Postpartum Nursing Care

Question 1

involution

Answer 1

return to prepregnant state

Question 2

how long should involution take?

Answer 2

6 weeks PP

Question 3

how much should fundal height decrease per day

Answer 3

1 cm

Question 4

causes of subinvolution

Answer 4

infection, retained placenta

Question 5

who is most affected by afterpains?

Answer 5

grand multips, multifetal gestation, polyhydramnios, macrosomia

Question 6

when do afterpains often occur

Answer 6

when breastfeeding, when infant cries

Question 7

when should afterpains resolve

Answer 7

3-7 days

Question 8

common PP bladder concerns

Answer 8

diuresis, decreased urge, distention, incontinence

Question 9

lochia rubra

Answer 9

bright red, 1-3 days

Question 10

when is more lochia expected?

Answer 10

breastfeeding, ambulation

Question 11

lochia serosa

Answer 11

pink/brown, days 4-10

Question 12

lochia alba

Answer 12

yellow/white, day 10+

Question 13

concerning lochia findings

Answer 13

saturating more than 1 pad/hour, golf ball sized clots

Question 14

PP activity restrictions

Answer 14

don’t lift anything heavier than baby, don’t drive for 2 weeks

Question 15

when should the umbilical stump fall off

Answer 15

2 weeks

Question 16

causes of PPH

Answer 16

uterine atony, unrepaired lacerations, retained placenta, coag issues

Question 17

risk factors for PPH

Answer 17

C-section/assisted delivery, LGA, twins, mag sulf usage

Question 18

interventions for PPH

Answer 18

empty bladder, fundal massage, uterotonic meds

Question 19

uterotonics

Answer 19

pitocin, misoprostol, methylergonovine, carboprost, TXA

Question 20

what medication is contraindicated for pts with asthma?

Answer 20

carboprost

Question 21

what medication should be used carefully in pts with HTN

Answer 21

methylergonovine

Question 22

s/s of endometritis

Answer 22

pelvic pain, uterine tenderness, foul smelling profuse lochia

Question 23

s/s of peritonitis

Answer 23

rigid abdomen, abd pain, vomiting

Question 24

what can cause peritonitis?

Answer 24

endometritis

Question 25

s/s of mastitis

Answer 25

quick onset fever, painful, swollen, reddened breasts

Question 26

mastitis tx

Answer 26

abx, feed or pump on affected side, heat before, cold after

Question 27

s/s of PP preeclampsia

Answer 27

headache, high BP, visual disturbances, edema, epigastric pain

Question 28

PP preeclampsia tx

Answer 28

mag sulf, labetalol/hydralazine