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Exam 3 > Postpartum Nursing > Flashcards

Postpartum Nursing Flashcards

1
Q

Define BUBBLE HEAT

A

B=breast
U=uterus
B=bladder
B=bowel
L=lochia
E=episiotomy
H=hemorrhoids
E=edema
A=attachment
T=teaching

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2
Q

What are some patients risk factors that puts patients at high risk for postpartum hemorrhage

A

Large baby
GDM
Multiple births
Over extended uterus
Operative baby
Use of magnesium sulfate because it relaxes the muscles

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3
Q

What actions should the nurse take immediately with a patient who is experiencing a postpartum hemorrhage

A

-Massage the fundas
-Have patient EMPTY bladder if able or do a straight catheter
-type and screen for need of blood
- admin medication oxytocin
-apply oxygen due to the RBCs (they carry oxygen)
-monitoring vitals

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4
Q

What education is required to a patient at risk of postpartum hemorrhage

A

-Monitor pad counts every hour
- empty bladder do not hold in urine

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5
Q

What follow up care would be needed for a patient who experience postpartum hemorrhage

A

-monitor vitals
-monitor blood loss
-monitor fundal height and continuous fundal massages if needed
-assess L.O.C

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6
Q

What education could you provide to your patients on how to treat a clogged duct

A

-still breast feed to help drain the fluid (milk) and pumping
-paired with WARM therapy , and hand massage

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7
Q

What signs should you be aware of if a patient is having a active postpartum hemorrhage

A

-feeling dizzy, lightheaded, foggy brain
- high HR, low BP
-boggy funds
- increased lochia (bleeding)
-pain, cramping

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8
Q

Define uterus involution

A

The uterus returns to the pre-pregnancy state (back to normal)

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9
Q

Define subinvolution

A

The uterus do not return to normal
- fragments of the placenta are retained in the uterus and risk for infection
-hemorrhage
-infection:
*c - section births
* sitting in bathtub water
* penetrating the vaginal area with any objects

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10
Q

During postpartum when may you expect to see your patient have their bowel movement

A

Between 2-3 days because it will take some time to establish bowel function again

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11
Q

What interventions would you provide to your patient to help with bowel movements

A
  • provide stool softener ( will not cause diarrhea)
    -increase fluid intake
  • promote ambulating
    -increase fiber intake
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12
Q

When your patient is breast feeding why may they feel labor contractions

A

Because the body is releasing natural oxytocin

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13
Q

Define lochia rubra

A

Bright red and small clots are seen

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14
Q

Define lochia serosa

A

Pinkish or brown color
-starts day 3 or 4

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15
Q

Define lochia alba

A

Yellow to white color
- starts day 10-14

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16
Q

When a patient is experiencing lochia is it normal for the patient to go back in color( stages)

A

No this is abnormal and should be assessed

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17
Q

What education would you provide to your patient about how to monitor blood loss

A

Measure using pads
- pad should be changed every hour
-1 pad an hour
- if more pads are being used within that hour then your are bleeding too much

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18
Q

When would you expect to feel an increase of lochia (blood)

A
  • during ambulation
    -breastfeeding
    -stress

*continue to monitor

*clots that are larger that a golf ball should be reported

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19
Q

How should a normal breast look

A

Soft, non tender, and nipples should be intact

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20
Q

What are some ABNORMAL signs of poor breastfeeding

A

Sore and painful nipples that lead to skin cracking
-flat or inverted nipples

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21
Q

If your patient has inverted nipples what intervention could you use to help your patient

A

Use nipples shields
or shells( can be used to prevent friction when not breastfeeding helps with sore nipples)
- have patient pump before feeding to get the nipple to pop out

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22
Q

What education could you provide to your patient to help with sore or cracked nipples and what could the nurse do

A

-Use creams
-air dry skin
-assess latching and that it’s correct

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23
Q

Define engorgement and what can the nurse do or teach the patient to help

A

Engorgement is when there is too much milk in the breast and causes inflammation
-the inflammation then will clog the milk ducts and then leads to a a clogged duct that results in mastitis

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24
Q

When is it expected that the uterus to return back to involution (normal)

A

At 6 weeks postpartum period 60g
- 6 week check up will happen

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25
What type of patients would be at risk for “after pains”
-grand multiparty patients -over distended uterus - marcosomia (big babies) -polyhydramnios (increased amniotic fluid) -twin pregnancies
26
Why does “afterpains” happen
Because the uterus is working harder to contract to get back to normal size so pain will be felt - resolves in about 3-7 days
27
If a patient is having problems with voiding after birth what action would the nurse do
Straight cath patient -use peri bottle
28
When assessing a patient bladder the nurse should
-bladder scan -monitor I&O - straight catheter -use peri bottle to help relax muscles -provide privacy
29
If a patient had an episiotomy why would you use ice packs first before the sits bath
Because cold will constrict blood vessels to help decrease inflammation - the site bath is used to clean the peri area, pain and decrease infection risk
30
What should you educate your patient about when D/C home if they had an episiotomy
They may experience itching and it is normal with healing tissue -assess for smelling discharge, swelling, redness, healing process
31
If you see a patient with edema what would be concerning complication
- if there is one side (unilateral) swelling * risk for DVT
32
Define SIDS
Sudden infant death syndrome -age 1yr and under
33
What are some risk factors to SIDS
-having extra objects in infant crib -having head elevated - co-sleeping - sleeping on belly - only need one blanket -use of a soft mattress and not a firm mattress which is best
34
What would patient center care management look like for SIDS
Client center care * providing education to families *watching SIDS information video before D/c home * educating about not using bumper pads on the crib( poor neck control)
35
What is the best way/position for an infant to sleep and why (teaching moment)
Infants should be sleeping on their backs because the risk of aspiration is decreased * when positioned on your back any fluids will fall back into the esophagus (leading to the stomach) vs laying on your stomach the fluids will fall into the trachea (windpipe)
36
What education would you provide to your patient who had a c-section birth while IN THE HOSPITAL
-foley - to help empty bladder due to movement restrictions, monitor I&O -SCDs- to promote blood circulation and prevention of DVT -incentive spirometer - help with lung expansion/ lung exercise - education on how to monitor incision care and excessive bleeding is not normal ( however it is normal to see blood)
37
Your patient had a c-section what home education would you provide
-Lifting restrictions (lift nothing over 10lbs) - splint the area when coughing
38
What labs would you expect to see for a patient who had a c-section
H&H WBC-(notify doctor if green pus is seen)
39
What medication intervention can you give your patient who had a c-section and what should you monitor
Motrin Q6h Tylenol Q6h *Toradol Q6h 3 doses max (must monitor liver and kidney function)
40
What medication could you give your patient to help with the pain of a episiotomy/laceration
Oxycodone PRN
41
What are the 4 causes of postpartum hemorrhage/bleeding
-uterine atony (TONE) poor contractions, lack of tone and can’t close blood vessels -retained placenta (TISSUE) as the surrounding RBCs are clotting the remaining placenta is not and is still bleeding -unrepaired lacerations (TRAUMA) cuts to other parts of the body -coagulation issues (THROMBIN) poor blood clotting
42
What patients may experience uterine atony
Multiple pregnancies Large babies Too much amniotic fluid Previous c-sections
43
If a doctor has an order for magnesium sulfate for a patient who has postpartum hemorrhage why would you question that order
Mag sulfate will cause the bladder (muscle) to relax
44
What medication would you use caution on for a patient with hypertension
Methylergonovine
45
What medication would you use with caution for a patient with asthma
Carboprost
46
What interventions would a new nurse do to a patient who is active hemorrhage
1 empty the bladder 2 massage the fundas 3 administer infusion of oxytocin by bolus 4 administer uterotonics medicatios
47
What is the leading cause to mastitis
Inflammation -> from a clogged duct (back up of milk)-> from engorgement Best treatment is cold compresses
48
Define mastitis and treatment
* this is a infection * treatment will consist of use of abx Assessment -breast are swollen and red -fever will show within hours -call the doctor -order for abx
49
What are some expected signs and symptoms that you will see for a patient who is experiencing hemorrhoids
-itching -discomfort (anal area) -bright red bleeding with BM -pain (anal area)
50
What education would you provide to your patient if they have questions on when hemorrhoids will go away
Decrease in size usually will happen within 6 weeks
51
What are some signs that a patient is having “normal” attachment to their new infant
-holding the baby -identifying familiar features on the baby -feeding the baby -PARTICIPATING in care for the baby -responding to infant cues
52
What are some abnormal concerns that a patient is not showing or having attachment issues with new born baby
- refuses to interact with infant -does not name the baby -does not hold or feed the baby -expresses disappointment over baby’s sex -sees infant as unattractive
53
What education would you give your patient when being D/c home about lifting things
Don’t lift any heavy objects over 10lbs
54
When should a postpartum patient receive their screening for dood disorders
Screening should be done at the 6 week check up
55
Define postpartum depression
Intense pervasive sadness * that is lasting MORE THAN 2 weeks
56
Define postpartum psychosis
***this can disrupt your sense of reality ~hallucinations and delusions -periods of mania and depression
57
What are some risk factors that can lead to postpartum depression
-Hx of depression -troubled childhood -low self esteem - stressing the home or work life -lack of effective support - different expectations between partners - feeling of disappointment related to birth experience
58
What are some nonpharm treatments to help with postpartum depression
-psychotherapy -cognitive behavioral therapy -counseling -psychodynamic/ interpersonal therapy -aromatherapy -acupuncture -exercise
59
What are some pharmacological treatments to help patients with postpartum depression
-antidepressants -hormone therapy
60
A patient is being screened for postpartum depression what are the doctors looking for within the screening
If the score is greater than 12 then further (action) assessment will be needed
61
What is the name for the postpartum screening scale
Edinburgh postnatal depression scale
62
Define what is Thrombophlebitis
Superficial venous thrombosis * not a fully DVT
63
A patient is found to have thrombophlebitis what are the interventions
-NSAIDS -promote rest -use of compression -education on elevation of lower extremities
64
Define endometritis
Infection of the lining of the uterus
65
What are some S/S that are expected in a patient who has endometritis
-fever -increased HR -chills -anorexia -nausea -fatigue -pelvic pain -UTERINE CONTRACTIONS -FOUL SMELLING DISCHARGE -PROFUSE LOCHIA
66
What are some s/s of a infected wound or incision
-fever -erythema -edema -warmth -tenderness -pain -seropurulent drainage -wound separation
67
What are some s/s of peritonitis
-rigid abdomen -abdominal pain -high fever -increased pulse -VOMITING

Exam 3 (1 decks)

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