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NURSING 242 (Fall 2018) > Postpartum Adaptation > Flashcards

Postpartum Adaptation Flashcards

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1
Q

(5) Goals to achieve in the postpartum period

A

1) Asses lochia, fundus, perineum, VS 2) Prevent Hemorrhage 3) Comfort Measures 4) Client Education 5) Promoting family infant

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2
Q

How often should newborn be feed in the first 24 hours

A

8 or more in 24

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3
Q

Thyroid function returns within _____ to _____ weeks after giving birth

A

4 to 6 weeks

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4
Q

____ is the hormone that causes “milk production”

A

prolactin

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5
Q

How long do “afterpains” typically last for?? What two things are known to cause an increase in afterpain discomfort?

A

2-3 days postpartum 1) Multiparity (more than one baby) 2) breastfeeding (take prescribed analgesic one hr prior to breastfeeding)

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6
Q

Where is the fundus located immediately after birth? 6-12 hours after birth?

A

Midline and approximately half way between the symphis pubis and the umbilicus. Then 6-12 hrs after birth the fundus is at the level of the umbilicus which then decreases “one” fingerbreadth per day

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7
Q

How would you describe the drainage on this pad?

A

LIGHT

(4 inches or less)

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8
Q

Cervix still dilated __ to __ cm 2-3 days postpartum and by the end of the first week the cervix is still dilated approximately ___ cm

A

2 to 3 1

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9
Q

Voluntary muscle and pelvic floor support regain tone during the first _____ weeks

A

6

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10
Q

After delivery of the placenta, hormones decrease thus resulting in a decrease in these (3) things:

A

1) decreased blood glucose 2) decreased estrogen 3) decreased progesterone level

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11
Q

points to remember about ARAB heritage

A

-prayer recited in newborn ear -circumcision is required -breastfeeding delayed for 2-3 days -wrapping infant abdomen is important to keep cold/wind from entering the body

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12
Q

How long does the postpartum period last?

A

From delivery of placenta to return of the non-pregnant state (6-8 weeks)

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13
Q

CLASSIFICATION of medications that help to contract the uterus

A

UTEROTONIC

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14
Q

_____________ IS AN INFECTION OF THE BREAST

A

MASTITIS

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15
Q

(5)

Indications

for C-Section

A

Maternal Fetal Don’t Play Uterine

M—Malpresentation of fetus

F—Fetal Heart rate difficulties

D—Dystocia

P—Placental abnormalties

U—Uterine surgeries

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16
Q

DEGREE OF LACERATION

A

FOURTH DEGREE LACERATION

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17
Q

______ , ________ and _______ cause a decrease in myometrial cell size which results in uterine involution

A

Ischemia autolysis phagocytosis

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18
Q

TERM THAT DESCRIBES A FUNDUS THAT BEGINS TO DESCEND

A

INVOLUTION

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19
Q

Elevated serum _______ level suppresses ovulation

A

prolactin

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20
Q

When does menstruation return for non’lactating women (bottle feeding)?

and for lactating women (breastfeeding)?

A
  • within 8 weeks
  • between 6 weeks and 6 months
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21
Q

How would you describe the drainage on this pad?

A

MODERATE

(less than 6 inches)

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22
Q

When to assess UTERUS, LOCHIA and PERINEUM

A
  • Q 15 minutes for 2 HOURS
  • Q 4 hrs for 24 hrs
  • Q shift after 24 hrs
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23
Q

_________ , ___________

and ___________

increase immediately after birth

A
  1. Heart Rate
  2. Stroke Volume
  3. Cardiac output
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24
Q

“3” greatest risks during the POSTPARTUM period are:

A

1) Hemorrhage 2) Shock 3) infection

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25
Q

Rugae reappear by week __________

A

3

(they reappear by week 3)

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26
Q

S/S of Postpartum Psychosis

A

Hateful Bitch Is Downright Angry

H—Hallucination

B—Bizarre Behavior

I—Insomnia

D—Delusions

A—Agitation

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27
Q

Type of water that should be used in preparation of infant formula

A

non fluoride water or distilled water

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28
Q

First milk rich in immunoglobulins

A

COLOSTRUM

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29
Q

Points to remember about MEXICAN heritage

A

-40 days without bath -abdominal binder to keep air from entering uterus -belt wrapped around newborn umbilicus to prevent naval from “popping” out

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30
Q

which hormone gives the “pregnancy glow”

A

estrogen

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31
Q

How long can breast milk be stored in insulated cooler bag?

A

24 hours

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32
Q

How often should you assess the Uterus, Lochia and perineum POSTPARTUM

A

-Every 15 minutes for 2 hours -Every 4 hours for the first 24 hours -Every shift after 24 hours

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33
Q

Difference between the DIRTY DUNCAN and SHINY SCHULTZ

A

Based on the appearance of the two different sides of the placenta. Fetal side is shiny and glistening because it is covered by membranes, therefore ‘shiny Schulze’. Maternal side is rough and red-looking, thus ‘dirty Duncan.’

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34
Q

(TRUE or FALSE) Breastfeeding should be initiated within 1 hour after delivery

A

TRUE

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35
Q

How long can you store mixed formula in airtight bottle held in refrigeration

A

up to 48 hours

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36
Q

Treatment (5) for breast engorgement

A

Females Purged Warm Infant Milk F- Feeding P- Pump or express milk W- Warm (compresses b4 feeding) I- Ice (after feeding) M- Meds

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37
Q

Three (3) Gastrointestional effects often seen postpartum

A

*Increased appetite *Delayed bowel movements *Gas Distention

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38
Q
A
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39
Q

Estrogen vs Progesterone

A

Estrogen- helps uterus to contract Progesterone- helps maintain pregnancy

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40
Q

Exogenous oxytocin can be administered postpartum to ……

A

Improve the quality of the uterine contractions

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41
Q

(5) Factors that cause delayed bowel movement

A
  1. Decrease GI muscle tone and motility
  2. Lack of food in labor
  3. Dehydration
  4. Pain
  5. Hemorrhoids
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42
Q

(3)

Breastfeeding advantages for mom

decreased risk of these diseases:

A
  1. Breast cancer
  2. Ovarian Cancer
  3. Type II DM
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43
Q

increased muscle tone throughout the body is due to a decrease in which of the hormones?

A

Progesterone

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44
Q

This hormone stimulates progesterone and estrogen production to maintain the pregnancy until the placenta is developed.

A

Human Chorionic Gonadotropin

(HCG)

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45
Q

The hormone released from the pituitary gland that coordinates and strengthens uterine contractions

A

Oxytocin

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46
Q
A
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47
Q

Seperation of the abdominal muscles

A

DIASTASIS RECTI

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48
Q

Frequency and amount of feedings (bottle)

A

Day 1-3 -0.5 to 1 ounce / feeding every 3-4 hours Day 4 -2.5 to 3 ounces / feeding up to 32 ounces/day

49
Q

Blood glucose levels DECREASE / INCREASE after delivery

A

decrease

50
Q

How would you describe the drainage on this pad?

A

HEAVY

(SATURATED PAD)

51
Q
A
52
Q

SWELLING OF BREASTS WITH BLOOD AND LYMPH INVOLVEMENT

A

ENGORGEMENT

53
Q

Thyroid function typically returns within ___ to ___ weeks after delivery

A

4-6

54
Q

Menstruation (for non-lactating women) returns within ____ weeks of delivery

A

8

55
Q

Signs (5) that “milk transfer” in occurring during breastfeeding…

A

1) Dirty Diapers —-3 or more stools/day by Day 3 —-4-5 wet diapers/day by Day 4
2) Baby Content
3) Audible swallowing
4) Breast softer after feeding
5) Pre and Post weights —–Up to 8 percent weight loss expected but no more than 10 percent

56
Q

______________ stimulates and sustains lactation

A

PROLACTIN

57
Q

VACCINE that is administered to the mother to prevent whooping cough in newborn

A

TDAP

58
Q

What is this show a picture of???

A

DIRTY DUNCAN PLACENTA

59
Q

the fundus should not be palpable _____ week postpartum

A

1

60
Q

risk factors for Postpartum Psychosis

A

*Bipolar disorder *Family Hx of bipolar disorder

61
Q

fundus typically descends ____ to _____ cm per day

A

1 to 2

62
Q

two things that induce uterine involution

A

1) breastfeeding- causes the release of oxytocin 2) Exogenous oxytocin - Given via IM or IV immediately after birth

63
Q

The placenta separates spontaneously from the uterus (after delivery) within _______ minutes

A

15-30 minutes

64
Q

Contraindications (5) for breastfeeding

A

He Drives His Red Car

  • H- HIV
  • D-Drugs (illegal drug use)
  • H- Herpes
  • R - Radioactive (Isotopes)
  • C - Chemotherapeutic (agents)
65
Q

Breastfeeding advantages for “MOTHER”

A

*decreased blood loss/infection *enhanced bonding *decreases the risk of maternal disease (breast & ovarian cancer, Diabetes)

66
Q

Ankyloglossia

A

tongue tied

67
Q

Contraindications for Epidural or Spinal

A

*Client anxious or refuses *infection at site of needle insertion *low platelet count

68
Q

Decreased estrogen is associated with these (4) things:

A

1) breast engorgement 2) diaphoresis (profuse perspiration) 3) diuresis (increased formation/excretion of urine) 4) decreased vaginal lubrication

69
Q

The pink to brownish discharge that occurs around day 4 and continues until day 10

A

LOCHIA SEROSA

70
Q
A
71
Q

DEGREE OF LACERATION

A

THIRD DEGREE

72
Q
A
73
Q

CARE OF EPISIOTOMY / LACERATION

(5)

A
  • ICE for first 24 hours
  • WARM BATHS after 24 hours
  • LIE on SIDE
  • TOPICAL ANESTHETICS
  • ORAL ANALGESICS
74
Q

EXERCISE THAT HELPS TO STRENGTHEN THE PERINEAL WALL

A

KEGAL

75
Q

(7)

BREASTFEEDING ADVANTAGES FOR BABY

reduces risk for:

A
  1. GI infections
  2. Otitis Media
  3. Respiratory Infections
  4. SIDS
  5. Diabetes
  6. Asthma
  7. Obesity
76
Q

Mom is “most likely” to decompensate within the first _______ hours following delivery

A

2 hours

77
Q

points to remember about HINDU heritage

A

-Exposure to cold is considered dangerous -Hot foods encouraged -Mom/baby confined to a room for 10 days to bond -baby is officially named on day 11 -son is blessing to carry family name

78
Q

Three (3) affective disorders that affect mom during pregnancy and delivery

A

*BABY BLUES *POSTPARTUM DEPRESSION *POSTPARTUM PSYCHOSIS

79
Q

ELEVATED SERUM ______ LEVEL

SUPPRESSES OVULATION

A

PROLACTIN

80
Q

_________stimulates the release of endogenous oxytocin from the pituitary gland

A

breastfeeding

81
Q

This hormone can be given to prevent spontaneous abortion

A

PROGESTERONE

82
Q

This hormone plays the greatest role in maintaining pregnancy

A

PROGESTERONE

83
Q

How often should mom be breastfeeding?

A

8 or more in 24

84
Q

_____stimulates “milk let down”

A

Oxytocin

85
Q

Voluntary muscle and pelvic floor support regain tone during the first _________ weeks

A

6

86
Q

2-3 days postpartum the cervix is still dilated ____________________________ and will be approximately _____________ dilated by the end of the week.

A
  • 2 to 3 cm
  • 1 cm
87
Q

No VBAC for patients that have had this procedure..

A

Vertical cesarean

88
Q

(T/F) Bladder distension, incomplete emptying and inability to void are common during the first few days postpartum due to trauma and decreased sensation

A

True

89
Q

How would you define the drainage on this pad?

A

SCANT- 1 -2 inch stain

90
Q

which hormone delays ovulation?

A

prolactin

91
Q

TX of engorged breasts

(5)

A
92
Q

______ is the hormone that causes “milk let down”

A

oxytocin

93
Q

Breast firmness/fullness typically occurs _____ hours after delivery

A

72 - 96 hours

94
Q

partial or complete separation of the rectus abdominis, or “six-pack” muscles, which meet at the midline of your stomach

A

Diastasis Recti

95
Q

what causes “slow involution”? Give three examples

A

*OVER-DISTENDED UTERUS 1) Multifetal gestation (twins) 2) Polyhydramnios (extra fluid) 3) Macrosomia (big baby)

96
Q

________ oxytocin can be administered postpartum to improve the quality of the uterine contractions

A

Exogenous

97
Q

Care of Episiotomy/Lacerations

A

I- Ice first 24 hours B- Bath (warm bath after 24 hours) S- Side (Encourage pt to lay on side) ANAL- Analgesics (PO and topical)

98
Q

HORMONE that is responsible for milk production

A

PROLACTIN

99
Q

Three (3) Maternal Phases of adjustment

A

1) TAKING IN PHASE (Dependent) 24-48 hours —focused on herself—-dependent on others —decreased ability to make decisions 2) TAKING HOLD (Independent) 2-10 days —-become independent–curious about baby needs —-s/s of baby blues —eager to learn 3) LETTING GO (Interdependent) —baby becomes separate entity from her —returns to work —feeling of guilt, grief, anxiety

100
Q

Oxytocin…Where is it produced in the body? What does it do?

A

Produced in the pituitary gland -coordinates and strengthens uterine contractions

101
Q

This hormone gives the “Pregnancy glow” and also helps the uterus to contract

A

estrogen

102
Q

(TRUE / FALSE)

BLOOD GLUCOSE LEVELS DECREASE IN THE POSTPARTUM PERIOD

A

TRUE

103
Q

Degree of laceration?

A

FIRST DEGREE

104
Q

DEGREE OF LACERATION

A

SECOND DEGREE

105
Q

FREQUENCY of BOTTLE FEEDING

(Newborn)

A

Day 1-3

0.5 - 1.0 ounces Q 3-4 hrs

Day 4 and on…..

2.5 - 3.0 ounces per feeding up to 32 ounces/day

106
Q

A firm and contracted uterus prevents these (2) things

A

1) excessive bleeding 2) hemorrhage

107
Q

HR, Stroke Volume and cardiac output ______ immediately after birth due to…….

A

increases due to blood from fetal circulation shifts back into the maternal circulation

108
Q

What causes moms’ HR, stroke volume and cardiac output to increase immediately after birth?

A

Blood from fetal circulation shifts back into the maternal circulation

109
Q

VAGINAL DISCHARGE STAINS A PAD LESS THAN 4 INCHES

A

LIGHT

110
Q

what is the fundus?

A

upper portion of the uterus between the fallopian tube

111
Q

Points to remember about Chinese heritage

A

-women are taken care of for 1 month PP -drinks tepid drinks/liquids -women wrap newborn tightly to avoid cold air -female relatives care for newborn until mom recovers

112
Q

Three (3) types of Lochia. Description of each

A

*lochia Rubra (1-3 days. Dark Red in color with small clots- no foul odor) *Lochia Serosa (4-10 days. pink or brownish. no foul odor) *Lochia Alba (11-21 days. yellow to white. stale odor)

113
Q

name this placenta presentation

A

SHINY SCHULTZ

114
Q

Breast milk is safely stored at room temperature for ______ to _______ hours

A

4 to 6 hours

115
Q

This hormone is often given to women to keep them from having a miscarriage

A

progesterone

116
Q

when do the Rugae reappear postpartum

A

by week 3

117
Q

Infection of the breast tissue resulting in pain, swelling, warmth and redness.

A

Mastitis

118
Q

Preferred method of anesthesia

A

Spinal

NURSING 242 (Fall 2018) (7 decks)

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