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RNC-OB > Postpartum > Flashcards

Postpartum Flashcards

1
Q

What causes uterine involution?

A

Decrease in myometrium cell size

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2
Q

Within 24 hrs uterus is about the size it was at ___ wks

A

20, at the umbilicus

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3
Q

Involution causes the fundus to descend into the pelvis at about ___ cm/day

A

1

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4
Q

After the placenta separates blood vessels in the _______ become occluded to prevent hemorrhage

A

Endometrium

Then superficial layers become necrotic and slough off

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5
Q

Endometrial tissue regenerates by ___ wks except at the placental site

A

2-3

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6
Q

The placenta site is about ___ cm following delivery and about ___ cm by 2-3wks

A

8-10

3-4

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7
Q

Describe lochia rubra

A

Day 1-3
Red
Bloody
Clots

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8
Q

Describe lochia serosa

A

Day 3-10
Pink
Bloody
Mucousy

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9
Q

Describe lochia alba

A

Day 10-14 or longer
Yellowish-white
Mostly mucousy

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10
Q

What is happening when a woman notices an inc in vaginal bleeding between pp day 7-14?

A

Normal
Superficial layers of placenta site slough off
Should only last 1-2 hours

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11
Q

Describe scant, light, moderate, and heavy bleeding in inches

A

Scant:

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12
Q

How much/how long does the cervix stay dilated?

A

2-3cm for first few days, ~1cm until end of first week

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13
Q

What can estrogen released from lactation do to the appearance of the vagina?

A

Delay formation of rugae (normally reappears in about 3wks)

Appears pale

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14
Q

What is the acronym used to assess the perineum?

A 
REEDA
redness
Edema
Ecchymosis
Drainage
Approximation
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15
Q

Following delivery adrenal glands decrease production of ___

A

Aldosterone

This leads to dec sodium retention and inc urine output

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16
Q

Renal and ureteral dilation resolve by ___wks

A

8

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17
Q

Glycosuria disappears by end of ___

A

First week

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18
Q

BUN increases to ~___mg/dl by end of first week

A

20

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19
Q

GFR renal blood flow and plasma creatinine return to normal by ___ wks

A

Six

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20
Q

How much urine can you remove at one time with a straight cath?

A

800 (to avoid hypotension)

21
Q

After delivery of the placenta mom gets an auto transfusion of _____ml causing stroke volume to ___ and heart rate to ___

A

750-1000
Increase
Decrease

22
Q

Does hct inc or dec after delivery?

A

Increases due to large reduction in plasma volume

23
Q

Blood volume returns to baseline by ___weeks after delivery

A

1-2

24
Q

WBC’s inc after delivery to ___

A

14-16k

25
Q

Cardiac output begins to decrease ___ minutes after delivery

A

15

Prelabor levels one hour after labor

Prepregnancy levels by 2-3 wks

26
Q

What helps the respiratory system to quickly return to prepregnant status after birth?

A

Sudden drop in progesterone
Emptying of uterus allows lung volume and tidal volume to normalize

Compensatory respiratory alkalosis gone in two days

27
Q

GI motility is reduced after birth. What do we do for this?

A

Encourage ambulation
PO fluids
Stool softeners

BM by 2-3 days, normal pattern by 2 wks

28
Q

Liver enzymes normalize by ___ wks

A

3

29
Q

Joint stability normalizes by ___ wks

A

6-8

30
Q

Diastasis recti (separation of abdominal wall is usually resolved by ___ wks

A

6

31
Q

How many additional kcals/day do lactating women need?

A

500-1000

32
Q

hCG is undetectable by ___, hPL is undetectable by ___

A

End of first wk, 24 hours

33
Q

Estrogen levels ___

Prolactin levels ___

A

Drop

Rise

34
Q

What is the acronym to remember for a postpartum assessment?

A 
BUBBLES
breasts
Uterus
Bowel
Bladder
Lochia
Epis/lac
pSychosicial
35
Q

Baby blues usually lasts about ___ wks

A

3

36
Q

What is endometritis/what are the symptoms?

A

Infection of uterus

Fever, inc abd pain, malaise, uterine tenderness, malodorous lochia

37
Q

What is normal blood loss with a vaginal delivery? Csection?

A

500

1000

38
Q

Early pp hemorrhage is one that happens in first ___ hours and can be caused by_______

A

First 24 hours

Atony
Lacerations
Retained products
Accretas
Rupture
Inversion
Coagulopathy
39
Q

Late pp hemorrhage happens ____ and can be caused by _______

A

Between 24hrs-6wks pp

Infection
Retained products
Subinvolution
Coagulopathy

40
Q

What are surgical interventions for a pp hemorrhage?

A

Uterine artery embolization
Uterine artery ligation
Uterine compression sutures
Hysterectomy

41
Q

Most changes that occurred during pregnancy resolve by ___ wks. This postpartum period is also called ___

A

6-8

Puerperium

42
Q

What are the three phases of maternal role attachment?

A

Taking in: first 48 hrs, dependent, relive birth experience, separates self from newborn

Taking hold: day 3-several weeks, active, desire to do infant care without help

Letting go: reconnects with others, inc confidence

43
Q

What hormones are responsible for milk production and delivery?

A

Pituitary hormones:
Galactopoietic hormone- prolactin
Galactokinesis hormone- oxytocin

44
Q

What is colostrum?

A

More protein and lactose
Less fat
Immunoglobulins and antibodies

There before milk comes in on day 2-5

45
Q

How does lactation keep ovulation at bay?

A

Prolactin levels suppress lutinizing hormone

46
Q

What is recommended for engorgement?

A

Mild analgesic
Ice pack
Frequent breastfeeding

47
Q

What is mastitis?

A

Infection of breast
Usually unilateral
Fever, chills, malaise, tender, hard, red, swollen

Continue to nurse
Antibiotics

48
Q

What are maternal warning signs ?

A 
Temp >100
Severe cramps with abd pain, chills/fever
Heavy bleeding/large clots
Foul discharge
Inc tenderness, redness, drainage, separation
     of stitches
Pain, burning, difficulty urinating
Red streaks/pain in calves
49
Q

What are newborn warning signs?

A 
Fever >100.4
60
Jaundice
Bleeding from circ
Foul discharge from umbilical cord
Feeding problems

RNC-OB (9 decks)

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