Postpartum system changes Flashcards
Vital signs PP
Temperature: slightly ^ -dehydration during labor 1st 24 hrs. Returns to normal within 24 hrs. T = 100.4 or >PP infection suspected. Temp. also rises 3rd -4th day with filling of breast milk Observe for s/s infection -nurse usually 1st to detect ↑ temp. [universal sign of infection 100.4 x 2 readings, on days 2-10 PP]
Pulse: HR ^ slightly x 1st hr.
Stroke volume & cardiac output also ^ x 1sthr. then decreases 8-10 wks.,returns to pre-pregnant state.
Rapid, thready pulse-sign of PP hemorrhage, infection
Hormonal System:
Pregnancy hormones decrease w. delivery of placenta. HCG & HPL disappear by 24 hrs. FSH rises 12 days -to begin new menstrual cycle. Menses resumes by 4-5 wks. if not Br. Fdg.
The Urinary System:
Loss of bladder tone d/t swelling & anesthesia ; urinating difficult. May not feel urge to void.
Hydronephrosis [enlargement of ureters] occurs after delivery & to 4 wks. PP. DIURESIS! ↓ bladder sensitivity -↑ risk for bladder infection -urinary stasis.
Avoid bladder damage -assess bladder q 1-2 hrs.til voids qs. Teach voiding q 2 –3 hours. Palpate abdomen gently, note location of fundus.
When do you suspect full bladder? During preg., 2000-3000 ml. of fluid accumulates in body -Client loses 5-10 lbs. of water weight in 1st wk.
Circulatory System:
Blood volume ^ 30 –50% in pregnancy.
With diuresis & blood loss@ delivery, blood volume returns to normal in 1-2 wks.
Blood loss for NSVD = 300 cc. & C/S = 500 cc.
Non pregnant: HCT=37 -47% & HGB=12 -16g/dL
Pregnant: HCT=32 -42 % & HGB = 11.5 –14g/dL HCT drops by 4 pts. & HGB drops by 1 g. for every 250cc. of blood client loses.
Respiratory System:
Normal range 12 - 20 bpm
Gastrointestinal System:
NSVD: bowels sounds. Eat right away.
C/S: bowel sounds hypoactive 1st 8 hrs.
Epidural/spinal: po clears after delivery, advance diet if +BS.
General anesthesia: usually NPO for ~ 6-8 hrs
Can go home without BM if + flatus
ntegumentary System:
Stretch marks [striae gravidarum] appear reddened on the abdomen. Fade by 3-6 months; Stretch marks may remain.
Modified sit-ups strengthen abdomen
