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Sophomore 1 Test 2 > Postpartum > Flashcards

Postpartum Flashcards

1
Q

How long does postpartum last?

A

6 weeks

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2
Q

What is involution?

A

the process of the uterus returning to non-pregnant size

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3
Q

3 Retrogressive Processes of Involution

A
  1. Contraction
  2. Catabolism
  3. Regeneration
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4
Q

Contraction Stage of Involution

A

Contraction of the muscle fibers of the uterus

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5
Q

Catabolism Stage of Involution

A

Myometrial cells undergo a reducing

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6
Q

Regeneration Stage of Involution

A

Regeneration of uterine epithelium form the lower layer of the decidua after the upper layers have been sloughed off and shed during lochial discharge

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7
Q

What is the function of a contraction?

A

To reduce hemorrhage

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8
Q

Assessment of the uterus includes what 3 aspects?

A
  1. Tone
  2. Placement
  3. Location
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9
Q

Tone of uterus

A

Should be firm (boggy is bad); by day 10 it should not be palpable

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10
Q

Placement of uterus

A

Left, right, midline (should be midline)

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11
Q

Location of uterus

A

Uterus descends at a rate of 1 cm per day in reference to umbilicus

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12
Q

What is lochia?

A

Sloughing of decidua after birth

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13
Q

3 Stages of Lochia

A
  1. Rubra
  2. Serosa
  3. Alba
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14
Q

Rubra

A

Red; lasts 3-4 days

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15
Q

Serosa

A

Red-tinged; (3-10 days)

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16
Q

Alba

A

Creamy white; it occurs from days 10-14 but can last 3-6 weeks postpartum in some women and still be considered normal

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17
Q

Lochia odor

A

Lochia has a “fleshy” smell; an offensive odor usually indicates infection

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18
Q

Lochia interventions

A
  1. One pad 1st hour
  2. One pad every 2-4 hr after
  3. By 8 hours compare to normal menses
    * May gush when standing to ambulate
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19
Q

Cervix Appearance Postpartum

A

Gradually closes by week 6 but never returns to pre-pregnant appearance

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20
Q

Vagina Appearance Postpartum

A

Returns to pre-pregnancy state in 6-8 weeks as ovarian function returns although it is somewhat larger than before pregnancy

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21
Q

Perineum Appearance Postpartum

A

Returns to normal in 4-6 months

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22
Q

Postpartum Blood Pressure

A

Falls mostly in the first 2 days, then increases 3-7 days after childbirth, and returns to pre-pregnancy levels by 6 weeks

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23
Q

Postpartum Blood Components

A
  • Early PP, Hct/Hgb decrease slightly then rise slowly over a couple of weeks
  • WBC are elevated PP, return to normal 4-6 weeks
24
Q

PP Clotting Factors

A

Increased clotting factors from pregnancy place at increased risk for thromboembolic conditions
- Remains elevated for 2-3 weeks

25
Q

PP women can experience bradycardia for how long?

A

Up to 2 weeks

26
Q

Causes of PP diuresis

A
  1. Large amounts of IV fluid during labor
  2. A decreasing effect of oxytocin as levels decline
  3. The buildup and retention of extra fluids during pregnancy
  4. A decreased production of aldosterone
27
Q

PP Urinary Retention

A
  • Could be related to anesthesia or oxytocin

- Will cause uterine displacement and uterine atony

28
Q

How long can PP diuresis last?

A

12 hours - 1 week

29
Q

How long can it take for the PP mom’s respiratory system return to normal?

A

1-2 weeks

* SOB and rib pains resolve

30
Q

PP Endocrine System

A
  1. Hormone rapidly decline
  2. Menses return 7-9 weeks if not breastfeeding
  3. If breastfeeding, menses might not return (not effective birth control)
  4. Progesterone undetectable by day 3
31
Q

Rubin’s Maternal Role Framework

A
  1. Taking in
  2. Taking hold
  3. Letting go
32
Q

Taking In

A

Dependent on someone else to help with care; recounts labor experience

33
Q

Taking Hold

A

Start to figure out balance with addition of new baby but still requires assurance that she is doing well as mother

34
Q

Letting Go

A

Mom reestablishes relationships with other people; mom relinquishes the fantasy infant and accepts the real one; the baby is not just her’s anymore

35
Q

Partner Adaptation

A
  1. Engrossment

2. “Try-on stage”

36
Q

Engrossment

A
  1. The partner perceives the newborn as attractive, pretty, or beautiful
  2. The partner has a desire to touch or hold the newborn
  3. Perception of the newborn as perfect
  4. The partner focuses all attention on the newborn when they are in the room
  5. Awareness of distinct features of the newborn
  6. The partner feels a “high” after the birth of baby
  7. The partner feels proud, “bigger”, more mature, and older after the birth of his/her child
37
Q

Try-On Stage

A
  1. Partner has preconceptions about what home life will be like with a newborn
  2. Reality check when partners realize that their expectations are not realistic
  3. Then, the partner makes a conscious decision to take control and be at the center of baby’s life regardless of preparedness
38
Q

Mastitis

A

inflammation of the breasts

- Causes related to milk stasis

39
Q

Metritis

A

Inflammation of the uterus

  • Involves the endometrium, decidua, and adjacent myometrium of the uterus
  • Prophylactic antibiotics are given before C-sections to prevent this
40
Q

Type of PP Infection Complications

A
  1. Mastitis
  2. Metritis
  3. UTI (most common cause of fever in PP women)
  4. Incisional
41
Q

Incisional Infection Complications in PP women

A

From c-section, episiotomy site, and genital tract lacerations
- Symptoms may not show up until 24-48 hours after birth

42
Q

Mastitis Treatment

A
  1. Emptying the breasts
  2. Antibiotics
    * Can continue breast feeding if no abscess is present
43
Q

Normal PP blood loss

A
  • Vaginal birth: 500 mL

- C section: 1000 mL

44
Q

Diagnosis of PP hemorrhage

A

The diagnosis is any amount of bleeding that causes hemodynamic jeopardy

45
Q

Early PP hemorrhage

A

Within 24 hours of delivery

46
Q

Late PP hemorrhage

A

24 hours - 6 weeks after delivery

47
Q

Causes of PP hemorrhage

A
  1. Uterine atony
  2. Retained tissue (placental fragments)
  3. Uterine inversion
  4. Subinvolution
  5. Trauma
  6. Coagulation disorder
48
Q

Uterine Atony

A

Loss of tone (never contracts)

- Due to bladder distention

49
Q

Subinvolution

A

Less than ideal involution

  • Failure to return to normal size
  • Uterus contracts, but not enough
50
Q

When does the secretion of milk begin?

A

4-5 days PP

51
Q

Contraceptives for breast-feeding women

A
  • Can’t use combined hormonal contraceptive because of risk for VTE
  • Can’t use diaphragm or cap until 6 weeks PP
  • Can take “mini” pill while breastfeeding (it only contains progesterone, NOT estrogen)
52
Q

Baby Blues

A
  1. Peaks 4-5 days
  2. Can last hours or days
  3. Resolves by day 10
53
Q

Symptoms of baby blues

A
  1. Anxiety
  2. Fatigue
  3. Increased sensitivity
54
Q

Depression

A

Occurs gradually and evident within first 6 weeks PP

55
Q

Symptoms of PP depression

A
  1. Restlessness
  2. Worthlessness
  3. Moody
  4. Sad
  5. Hopelessness
  6. Low energy level
  7. Negative bonding
  8. Disinterest in caring for children
56
Q

PP Psychosis

A
  1. Surfaces within 3 months
  2. Considered a psychiatric emergency
  3. Different from blues and depression because this is a break from reality
  4. At risk for infanticide and child abuse
57
Q

Symptoms of PP Psychosis

A
  1. Not logical
  2. Delusional
  3. Hallucinations
  4. Mood lability - swift/rapid
  5. Disorganized thinking

Sophomore 1 Test 2 (4 decks)

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