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maternal child health RN > Powerpoints Test 2 Module 4 > Flashcards

Powerpoints Test 2 Module 4 Flashcards

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1
Q

Begins immediately after birth and continues for approximately 6 weeks or until the women’s reproductive system returns to its pre-pregnant state.

A

Postpartum

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2
Q

Postpartum nursing interventions

A

Bonding: encourage patients to see, hold, and touch their newborn
>Taking in: focus is caring for self
>Taking hold: focus is on caring for the baby
>Letting go: focus is on the family unit
•Postpartum “Blues” vs. Postpartum depression

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3
Q

Uterus-

? is the retrogressive return to normal condition after pregnancy

Immediately after delivery what should you see:

A

•involution

-Fundal height is midway
•Afterpains
•***Non-Pregnant 2 oz/2 lbs 4 oz

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4
Q

Factors that affect involution

Slow?

Enhanced ?

A 
Slow Involution
•Prolonged labor
•Anesthesia or excessive analgesia
•Difficult birth
•Grand multiparity
•Full bladder
•Incomplete expulsion
Enhance Involution
•Uncomplicated labor and birth
•Complete expulsion
•Breastfeeding
•Early ambulation
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5
Q

Normal involution of the uterus each day

A
  • The height of the fundus then decreases about one finger breath (approximately 1 cm) each day.
  • 14 Days~ not palpalable
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6
Q

How to assess a fundus

A

Check for

  • Consistency
  • Position
  • Height
  • Tenderness
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7
Q

The uterus rids itself of the debris remaining after birth through a discharge called what?, which is classified according to its appearance and contents.

A

Lochia

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8
Q

The composition of lochia is made up of:

A

Endometrial tissue
•Epithelial cells
•Erythrocytes
•Leukocytes

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9
Q

How should you have rubra (red) discharge after birth?

What should It look like ?

When to know it’s abnormal?

A

1-3 days

Bloody & clots
Increased flow:
- breastfeeding
- standing
- physical activity

Foul Smell
Large clots
Quickly
saturates pad

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10
Q

How should you have serosa pink/brown discharge after birth?

What should It look like ?

When to know it’s abnormal?

A

3-10 days

Blood & mucous consistency

Foul Smell
Large clots
Quickly saturates pad

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11
Q

How should you have alba white/yellow discharge after birth?

What should It look like ?

When to know it’s abnormal?

A

10-14 days or longer

Mostly mucous
No strong odor

Foul Smell
Red/pink
Lochia return

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12
Q

How to assess ones pad/lochia after giving birth

A

Assessment
•Type & Amount
•Presence of odor
•Presence of clots

Scant amt - 1inch
Light-4 inches
Moderate-6inch
Heavy -heavy in 1 hour

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13
Q

Assessment of Perineum

REEDA

A
  • R-redness
  • E-edema
  • E-ecchymosis
  • D-drainage
  • A-approximation
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14
Q

Breast Care:

Lactating Mother

A

Keep breasts clean and dry (use breast pads as needed)

•Report sore or cracked nipples to lactation nurse

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15
Q

Breast Care: Non-Lactating Mothers

A

Firm, supportive bra for 3-4 days
•Apply cold compress for 15 minutes as needed
•Clean, raw, green cabbage leaves for swelling or discomfort
•Pain medicine as needed
•Do not massage or apply heat to the breast
•Educate on Comfort Measures, such as ice packs and ibuprofen
•Discuss breast engorgement and breast pads for leaking

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16
Q

Normal immediate weight loss after birth

A

Immediately weight loss?
•afterbirth is 13 pounds, which accounts for the fetus, placenta, and amniotic fluid

  • Loss of extra-cellular fluid weight loss?
  • leads to an additional loss of 5 to 15 pounds during the puerperium.
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17
Q

What may cause difficulty voiding after birth and when should it diminish

A

Effects of anesthesia or trauma to the bladder from delivery may prevent the bladder from emptying completely.

Effects of trauma to the urethra and bladder should typically diminish in 24 hours.

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18
Q

Nursing interventions for bladder emptying

A 
I&O for 24 hours post
•Void every 3-4 hours.
•Voiding at least 150 ml.
•Unable to void at 6 hours post-delivery
•Foley catheter should be left in place if more than 700ml output, prevention of hypotension post bladder decompression.
•Peppermint oil in the toilet
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19
Q

How much blood one looses vaginally and c-section?

A

Increase in circulating blood volume during pregnancy

  • Blood loss:
  • vaginal delivery ~ 500 mL
  • cesarean delivery ~ 800 and 1000 mL.

•Due to the increase in circulating blood volume during pregnancy, blood loss at delivery can be managed in normal healthy person.

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20
Q

Reason for diuresis (urge to urinate) after pregnancy

A

Excess fluid
3000 mL of fluid per day
Diaphoresis

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21
Q

GI assessment after birth

What GI risks do one have after birth?

A

Assess bowel sounds, distention, and flatus
•Effects of anesthesia, medications (magnesium sulfate, and narcotics), hemorrhoids, episiotomy, lacerations, dehydration, immobility, and fear of pain place the mother at risk for constipation.
•Gaseous distention can occur for 2-3 days follow birth from a decrease in gastric mobility and muscle tone, and relaxation of the abdominal wall.

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22
Q

Normal GI output after birth

Fears of postpartum mom and GI and birth?

A

Constipation can occur from the lack of fluid and food intake during labor

  • Bowel tone is sluggish as a result of elevated progesterone levels.
  • Often patients are hesitant to have a bowel movement due to pain in the perineal area that is cause by an episiotomy, lacerations, or hemorrhoids.
  • Some patients are also fearful that they will rip their stitches during a bowel movement.
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23
Q

Postpartum constipation prevention

A

Discuss fears about sutures and perineal changes
•Advise early and frequent ambulation
•Discuss side effects of medications
•Encourage drinking 6-8 glasses of water/day
•Eating high fiber diet
•Sitz baths for pain management and topical anesthetics to help control perineal pain.
•Normal bowel activity returns 2-3 days postpartum.

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24
Q

Hemorrhoid statistics in postpartum women

A

•In a prospective study of 165 pregnant women

  • 7.8% experienced thrombosed external hemorrhoids in late pregnancy
  • 35% experienced anal lesion in the postpartum period
  • 20% thrombosed external hemorrhoids in the postpartum period
  • 15% anal lesions in the postpartum period.

•91% of these women had hemorrhoids on their first postpartum day. **

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25
Q

Hemorrhoid education in postpartum women

A

Avoid straining during bowel movements.
•Drink plenty of water and eat a diet high in fiber.
•Take stool softeners as advised by your provider.
•Walking helps with normal bowel elimination.
•Narcotic medications may contribute to constipation.

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26
Q

Why anal incontinence occurs after birth

A

The most common cause of fecal incontinence in healthy women is childbirth trauma.
•Mechanical disruption in the anal sphincter
•Damage to the nerves

  • Rectovaginal fistula can occur after episiotomy breakdown, increased with 3rd and 4th degree lacerations.
  • Anal sphincter damage may not manifest until years following childbirth.
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27
Q

Anal Sphincter Repair and education regarding future pregnancies

A

Women who have undergone secondary repair of the anal sphincter should be counseled regarding future pregnancies and vaginal deliveries.

•Experts advise that women who have had damage to their anal sphincter, should opt for a planned cesarean birth.

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28
Q

What happens to ones diaphragm (respiratory) during and after pregnancy

A

As the diaphragm raises near term
•thoracic rather than abdominal breathing in the third trimester

•The diaphragm descends following delivery and the postpartum breathing returns to the pre-pregnant state.

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29
Q

separation of abdominal muscles

A

•Diastasis Recti

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30
Q

What happens to ones muscle tone after pregnancy

education

A
  • The abdominal wall is weakened and the muscle tone is decreased after pregnancy.
  • Patients should be instructed to perform light abdominal exercises to regain abdominal tone to improve the separation.
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31
Q

Telogan effluvium

When it goes back to normal?

A

• Normal hair patterns return in 6 to 15 months after delivery.

Hair loss

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32
Q

To Who and when is the flu vaccine recommended to

A

Recommended October through April

  • Women who will be pregnant during influenza season
  • Caregivers of children from birth to age 5
  • Health care workers
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33
Q

Rhogam injection

When and how it’s administered

side effects

A

IM injection

  • Administered around 28 weeks gestation in the clinic
  • Administer within 48 hours after delivery
  • Side effects:
  • Irritation at injection site
  • Fever
  • Lethargy
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34
Q

made up of antibodies called immunoglobulin, that help protect a fetus from its mother’s antibodies. It prevents the Rh-negative mother from making antibodies during her pregnancy.

A

Rhogam injection

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35
Q

Types of postpartum pain

A

Most patients experience some discomfort

  • Causes of discomfort include:
  • Episiotomy or laceration repairs
  • Hemorrhoids
  • Afterpains or cramps
  • Breast engorgement
  • Cesarean incision site pain
  • Gas pain
  • Postpartum Uterine Infection
  • Right Shoulder pain after C-Birth or Tubal Ligation
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36
Q

Postpartum Pain interventions

A

Eliminate or reduce pain to tolerable level

•Use pain medications as needed, and as prescribed
•Alternative comfort measures
-K-pad
-Massage/touch
-Guided imagery
-Movement (walking for gas pains)
-Ice pack
-Breathing exercises
-Relaxation
-Sitz baths
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37
Q

Postpartum fever-

First day vs 24 hours

Nurse should be aware of what?

A

First postpartum day

  • > 101.0 F (38.3 C)
  • Dehydration effects
  • > 24 Hours
  • > 38 Degrees Celsius (100.4 F) after the first 24 hours.

Important to Note:
Nursery staff should be made aware of maternal temperature.

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38
Q

Blood from severed vessels of placenta may cause

A

Pph

Postpartum hemorrhage

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39
Q

Risk factors for postpartum hemorrhage

A
  • Antepartum
  • Pre-Eclampsia
  • Multiparity
  • Multiple gestation
  • Previous PPH
  • Previous C-section
  • Intrapartum
  • Pitocin augmentation/induction
  • Prolonged third stage
  • Instrument assisted vaginal delivery
  • Shoulder dystocia
  • Episiotomy/laceration
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40
Q

S/s of postpartum hemorrhage

A 
Copious vaginal bleeding
•Increased abdominal girth
•Persistent unrelieved pain
•Tachycardia, early sign
•Tachypnea
•Hypotension, possibly late sign
•Lightheadedness and/or dizziness
•Pallor (pale skin)
•Cool clammy skin
•Oliguria (less than 30ml of urine per hour)
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41
Q

Postpartum hemorrhage causes

A

Think of 4 T’s

  • Tone- uterine atony – most common
  • Trauma- Laceration/inversion
  • Tissue- Retained placental tissue
  • Thrombin- Depleted coagulation factors
****Iatrogenic
•Oxytocin induction or augmentation
•Forceps or vacuum extraction
•Magnesium Sulfate
•Distended bladder
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42
Q

PPH- retained placenta -

How long is considered retained?

Treatment?

A

Failure to deliver placenta after 30 minutes

  • Treatment
  • Gentle cord traction
  • Manual extraction
  • Consider dose of antibiotic therapy after
  • Find cleavage plane b/t placenta and uterus
  • Advance fingertips cleaving the placenta free
  • If no plane, consider placental insertion problem and need for the OR
  • May need additional pain management if no epidural/spinal
  • Consider injection of 20 units of Pitocin in the umbilical vein
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43
Q

PPH- uterine inversion

Cause and tx?

A

Rare

•Cause: Uterine atony/congenital weakness/cord traction
Tx-
•Prompt recognition is key
•Do not remove placenta
•Use your fist to replace the uterus
•Uterus not replaceable due to contraction ring
•Use Nitroglycerin or terbutaline
•If fails, go to OR for general anesthesia

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44
Q

Pph

Uterine atony

What is it ?

Common?

A

Hypotonia of the uterus

  • The placenta circulates 750-1000ml of blood every minute, therefore, failure of the uterus to contract after placental separation can result in a significant blood loss.
  • Accounts for 80% of all hemorrhages
45
Q

Pph prevention

A

Management of anemia in pregnancy

  • Appropriate labor management
  • Appropriate patient selection for induction
  • Third stage management
  • Initiate Pitocin immediately after infant delivery
  • Fundal Massage

•PPH is one of the few obstetric complications with an effective preventive intervention. ***

46
Q

Pph treatment

A

Pitocin – begin after delivery of infant

  • Massage uterus
  • Inspect vaginal vault/cervix/placenta
  • EMPTY BLADDER!!!!!
  • Methergine 0.2mg IM every 15min x 3 doses
  • Contraindicated in HTN disorders
  • Hemabate 0.25mg IM every 15min x 5 doses
  • Contraindicated in reactive airway disease
  • Misoprostil 1000mcg PR x1
47
Q

Pph general management

A

Fundal massage, support lower uterus while massaging fundus.

  • Weigh pads
  • Assess VS q 5-10 minutes until stable
  • Apply pulse oximeter-administer oxygen per facility protocol
  • I & O-insert indwelling
  • Pain assessment- administer medications
  • Elevate patient legs 20-30 degree to increase venous return
  • Have tamponade balloon and resuscitation equipment ready
48
Q

Pph drug therapy

A
  • Oxytocin
  • Methylergonovine (Methergine)
  • Prostaglandins
  • Hemabate
  • Dinaprostone (Prostin E2)
  • Misoprostol (Cytotec)
49
Q

How to give oxytocin with PPH

Danger with infusions ?

A

20 units/Liter

  • Avoid IV push~ causes vasodilation
  • Fluid Overload is a potential danger with Oxytocin infusions.
50
Q

How to give Methylergonovine (Methergine)

How often?

Med type?

What patients to avoid?

A
  • 0.2 mg IM
  • Q 2-4 hours
  • Vasoconstrictor
  • Avoid with hypertensive patients and any cardiac history
  • Avoid with Asthmatic patients
51
Q

Hemabate with PPH

How to give

Patients to avoid?

May cause what?

A

Q 15-90min IM: 0.25mg

  • 8 doses max
  • Cause significant GI issues: Consider using Lomotil
  • Avoid with asthmatics, patients with hepatic, renal or cardiac diseases
52
Q

PPH:
Misoprostol (Cytotec)

How to give?

  • Causes the uterus to do what?
  • Do NOT handle cytotec when?
A

600-1000 micrograms rectally x 1

  • Causes the uterus to contract and expel any remaining fragments/blood
  • Do NOT handle cytotec if you are pregnant or trying to get pregnant.
53
Q

silicone, obstetrical balloon specifically designed to treat postpartum hemorrhage (PPH).

The device is used for the “temporary control or reduction of postpartum hemorrhage when conservative management of uterine bleeding is warranted.

A

Bakri balloon

54
Q

Know lacerations after birth

1-4th degree

A

1- slight tear

2-superficial - stop before hitting anus

3- hit top of anal sphincter-external

4 -hit internal anal sphincter and rectal mucosa

55
Q

Hypertensive disorders in pregnancy

A

Chronic Hypertension (of any cause)

  1. Gestational Hypertension or PIH
  2. Preeclampsia superimposed on Chronic Hypertension
  3. Preeclampsia-Eclampsia
56
Q

Labetalol (Trandate)

Type of med

Does what?

Contraindicationed in who?

Side effects?

A
  • Beta Blocker
  • Decreased BP without decreasing maternal heart rate or cardiac output
  • Crosses placenta
  • Side effects: Hypotension, Dizziness, N/V, Bradycardia (maternal and fetal)
  • *****Contraindicated in women with asthma or hypoglycemia
57
Q

Hydralazine (Apresoline)

Used for ?

Precautions?

When to repeat dose?

Side effects?

A
  • Most widely used agent for acute hypertension
  • Extremely safe
  • Do not allow pressure to fall below 90 to prevent further blood flow to placenta and fetus.
  • Dose can be repeated every time diastolic pressure reaches 110mmHg
  • Side effects: Tachycardia, dizziness, faintness, headache, palpitations, numbness, or disorientation. Fetal effects are low heart rate and low Apgar at 1 minute.
  • Contraindicated in patients with hypertension and tachycardia.
58
Q

Seizure in pregnancy associated with pre-eclampsia

  • May occur up to ? hours after delivery
  • nursing interventions?

Medications? Route ?

A

eclampsia

  • May occur up to 48 hours after delivery
  • Protect airway – patient on side, O2
  • Get help
  • Mg sulfate 6gm IV bolus
  • If has Mg running give 2 gm bolus
  • If no IV 5g IM in each buttock for 10g total
  • Benzodiazepines
59
Q

How Long seizures and bradycardia typically last in eclampsia

A

Seizures seldom last more than 3-4 minutes (usual duration 60-75 seconds)

Fetal Bradycardia lasting 3-5 minutes is a common finding during and immediately after eclampsia

60
Q

Eclampsia management

And documentation?

A

Prevent injury

  • Avoid pushing drugs through direct venous access
  • Do put anything in the mouth
  • Maintain oxygenation
  • Minimize aspiration

•Pharmacologic agents
Valium is no longer the first line agent to stop seizure activity, depresses fetus and decreases maternal gag reflex

•Maternal and Fetal Status
uterine hyperstimulation and fetal bradycardia are common responses in postictal state

•Document time of onset, associated symptoms, and duration of seizure

61
Q

Drug used to prevent seizures in preeclampsia
•Acts as a CNS depressant and smooth muscle depressant
•Prevents or lessens seizures by elevating seizure threshold
•Dilates vessels and increases cerebral perfusion
•Blood pressure will decrease initially due to vasodilatation, but decrease does not continue with prolonged infusion (may need anti-hypertensive medications also)

  • ***High Risk Medication
  • Double Check
  • Must be on its own IV pump and not hung as secondary
A

Anticonvulsant

Magnesium sulfate

62
Q

Postpartum family education

A

Both mother and the family support system needs to have information about normal and abnormal mood changes.
•Rest and good nutrition can help most mothers overcome the normal psychological adjustments.

63
Q

Depression during pregnancy

What might it lead to?

A

Assessment may be difficult in pregnancy because symptoms of pregnancy may mimic depression
•If untreated, may lead to Postpartum Depression

64
Q

Postpartum

Psychological Disorders

A
  • Baby Blues
  • Postpartum depression
  • Postpartum psychosis
  • Anxiety Disorders
  • Panic Disorder
65
Q

Typically begins Postpartum Day 3 and can last 2-3 days
•symptoms subside by the second week.
•Coincidences with the normal physiologic drop in estrogen, progesterone and prolactin levels.
•Occurrence is 3-50% of women

A

Postpartum baby blues

66
Q

Postpartum Baby Blues:

Symptoms

A
  • Inability to cope
  • Fatigue
  • Anxiety
  • Irritability
  • Tearfulness
  • Insomnia
  • Weepiness
  • Headaches
  • Poor Concentration
  • Affective lability
67
Q

Symptoms include: agitation, confusion, insomnia, delusions, hallucinations, and rapid mood swings
•5% of women may commit suicide and
2-4% may harm the infant
•is a Psychiatric Emergency
-Incidence 1-2 per cases per 1000 births

A

Postpartum psychosis

68
Q

Postpartum psychosis nursing interventions

A
  • Recognize the signs and symptoms and realize these women may be experiencing feelings of guilt or shame
  • Women may find it difficult to share these feelings with the nurse or provider but the nurse should encourage the mother to share any negative emotions she may be experiencing
  • Include support person(s) in DC teaching
69
Q

Maternal Depression:

Effects on Infant Behaviors

A 
Fussier
•More avoidant
•Fewer positive facial expressions
•Fewer positive vocalizations
•Early unplanned weaning
70
Q

is the phrase used to describe the time in a baby’s life when they cry more than any other time.

begins at about ? weeks of age and continues until about ? months of age?

During this phase of a baby’s life they can cry for hours and still be healthy and normal.

State mandated to do what?

A

The Period of PURPLE Crying

2 weeks until 3-4 months

Educate families about this

71
Q

How to smooth a purple crying infant

A

Feed your baby.

Hunger is the main reason a baby will cry.

Burp your baby.

Give your baby a lukewarm bath. …
Massage your baby. …

Make eye contact with your baby and smile.

Kiss your baby.

Sing Softly.

Hum in a low tone against your baby’s head.

72
Q

How much is total volume of lochia ?

A

About 225ml

Varies by 150-400mL

73
Q

What time of day is one expected to have the most lochia

A

Greater in the morning because of pooling

74
Q

What women have more lochia

What women have less?

A

More- multipara women , vaginal births

Less- first time moms, c-section births

75
Q

Following delivery the cervix looks how?

External Os look?

Internal Os? Closes when?

A

Edema and bruised

Slit vs dimple prior to birth

Closes by 2 weeks following delivery

76
Q

The vagina after birth

A

Will never return to the pre-pregnant size

Dryness and pain due to decreased estrogen levels

Encourage water based lubricants to ease pain

Mucous production returns with ovulation

77
Q

Vulva after birth

A

May appear bruised early in the puerperium due to pelvic congestion which goes away after delivery

Gradually regains tone of the pelvic floor in the first 6 weeks due to decreased estrogen

78
Q

Perineum after birth?

A

Skin stretches and thins

Lacerations and episiotomies

Swelling

79
Q

Physiology of the breast after birth

  • what stimulates milk glands
  • hormone responsible for milk let down
  • Separation of placenta from uterine wall creates a drop in progress strong levels and increase in estrogen

What else ? Size/color?

A

Prolactin - stimulates milk glands

Oxytocin

Lactogensis 2

Increase in size

Darkened areola

80
Q

How to asses breasts after birth

A

Condition of breasts and nipples

Comfort/cream, gels?

Assess infant latch

81
Q

How common is urinary incontinence during and after birth?

S/s?

do they resolve?

A

30-60% of women During

6-35% after

S/s- mild Leakage

The issues resolved in the postpartum period In 70% of those affected

82
Q

How to resolve urinary incontinence

A

Kegels- contracting your pelvic floor muscles like your peeing and stopping it mid flow. Repeat 10x

Work up to keeping muscles contracted for 10 seconds at a time

83
Q

GI system after pregnancy

A

Hungry and thirsty after delivery due to energy used during labor

Diaphoresis leads to thirst

84
Q

What to do before giving food and drink after birthing

A

Evaluation of postpartum status

85
Q

Rubella vaccination - what to educate

A

Prevents fetal anomalies

Pregnancy prevention should occur 4 weeks following vaccine

86
Q

RH factor

Transfer of RBC occurs when there is a defect or break in the placental membrane

This is the cause of what

A

RH sensitization

87
Q

RH factor

Antibodies develop leading to possible harm to future pregnancies with?

A

RH positive infants

88
Q

RHogam given for who

Prevents ?

When tonadminister?

A

Rh negative mother/Rh positive baby

Prevents sensitization of mother

Administer after each delivery and after uterine injury and/or tests such as miscarriage Or amniocentesis

89
Q

Postpartum hemorrhage
s/s?

Who it affects?

How much blood is considered PPH? Vaginally and c-section?

Decrease in what lab ?

How common?

A

Hemodynamic instability - light headed, tachycardia, hypotension

500ml- vaginally
1000ml C-section

10% decrease in hemacrit

Vaginal- 4%
C-section- 6%

90
Q

Ways to clear retained placenta following delivery

A

Manually

Sharp curettage

91
Q

PPH general management

BLEEDING

A 
B- Blood loss needs
L-loss estimation 
E-etiology, uterine, laceration, hematoma 
E- EBL replacement 
D- drug therapy 
I-intraoperative 
N- non-obstetrical 
G- general complication assessment
92
Q

PPH and fluid and blood replacement

How much fluid and what kind?

Additional Blood replacement depends on?

And?

A

3:1 blood loss replacement with lactated ringers or normal saline - 3mL for every 1mL of blood loss to maintain cardiac output

Depends on pt status and health hx

Oxygen administration

93
Q

Emergency blood type administration?

A

O negative

94
Q

I and o measurement is indication of what?

A

Adequate organ perfusion and oxygenation

95
Q

Cathedar is invasive or non ?

A

Non invasive

96
Q

How does aldosterone and angiotensin assist circulatory blood volume

A

Conserves fluid volume

97
Q

Why might the uterus fail to contract or remain firm during involution?

A

Placental separation after delivery exposes large uterine blood vessels which are normally closed off the uterine contractions

98
Q

What to do if ones uterus fails to contract

A

Fundal massage

Oxytocin admin

Natural oxytocic substances release during breast feeding help stimulate contractions

99
Q

First line tx for post partum hemorrhage

Given when

A

Oxytocin

After delivery to prevent uterine atony

100
Q

What to monitor with oxytocin

High alert med - what is required ?

Complications?

Document what?

A

I&O

Independent double check to verify patients identity and med correction/dose/route/pump settings

Can cause anaphylactic reaction, cardiac arrhythmia, hypertensive episodes, nausea, vomiting, hemorrhage, uterine rupture

Document the response to oxytocin, blood pressure, pulse rate and pattern, respiratory rate—
Document rate, input and output, effect on uterine atony and postpartum hemorrhage. Document that teaching was performed in that patient comprehends your teaching

101
Q

Women me excrete up to how many milliliters of blood per day after 12 hours postpartum?

What should they be educated on?

A

3000 mL

They should be educated about sweating, increased urination, and perspiration during this period

102
Q

Bladder tone after delivery

A

Diminished tone resulting in inability to feel the need to urinate

103
Q

What does a full bladder due to the uterus

What to do after delivery?

A

A full bladder displaces The uterus upwards and laterally to the right and

prevents contraction of the uterus

This causes uterine atony which increases risk of PPH

104
Q

Healing of perineum occurs within when?

A

The first two weeks but it may take up to 4 to 6 months to completely heal

105
Q

What does the type and amount of Lochia after birth determine

A

Infection, normal uterine involution, the stage of healing of the placenta site.

and progressive change from bright red at birth to dark red to pink white or clear should occur

106
Q

How does the placenta site heal?

A

By the process of exfoliation

107
Q

Immediately after birth of placenta , then uterus contracts to the size of a

During pregnancy the uterus is increased how many times it’s non-pregnant size

WT of non pregnant uterine

A

large grapefruit

11x

2oz

108
Q

PPH hematoma s/s

A

Increased pelvic pain and or rectal pressure

Reddish blue mass visualized

109
Q

Tx of PPH hematoma

A 
Contact provider 
Monitor
Inspection 
Increase IV fluid rate 
Record vitals 
Evaluate color 
Type and amount of blood loss

maternal child health RN (15 decks)

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