Postpartum Care Flashcards
Postpartum changes in uterus
Palpable fundus 1-2 cm below belly button, size of large grapefruit, descends 1 cm every 24 hrs,
Supine hypotension syndrome
Woman is lying flat and bp goes down from pressure on vena cava, starts at 2nd trimester- lay on left side
Uterus Involution process
Regeneration of endometrium, uterus decreases bc of this, oxytocin from beast feeding helps it contract and shrink, auto lysis occurs
Autolysis
When protein material of the uterine wall is broken down into simpler components that are absorbed by the body
Exfoliation process of the uterus
Prevents scar tissue formation by growing new endometrium under placental site w
Types of lochia
Rubra- red (day 1-3)
Serosa- pink (day 4-9)
Alba- white (day 10- 3-6 weeks)
Postpartum changes in cervix and vagina
Soft, opens to 2 cm, takes a fish mouth appearance, external os closes after a few days, vagina regains elasticity in 3-6 weeks, episiotomy heals 3-6 weeks
Postpartum changes in abdominal wall
Flabby when standing, pouches over like 3 month pregnancy
Postpartum changes in cardiovascular system
Hr- bradycardia for 1-2 days as low as 50 bpm from hemodynamics chants and vagal stimulation of sympathetic NS, blood volume decreases for 2 weeks, coagulability increases, watch for clots, blood pressure unchanged
Postpartum changes in hgl and hct
Rises within 5-7 days, may need iron supplements
Postpartum changes in urinary system
Increased capacity of bladder may cause over-distention or residual urine, bladder infections may occur, Gfr increased for a few more weeks
Postpartum changes in ovulation and menstration
Influenced by breast feeding, non lactating women get period back in 10-14 weeks, lactating women up to 17 weeks
Postpartum changes in GI system
Motility and tone return to normal within 2 weeks, constipation is common, episiotomy and hemorrhoids make bowel movements painful
Postpartum changes in breasts
Colostrum until 3-4 days the milk supply is kept up by consistent breast feeding
2 hours post Partum assessment
Vs, fundus should feel firm, lochia is rubra, check underneath, assess anesthesia effects
Daily nursing care for breasts
Soft then firm after 2 days, warm compresses if feeding, if not avoid stimulation and use tight bra and cabbage leavesn
Daily nursing care for uterus
Firm. Decrease in size 1cm per day
Daily nursing care for bladder
Voids 150 ml for first 3 voids
Daily nursing care for bowel
Fiber, increase liquids, walking, oob
Daily nursing care for lochia
Check qshift and note color and amount
Daily nursing care for episiotomy
Ice 24 hours, check qshift, turn on left, check for intactness, comfort pt because crying is normal
Homans sign
Assess for pain in the calf of each leg- don’t rub or massage, assess for redness too for possible dvt
Red flags- call if experiencing
Pain, fever, bleeding, malaise, excessive sadness
Danger signs for neonate
Decreases in wet diapers, lethargic, fever, poor eating
