Postpartum Care Flashcards
when is the uterus considered a pelvic organ after birth
2wks
when does the uterus return to pre pregnany size
4 wks
progression of lochia and when does it resolve
rubra–> serosa –> alba
6 wks
what is lochia
sloughing of the decidua, and contains decidua, epithelial cells, erythrocytes, and bacteria
is leukocytosis common after birth
yes
leading cause of maternal mortality
unrecognized maternal hemorrhage
normal blood loss in birth
500 ml/min
second degree perineal involvement
superficial muscle involvement
third degree perineal involvement
rectal sphincter torn
4th degree perineal involvement
tear into the rectum
endomyometritis tx
Gentamycin/Clindamycin (Gold Standard)
how to tell if mom has infection post puerperium
fever*
leukocytes are gonna be elevated regardless, not goo d indicator
sheehans syndrome
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
when does ovulation occur in a mom that breast feeds
may not return until lactation ceases
when can oral contraceptives be started
4 wks postpartum
PROGESTERONE only
drugs that are absolutely contraindicated in breast feeding
chemotherapy drugs alcohol, drugs radioactive nuclear medicine tracers lithium carbonate chloramphenicol phenylbutazone atropine thiouracil iodides ergotamine and derivatives mercurials
strongly avoided drugs when breast feeding
Antipsychotics, antidepressants, metronidazole, tetracycline, sulfonamides, diazepam, salicylates, corticosteroids ,phenytoin, phenobarbital, or warfarin
drugs safe in normal doses
Acetaminophen, insulin, diuretics, digoxin, beta-blockers, penicillins, cephalosporins, erythromycin, birth control pills, OTC cold preparations, and narcotic analgesics (short term in normal)
1 problem postpartum problem during lactation
Quick onset of painful breast, red, swollen, sting, tender to touch, sometimes fever
cause: staph and strep
tx of mastitis
(non beta lactamases) Augmentin, dicloxacillin
obstructed ducts tx
Rx-moist compresses and to breast feed on that side to empty it out
when do non lactating women ovulate and get menstruate
6-8 wks in the non-lactating (range 6wk to 18 months).
