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NUR 435 Exam 2 > Postpartum Care > Flashcards

Postpartum Care Flashcards

1
Q

Postpartum Period

A

Birth to about 6 weeks after

Return of reproductive organs to pre-pregnancy state

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2
Q

4th Trimester

A

Puerperium

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3
Q

Uterus Weight Full Term

A

11x bigger than per-pregnacny!!

6weeks - 80 grams

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4
Q

Subinvolution

A

Failure of uterus to return to original state
Hemorrhage is a BIG Problem
Most common cause: Retained placental fragments and infection

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5
Q

Oxytocin

A

Released by posterior pituitary
Promotes homeostasis
Prevents hemorrhage
Causes contractions- compresses blood vessels
Helps uterus get smaller
Breastfeeding within 1-2 hours also helps!

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6
Q

Afterpains

A

Contractions after birth

More common with 2+ child

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7
Q

Lochia Rubra

A

Red discharge

Birth to about 4 days

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8
Q

Lochia Serosa

A

Pink discharge

Day 3/4 until about 10 days

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9
Q

Lochia Alba

A

White/ Yellow discharge
Can continue up to 4-8 weeks after delivery
Flow is normally until 6 weeks

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10
Q

Menstrual Cycle

A

Not breastfeeding will return around 4-10 weeks

Breastfeeding will return around 3 months or cessation of breastfeeding

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11
Q

Fundus Movement

A

Decreases 1cm a day

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12
Q

Hemorrhage

A

1 pad per hour
>500 ml vaginal deliver
> 1,000 ml c-section

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13
Q

Fluid Change

A

Diuresis 12 hours after birth
Decreased bladder sensitivity- may cause over distention of the bladder
Diaphoresis is very common- especially at night
May lose up to 5lbs in first few days

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14
Q

1st Degree Laceration

A

Only the skin of the perineal area

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15
Q

2nd Degree Laceration

A

Skin and the perineal muscle

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16
Q

3rd Degree Laceration

A

Skin, perineal muscle, and part of the anal sphincter

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17
Q

4th Degree Laceration

A

Skin, perineal muscle, complete tear of anal sphincter and involves tissue lining the rectum
Extensive repair

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18
Q

Bowel Function

A 
May take up to 3-4 days 
From lack of food during labor, fear r/t lacerations
STOOL SOFTENERS! 
Should be passing gas
NO SEX 6 WEEKS
19
Q

Breast Changes

A 
Little change in 1st 24 hours
72-96 hours breast milk comes in (3-4 days)
Become fuller and heavier
Warm, full and tender
Cant pump away inflammation
Progesterone DROPS
20
Q

Not Breastfeeding Measures

A

Tight, supportive bra
Avoid stimulation- hot shower
Breast Binder
Ice packs

21
Q

Ovulation

A

Not breastfeeding- 7-9 weeks

Breastfeeding- 2-18months depending on exclusivity

22
Q

Blood Changes

A

Increased clotting factors and fibrinogen
Hypercoaguable state
High risk for thromboembolism, especially after c/s
150,000 platelet count= LOW < = Pre-eclampsia

23
Q

Skin Changes

A

Face, nipples and line down center of stomach get darker from increased estrogen

24
Q

Striae Gravidarum

A

Stretch marks
darker pink/ red/ purple in white women
2/3 get them
10% of black women get them- appear lighter

25
Q

BUBBLE HE

A 
Breasts
Uterus 
Bladder
Bowel
Lochia 
Episipotmy 
Homans sign
Emotional status
26
Q

Breast Assessment

A

Assess for engorgement, sore or cracked nips

27
Q

Uterus Assessment

A

Fundus should be level of belly button shortly after birth
Moves 1 cm a day
To the right- possible full bladder or uterine atony!!
Fundal massage if uterine atony is expected

28
Q

Bladder Assessment

A

Assess for complete emptying, burning and ability to void
Epidural- may need straight cath
C- seciton- indwelling cath

29
Q

Bowel Assessment

A

No bowel movement 2-4 days
Passing gas is a positive sign
For a c/s assess bowel sounds

30
Q

Lochia Assessment

A 
Rubra- while in hospital
Assess amount, color, any odor
More than a pad an hour- EXCESSIVE 
Clots are normal with fundal massage 
1st few times ambulating- use a blue pad, blood can pool in vagina then rush out when standing
31
Q

Episiotomy Assessment

A

Assess approximation, swelling, bruising
Ice packs are recommended
Topical meds can help - epifoam, benzocaine
3rd and 4th degree- sitz baths!

32
Q

Homans Sign

A

Quickly dorsiflexing the foot upward
Looking for calf pain- can indicate thromboembolism
Assess for leg soreness, warmth or redness

33
Q

Ambulating PP

A

After meds wear off and are stable

4x a day

34
Q

Sequential Compression Devices

A

For c-section patients
On until ambulating
Decreases chances of blood clots

35
Q

Emotional Status Assessment

A

Note affect, support system
Assess for hx or anxiety, depression, panic disorders
Reaction to labor and birth
Interactions with the baby and partner/family members

36
Q

DTAP Immunization

A

PERTUSSIS
In late 2nd or 3rd trimester
Recommended for those interacting most with baby
Not immunized during pregnancy- do in PP

37
Q

Rubella Immunization

A

Vaccination during PP if not immune
Informed consent is important!
Cannot get pregnant for 1month after vaccination
Side effect: muscle pain

38
Q

RHOgam

A

Given to RH- moms at 28 weeks
Prevents sensitization
Sensitization can occur during miscarriage, trauma, birth
Jehovah witness denies - made from human plasma

39
Q

RH -/+ Problems

A

If not given RHOgam, RH- blood will attack RBC of baby

Causes anemia, jaundice, and more

40
Q

Discharge Lengths

A

Vaginal delivery - 48hour

C-section - 96hours, stay a tleast for 48 hours, most go home around day 3

41
Q

Prenatal Vitamins

A

Continue for up to 6 weeks after birth

42
Q

Supporting Mom & Baby Bonding

A

Early skin to skin
Rooming in
Touching behaviors
Eye contact, odor, voice recognition

43
Q

Discharge Teaching

A

Bathing/dressing, diapers, hearing and newborn screening, circumcision care, breastfeeding, formula feedings, contraception, care after discharge, are seat, back to sleep, self care.
6-8week for 1st checkup

44
Q

SMILE!

A

YOURE GOING TO DO GREAT!

NUR 435 Exam 2 (4 decks)

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