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Women and Families > Postpartum > Flashcards

Postpartum Flashcards

1
Q

what changes postpartum physical adpatations

A
  • vital signs
  • cardiovascular
  • reproductive
  • urinary
  • gastrointestinal
  • musculoskeletal
  • interhumentary
  • neurologic
  • immune
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2
Q

VS: postpartum temperature

A

97-100.4

may be elevated for 24 hr after brith and elevated again after milk comes in

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3
Q

VS: postpartum BP

A

usually 120/80

  • assess for orthostatic hypotension
  • assess for hypertension/ reclampsia
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4
Q

VS: postpartum HR

A

60-100 normal

-slight bradycardia not uncommon (50-90)

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5
Q

Postpartum changes in cardiovascular/ lab values and EBL

A
  • increase blood volume 40-50%
  • normal pp blood loss (EBL): 200-500mL vaginal and 700-1000mL cesarean
  • cardiac output: preload increased and returns to normal with 1hr
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6
Q

postpartum changes reproductive system

A 
everything:
uterus
lochia
cervix
vagina
breast
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7
Q

changes in uterus postpartum

A
  • spongy layer of decide is sloughed off
  • placental site heals by exfoliation
  • uterin cells will atrophy : involution
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8
Q

changes in lochia postparturm

A

-uterine debris in the uterus is discharged though loch

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9
Q

changes in cervix/ vagina postpartum

A
  • cervix: spongy, flabby, and may appear bruised
  • extrnal os may have lacerations is irregular and closes slowly: shape of the external os changes to a lateral slit
  • vagina may be edematous , bruises with small superficial lacerations
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10
Q

postpartum changes in breast/lacation

A
  • estrogen/progesterone decrease

- breast are ready for lactation

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11
Q

relationship between postpartum ovulation and menstruation

A
  • nonbreastfeeding: menstruation occurs 7-12 weeks, first ovulation can occur 5 week
  • breastfeeding, takes 3 or more months for mensuration/ovulation: exclusive bf reduce risk of pregnancy
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12
Q

postpartum urinary changes

A
  • postpartum diuresis causes loss fo 5 lbs
  • increased bladder capacity
  • urinary stasis
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13
Q

causes of urinary stasis

A
  • swelling and bruising of tissues around the urethra
  • decrease in sensitivity to fluid pressure
  • decrease in sensation of bladder filling
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14
Q

postpartum changes in gastrointestinal

A
  • hungry 1-2hr after brith

- bowel patterns slow and risk for constipation

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15
Q

causes of risk of constipation

A

-episiotomy, lacerations or hemorrhoids may delay elimination

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16
Q

postpartum changes musculoskeletal

A
  • loose and flabby but will respond to exercise

- diastasis recti abdominis

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17
Q

diastasis recti abdonminis

A

abdominal muscle divides into 2, may cause hernia

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18
Q

postpartum changes integumentary

A
  • perineum may be: edematous, bruised
  • lacerations or episiotomy may be present
  • striae
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19
Q

postpartum changes neurologic

A

-headaches and carpal tunnel

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20
Q

postpartum changes immune

A
  • rubella: can cause brith defects
  • Rh + results in incompatibility
  • HIV
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21
Q

postpartum assessment mnemonic

A 
Breast
Uterus
Bowel
Bladder
Lochia
Episiotomy/Lacerations
H- Hemorrhoids/Homan's
Emotions
22
Q

how to initiate an assessment

A
  • identify yourself
  • identify your patient
  • ppe
23
Q

what to look for in breast assessment

A
  • skin integrity: abnormalities, redness, blisters, nipple: cracks, tissues, soreness, inversion
  • consistency: presence of breast fullness due to milk presence and engorgement
  • lactation status
24
Q

what to look for in a uterus/abdominal assessment?

A
  • tone
  • position of funds to midline
  • heigh of fundus related to umbilicus
  • assess incision for bleeding, approximation and signs of infections
25
Q

Fundal message

A
  • bimanual
  • to make fundus firm
  • may hurt
26
Q

what to look for in a bowel and bladder assessment

A
  • intestinal elimination: maternal concerns regarding bowel movements
  • adequacy of urinary elimination
  • bladder distention and pain during urination
27
Q

Assessment of loch and perineum

A
  • assess loch for: amount, color, order, presence of clots
  • wound assessed for REEDA
  • presence of hemorrhoids
  • level of comfort/discomfort
  • efficacy of any comfort measures
28
Q

What does REEDA stand for and when is it used

A
  • assessing any wound
  • Redness
  • Edema
  • Ecemycin: bruising
  • Discharge
  • Approximation
29
Q

Postpartum loch flow

A
  • scant: 1inch stain
  • light:1-4inch stain
  • moderate 1-6 inch stain
  • heavy: saturated within an hour
30
Q

Episiotomy what is it and what to do for it

A

incision for in perineum

-sitz bath recommended

31
Q

Hemorrhoids

A

distended viens

32
Q

assessment for extremities

A
  • asses calf for redness and warmth
  • varicosities (viens)
  • edema
33
Q

Nursing process

A
  • Assessment
  • nursing diagnosis
  • planning
  • implementation/interventions
  • evaluation
34
Q

nursing diagnoses for postpartum patient

A
  • knowledge deficient
  • fluid volume deficient
  • urinary retention
  • constipation
  • infection, risk for..
  • pain, acute
  • sleep pattern, disturbed/fatigue
35
Q

interventions: comfort measures: relieve of afterpains

A
  • positioning
  • ambulation
  • analgesics
36
Q

interventions: comfort measures: perineal care

A
  • ice packs
  • sitz baths
  • analgesics
37
Q

interventions: suppressing lactation

A
  • well bitting bra
  • cold compresses or cabbage leaves
  • anti- inflammatory meds
38
Q

care of C-section mother

A
  • minimize complications: deep breathing and incentive spirometry, ambulation, pain management
  • rest
  • minimize gas pains
  • consider grief response
39
Q

care of postpartum adolescent: discussion

A
  • postpartum hygiene: demonstrate self care
  • contraceptive consoling
  • newborn care: physical exam at bedside
40
Q

care of postpartum adolescent: nurse-patient relationship

A
  • positive feedback
  • sensitive, nonjudgemental
  • still trying to meet educational goals
  • relies on others
41
Q

care of postpartum adolescent: opportunities

A
  • include family
  • role model
  • ensure knowledge and skills/ teach back
  • information about options in community
42
Q

cultural influence in postum period

A
  • determine customs and practices
  • ask about fluids and temperature
  • breastfeeding practices: assistance or alone
  • role of grandmother
43
Q

maternal psychological adjustment: taking in period

A

they need a moment to care for themselves, not ready to learn or assume full care of baby (day 1)

44
Q

maternal psychological adjustment: taking hold

A

ready to learn and take care of baby (2-3 days)

45
Q

attachment

A

interactive process between the parent and infant which develops their relationship

46
Q

signs of attachment

A
  • en face position
  • fingertip explorations– palmar contact–enfolding
  • engrossment: father’s characteristics
47
Q

postpartum blues

A

adjustment reaction with depressed mood

-related to rapid changes in estrogen, progesterone, prolactin

48
Q

how many people experience postpartum blues

A

85%

49
Q

how long does postpartum blues last

A

2-4day to 14 days

50
Q

Contributing factors to postpartum blues

A
  • anxiety of new moms
  • physical discomfort of early postpartum
  • difficulty sleeping
  • feeling let down

Women and Families (7 decks)

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