems to suppress ovulation

Answer 90

Prolactin

Question 91

If not breast feeding, menstruation _______

Answer 91

6-10 weeks

Question 92

Is breast feeding a reliable form of contraception?

Answer 92

Only for 3 months when exclusively breast feeding

Question 93

Should you bring breast to baby or baby to breast?

Answer 93

Baby to breast!

Question 94

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

Answer 94

Taking-in phase

Question 95

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

Answer 95

Taking-hold phase

Question 96

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

Answer 96

Letting-go phase

Question 97

What are the three stages to the maternal psychological adaptation

Answer 97

1. Taking-in phase 2. Taking-hold phase 3. Letting -go phase

Question 98

What are the three stages of father or partner attachment

Answer 98

1 expectations 2 reality 3 mastery

Question 99

Preconceptions of what home life may be like with newborn

Answer 99

Expectations

Question 100

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

Answer 100

Reality

Question 101

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

Answer 101

Mastery

Question 102

What does external cervix look like after a pregnancy

Answer 102

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