postpartum care Flashcards
postpartum period lasts
6-12 weeks
immediate puerperium
24 hours
most dangerous time for mom
early puerperium
24 hours to 1 week
remote puerperium
period of time required for genital organ involution and return of mensus
1-6ish weeks post partum
immediate puerperium is dictated by
events of delivery
will influence the after care
epidural will be managed by anesthesiologist and OBGYN
bP and pulse need to be taken every 15 minuted
temperature at least every 4 hours
after pains will get ___ with subsequent pregnancies
worse
post partum chills
can come on after birth around 60 minutes or when breatfeeding
urinary status
proteinuria urinary stasis
incomplete bladder emptying for 1-2 days
can get urinary tract infections from trauma to urethra
postpartum hemorrhage definition
EBL>500mL vaginal or
>1000mL C-setion
10% drop in hct
postpartum febrile morbidity
temp >38
at least twice
4 hrs apart
common : breast engorgement, atelectasis, UTI, endometritis, drug rxn, wound infx
prolonged labor leads to
uterine atony
MCC of PPH
Hypertension can be seen up to
6 weeks post partum
early peurperium is seen with
cervix gradually closes
vagina, perinuem and pelvic musculature decreases to normal size
tears heal
pospartum vaginal discharge heaviest 3-4 days
lochia rubra
dark blood seen initiall 3-4 days
lochia serosa
3-4 days to 2-3 weeks postpartum
mucopurulent
more serous
need to ask how fast she is soaking through pads
lochia alba
can last up to 6 weeks
thicker mucoid
yellowish white
remote puerperium is seen with
involution (6-8wks)
lochia ceases about 5-6 weeks postpartum
striae fade from red to silver but are permanent
hair patter returns to normal 6-15 months postpartum
ovulation begins as early as
27 days after delivery
avg 70-75 days in nonlactating mothers
avg 6 months in lactating mothers
menstruation begins at 7-12 weeks in nonlacting mothers and as late as 36 months in breastfeeding
pad trick for perinium
Put BULKY ass pads and witch hazel in freezer
bladder care
peri bottle for squiriting on perinium after urinating
postpartum immunizations
rhogam within 72 hours of birth
if mom was negative on rubella titers vaccinate now
contraception and sterilization
DO NOT GIVE ESTOGEN
mini pill (progesterone ONLY)
can get IUD at 6 week postpartum visit
hospital stay postpartum
24-48 vaginal
24-96 c section
vitamin supplements postpartum
Ca
vitamin B12
vitamin D
iron given only if mother needs it
resumption of coitus
no sooner than 2 weeks
postpartum visits should occur
4-6 weeks after uncomplicated
visit and exam 7-14 days after cesarean or complicated delivery
most women may resume work 4-6 weeks postpartum and considered maternity leave
“Zombie period”
3-6 weeks
baby is awake at night
