Postpartum Nursing Care Flashcards

1
Q

What stage of labor is the postpartum period?

A

4th stage

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2
Q

How long does the postpartum period last?

A

6 weeks

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3
Q

What are our nursing goals during the post partum period? (6)

A
  • Prevent hemorrhage –> promote perfusion and oxygenation
  • Assist in recovery
  • Identify deviations from normal
  • Provide comfort
  • Promote bonding
  • Education
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4
Q

Describe the let down reflex

A

(1) Stimulation of the nipples sends a signal to the brain –> (2) The brain releases oxytocin causing the milk ducts to expand and contract –> (3) The expansion and contraction moves milk from dripping to actively flowing

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5
Q

Colostrum secretion time frame?

A

First 48-72 hours

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6
Q

Mature milk should arrive in the breasts about when?

A

Around day 3 (however can be between 3-5 days)

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7
Q

A decrease in what two (2) hormone levels allow for the increase of prolactin levels, which promote breast milk production?

A

Estrogen and progesterone

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8
Q

Puerperal Infection

A

Any infection within 28 days of miscarriage, abortion, or birth

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9
Q

Name some common puerperal infections

A
  • Endometritis
  • Mastitis
  • UTI
  • Wound infection
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10
Q

Risks for puerperal infection

A
  • cracks in nipples
  • surgical incision
  • tissue trauma during labor
  • open wound
  • retained placenta or clots
  • increased pH of vagina after birth
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11
Q

Blood draw before or after antibiotics are given to treat an infection?

A

Blood draw before

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12
Q

Mastitis

A

Inflammation of the breast tissue

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13
Q

Causes/risks for mastitis

A
  • poor breastfeeding technique
  • inadequate milk duct drainage
  • blocked milk duct
  • poor hygiene
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14
Q

s/s of mastitis

A
  • flu-like symptoms (fever & chills)
  • redness and warmth of the breast
  • tenderness
  • edema and heaviness of affected breast
  • possible purulent drainage
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15
Q

Mastitis treatment

A
  • breastfeeding
  • moist heat
  • massage the area to improve flow and reduce stasis
  • increase fluid intake
  • supportive bra
  • emotional support
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16
Q

Placenta accreta

A

Abnormal adherence of placenta to uterine wall

  • hole in the uterus when the placenta detaches and/or retained placenta
  • hole often ends in emergency hysterectomy
17
Q

Definition of postpartum hemorrhage?

A

Loss or > 500 mL of blood for a vaginal birth OR loss of > 1000 mL of blood for a c/s

  • can be primary/early (within 24 hrs) OR secondary/late (after 24 hours)
  • change in hematocrit by 10%
18
Q

T T T T mnemonic for PPH causes?

A

Tone, trauma, tissue, thrombin

19
Q

PPH causes related to tone

A

Lack of uterine tone (uterine atony) — soft, spongy, boggy uterus — slow and steady loss of blood

Causes
- repeated uterine distention (multiple gestations/multifetal gestations)
- muscle fatigue from delivery
- unable to empty bladder (pushes on uterus)
- obstetric medications (anesthetics, magnesium sulfate, nifedipine, terbutaline)

20
Q

PPH causes related to trauma

A

Damage to genital structures — uterus, vagina, perineum
- incision from c/s
- from baby passing through vaginal canal
- from medical instruments (forceps, vacuum extraction, episiotomy)

Hematoma — mass or collection of blood
- severe pain
- persistent bleeding

21
Q

PPH causes related to tissue

A

Placental fragments retained in uterine cavity

Prevention
- make sure placenta comes out intact
- remove retained tissue ASAP

22
Q

PPH risk factors

A
  • uterine atony
  • magnesium administration
  • lacerations of the cervix/vagina
  • hematoma development
  • retained placental fragments
  • obesity