postpartum care (exam1) Flashcards
post partum priorities
prevent hemorrhage
normal sized clots at 24 hours
nickel sized
rubra color up to 3 days post op
dark red
baby blues
2-3 days after birth
gone within 1-2 weeks
improper latch leads to
tenderness
colostrum
precursor to milk
golden yellow - thick secretion
5-10 mL per feeding
when is breast milk produced?
within 72 hours after birth
linea nigra
hormone induced darkened pigmentation
fades after delivery
NORMAL
BUBBLER assessment
breasts
uterus
bladder
bowel - want BM prior to discharge
lochia
extremities
response
LATCH score
latch
audible swallow
type (nipple)
comfort
hold
abdominal incision assessment
R edness
E dema
E ecchymosis
D ischarge
A pproximation
urterine assessment
fundal height
fundal location (midline)
uterine tone (firm)
fundus decreases 1 finger width (1cm) each day
what does a boggy uterus mean?
uterus is not contracting
can lead to PP hemorrhage
perineal edema management
ice packs for 24 hrs - 20 mins on/20 mins off
sittz bath for 24 hrs (enhancing circulation)
clot size that should be reported
larger than a quarter
deep tendon reflexes rating scale
normal +2
pts w preeclampsia
post term skin assessment
dry and cracking
taking in stage post partum
post birth
first 24 hrs
self focused
need to talk about birth
taking hold stage post partum
day 2-3
baby focused
open to learning
letting go stage post partum
interdependent
family moves forwards
lacerations
1st skin tear
2nd muscle tear
3rd continues to anal
4th involves rectal wall
post partum teaching
kegels
exercise - prevent DVT
nutrition - vitamin C
fluids 8-10 glasses water
lactating - 500 cals per day
no tampons / tub baths
post part immunizations
rubella- terategenic during pregnancy
rhogam - Rh- moms @ 28 wks / PP
TDaP - get with rhogam - 27-36wks / PP
influenza - can be given with rhogam
who is at risk for after pains?
pts who breast feed
causes cramping/ contracting of uterus
