Postpartum Assessment Flashcards
What is a sign of a cervical laceration?
Free flowing bright red blood
What is a normal place to palpate the fundus immediately postpartum?
Between the umbilicus and the symphysis pubis
True or False: It is normal to palpate the fundus 1 cm above the umbilicus at 12 hours postpartum?
True
At how many days postpartum should the uterus be no longer palpable?
10 days
What is a factor that can increase involution of the uterus?
Breastfeeding- increase in oxytocin
What are three things that can slow down involution?
- Over distended uterus
- Retained placenta
- C-section delivery
What is lochia?
This is the decidua (thick layer of mucous membranes that lines the uterus in pregnancy) that is dead and sloughing off.
In which time should the placenta detach from the uterus?
Within 30 minutes
What are the three types of lochia?
Rubra
Serosa
Alba
What is a concern with patients that had a c-section that has to do with bowel sounds?
Ileus- the bowel sounds will be heard high but not low
What can be a normal range of WBCs postpartum?
25-30, 000
What are three reasons for diuresis in the mother?
- Decrease in aldosterone
- Low estrogen levels
- Hypervolemia compensation to get rid of fluid.
When is a normal time for menses to return?
- 7-9 weeks for bottle- feeding mothers
- 2-18 months for breastfeeding mothers
What is the only birth control pill that is safe for breastfeeding mothers?
Progestin-only. Estrogen decreases milk production.
What are the four warning signs of inflammation for DVT?
Red, hard, tender, and warm
What is the measurement difference for swelling in the leg?
2 cm
What are the three criteria for Virchow’s triad?
Venous stasis, hypercoagulation, and blood vessel trauma
What are the three main risk factors for developing a DVT in pregnancy?
Left leg
Edema
First Trimester
Who is the most common person to get postpartum endometritis?
Those women who labored and then went to c-section.
What does the TIME acronym stand for in regard to sepsis?
T: temperature
I: infection
M: mental decline
E: extremely ill
What are the two phases of Sepsis?
Phase 1 (early): warm stage- fever, tachycardia, nausea, vomiting, diarrhea, temp of 102.
Phase 2 (late): cool stage-cold, clammy, bradycardia, hypotension, temp of 93.
What are the blood pressure parameter goal for sepsis?
SBP: >100
DBP: >65
What is the difference between “Baby Blues” and Postpartum Depression?
Baby Blues: can last 1 day or up to 3 weeks- this has more to de with labile emotions.
Postpartum Depression: can last weeks to months
What are the three stages of Family Adaptation?
- Taking In: the mother is focused on herself and the infant’s immediate well-being. This can last 2 days.
- Taking Hold: the mother is taking initiative and has mood swings. This can last 10 days.
- Letting Go: relationships are reestablished and the mother is confident in taking care of the infant.
How do you assess for symphysis pubis separation?
They can’t walk forwards, they can walk backward.
What are symptoms to watch for with a hematoma?
Disproportionate pain in the perineum.
Which conditions are safe to take the Progestin-only birth control pill with?
Breastfeeding, hx of DVT, and elevated blood pressure.
What are two antibiotics that a woman should take back-up forms for birth control with?
Penicillin and tetracyclineWha
What are the two types of Postpartum Thyroiditis?
Autoimmune: this is from an underlying condition that flares after childbirth. This can lead to chronic hypothyroidism.
Non-Immune: transient and can go away
Which hormone is responsible for the production of breastmilk?
Prolactin
Which hormone is responsible for the letdown and uterine contractions?
Oxytocin
What are the Three stages of breastmilk?
- Colostrum (2-4 days)- high in protein and antibodies
- Transitional (2 weeks)- this is high in fat, calories, and lactose
- Mature (2+ weeks)- this includes foremilk (the first milk) and hindmilk (this is thick and creamy and high in fat).
What is most important for supply of breastmilk?
The length of time and strength of the suck.
What is the 5:5:5 rule for breastmilk?
5 hours left out on the counter
5 days in the fridge
5 months in the freezer
What are benefits of kangaroo care/ skin-to-skin?
Stabilization of the infant’s heart rate, stabilization of temperature, improved and more regular breathing pattern, and improved O2 saturation.
What is the major cause of mastitis?
Staph infection
How does mastitis differ from engorgement?
Mastitis is unilateral and engorgement is bilateral.
What are the signs and symptoms of mastitis?
Fever, chills, body aches, tachycardia, malaise, headaches, swollen, red, hard, and tender breast
True or False: you should not feed while you are being treated for mastitis?
False: you should feed when being treated because it avoids stasis.
