Postpartum

Question 1

Factors that Slow Uterine Involution (D - J)

Answer 1

Difficult Birth,
Expulsion (incomplete) of the placenta,
Full bladder,
Grandmultiparity,
Hyperdistention of uterus,
Infection,
Juice (anesthesia)

Question 2

Taking-In Period

Answer 2

Soon after birth, the woman tends to be passive and somewhat dependent. She follows suggestions, hesitates to make decisions, and is preoccupied with her needs. (Food and Sleep are her major needs)

Question 3

Taking-Hold Period

Answer 3

By the 2nd to 3rd day after birth, the new mother may be ready to resume control of her body and mothering in general. (Mom is unsure of herself and needs assurance that she is doing well as a mother).

Question 4

Nursing interventions that foster the process of becoming a mother (BAM)

Answer 4

Instructing about infant caregiving, Building awareness/responsiveness to infant interactive capabilities, Promoting maternal-infant attachment, Preparing the woman for the maternal social role, Encouraging a therapeutic nurse-patient relationship.

Question 5

Amount of Lochia

Answer 5

Heavy: 6 inch stain within 1 hr
Moderate: stain

Question 6

Postpartum Assessment

Answer 6

BP and HR q 15 min X 8, then q 4 hrs
Temp q 4 hr X 2, then q 8 hrs
Postpartum Assessment q 15 min X 4, then q 30 min X 2, then q 4 hrs

Question 7

Causes of early (birth to 24hrs) postpartum hemorrhage (4 T’s)?

Answer 7

Tone - Uterine Atony

Trauma - Lacerations/Hematoma

Tissue - Placenta fragments

Thrombosis - Altered clotting DIC

Question 8

Four Levels of perineal lacerations

Answer 8

1st - skin of bag and perineal

2nd - Into muscle

3rd - Anal sphincter

4th - Exposed lumen of the rectum