postpartum care

Question 1

postpartum period lasts

Answer 1

6-12 weeks

Question 2

immediate puerperium

Answer 2

24 hours

most dangerous time for mom

Question 3

early puerperium

Answer 3

24 hours to 1 week

Question 4

remote puerperium

Answer 4

period of time required for genital organ involution and return of mensus

1-6ish weeks post partum

Question 5

immediate puerperium is dictated by

Answer 5

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

Question 6

after pains will get ___ with subsequent pregnancies

Answer 6

worse

Question 7

post partum chills

Answer 7

can come on after birth around 60 minutes or when breatfeeding

Question 8

urinary status

Answer 8

proteinuria urinary stasis

incomplete bladder emptying for 1-2 days

can get urinary tract infections from trauma to urethra

Question 9

postpartum hemorrhage definition

Answer 9

EBL>500mL vaginal or
>1000mL C-setion

10% drop in hct

Question 10

postpartum febrile morbidity

Answer 10

temp >38
at least twice
4 hrs apart

common : breast engorgement, atelectasis, UTI, endometritis, drug rxn, wound infx

Question 11

prolonged labor leads to

Answer 11

uterine atony

MCC of PPH

Question 12

Hypertension can be seen up to

Answer 12

6 weeks post partum

Question 13

early peurperium is seen with

Answer 13

cervix gradually closes
vagina, perinuem and pelvic musculature decreases to normal size

tears heal

pospartum vaginal discharge heaviest 3-4 days

Question 14

lochia rubra

Answer 14

dark blood seen initiall 3-4 days

Question 15

lochia serosa

Answer 15

3-4 days to 2-3 weeks postpartum

mucopurulent
more serous

need to ask how fast she is soaking through pads

Question 16

lochia alba

Answer 16

can last up to 6 weeks

thicker mucoid

yellowish white

Question 17

remote puerperium is seen with

Answer 17

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

Question 18

ovulation begins as early as

Answer 18

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

Question 19

pad trick for perinium

Answer 19

Put BULKY ass pads and witch hazel in freezer

Question 20

bladder care

Answer 20

peri bottle for squiriting on perinium after urinating

Question 21

postpartum immunizations

Answer 21

rhogam within 72 hours of birth

if mom was negative on rubella titers vaccinate now

Question 22

contraception and sterilization

Answer 22

DO NOT GIVE ESTOGEN

mini pill (progesterone ONLY)

can get IUD at 6 week postpartum visit

Question 23

hospital stay postpartum

Answer 23

24-48 vaginal

24-96 c section

Question 24

vitamin supplements postpartum

Answer 24

Ca
vitamin B12
vitamin D
iron given only if mother needs it

Question 25

resumption of coitus

Answer 25

no sooner than 2 weeks

Question 26

postpartum visits should occur

Answer 26

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

Question 27

“Zombie period”

Answer 27

3-6 weeks

baby is awake at night