Postpartum Care

Question 1

when is the uterus considered a pelvic organ after birth

Answer 1

2wks

Question 2

when does the uterus return to pre pregnany size

Answer 2

4 wks

Question 3

progression of lochia and when does it resolve

Answer 3

rubra–> serosa –> alba

6 wks

Question 4

what is lochia

Answer 4

sloughing of the decidua, and contains decidua, epithelial cells, erythrocytes, and bacteria

Question 5

is leukocytosis common after birth

Answer 5

yes

Question 6

leading cause of maternal mortality

Answer 6

unrecognized maternal hemorrhage

Question 7

normal blood loss in birth

Answer 7

500 ml/min

Question 8

second degree perineal involvement

Answer 8

superficial muscle involvement

Question 9

third degree perineal involvement

Answer 9

rectal sphincter torn

Question 10

4th degree perineal involvement

Answer 10

tear into the rectum

Question 11

endomyometritis tx

Answer 11

Gentamycin/Clindamycin (Gold Standard)

Question 12

how to tell if mom has infection post puerperium

Answer 12

fever*

leukocytes are gonna be elevated regardless, not goo d indicator

Question 13

sheehans syndrome

Answer 13

blood loss during pregnancy followed by circulatory collapse of the pituitary
causes array of multiglandular disorders
causes agitation, hallucinations, delusions, & depression
Failure of lactation, amenorrhea, breast atrophy, loss of
pubic and axillary hair, hypothyroidism, and adrenal
cortical insufficiency
Incidence less than 1/10,000 deliveries
Very uncommon

Question 14

when does ovulation occur in a mom that breast feeds

Answer 14

may not return until lactation ceases

Question 15

when can oral contraceptives be started

Answer 15

4 wks postpartum

PROGESTERONE only

Question 16

drugs that are absolutely contraindicated in breast feeding

Answer 16

chemotherapy drugs
alcohol, drugs
radioactive nuclear medicine tracers
lithium carbonate
chloramphenicol
phenylbutazone
atropine
thiouracil iodides
ergotamine and derivatives
 mercurials

Question 17

strongly avoided drugs when breast feeding

Answer 17

Antipsychotics, antidepressants, metronidazole, tetracycline, sulfonamides, diazepam, salicylates, corticosteroids ,phenytoin, phenobarbital, or warfarin

Question 18

drugs safe in normal doses

Answer 18

Acetaminophen, insulin, diuretics, digoxin, beta-blockers, penicillins, cephalosporins, erythromycin, birth control pills, OTC cold preparations, and narcotic analgesics (short term in normal)

Question 19

1 problem postpartum problem during lactation

Answer 19

Quick onset of painful breast, red, swollen, sting, tender to touch, sometimes fever

cause: staph and strep

Question 20

tx of mastitis

Answer 20

(non beta lactamases) Augmentin, dicloxacillin

Question 21

obstructed ducts tx

Answer 21

Rx-moist compresses and to breast feed on that side to empty it out

Question 22

when do non lactating women ovulate and get menstruate

Answer 22

6-8 wks in the non-lactating (range 6wk to 18 months).