PP 2 of test 2

Question 1

What is involution?

Answer 1

the return of the uterus to it’s pre-pregnancy size

Question 2

What speeds up involution?

Answer 2

oxitocin from BF or the drug oxitocin, fundal massage

Question 3

What slows involution?

Answer 3

bottle feeding, anethesia, full bladder, infection, uterin destention (from twins..), placental fragments

Question 4

subinvolution

Answer 4

uterus doesn’t go back to original size

Question 5

What are the 3 types of lochia?

Answer 5

Rubra, serosa & alba

Question 6

What is lochia rubra?

Answer 6

seen in days after birth (3-4) blood and decidual & trophoblastic debris (clots)

Question 7

what is lochia serosa?

Answer 7

by 4-5th day, it starts to change from red to brown (old blood), serum, leukocytes and debris

Question 8

what is lochia alba?

Answer 8

clear, yellow lighter color. can happen up to 6 wks

Question 9

After a few days, how much does the cervix close back to?

Answer 9

2-3 cm

Question 10

How is the abdomen after birth?

Answer 10

decreased muscle tone, striae-red, fades to silver, separation of rectus muscles

Question 11

How is GI after birth?

Answer 11

Risk for constipation

Question 12

How is urinary after birth?

Answer 12

increased capacity, decreased tone of bladder, postpartal diuresis-during 1st 24 hrs, full bladder displaces uterus

Question 13

What does the BP do after birth?

Answer 13

bradycardia of 50-70bpm for 6-10 days

Question 14

Why are they tachacardia?

Answer 14

related to blood loss, fever or difficult, prolonged labor and birth

Question 15

Cardiac output?

Answer 15

increased during pregnancy and stays that way until about 2 wks after birth

Question 16

h&h

Answer 16

decreased during pregnancy, may go up initially after birth but will go back down. 2-6 wks pp, everything normalizes;

Question 17

WBC

Answer 17

can increase around 10-12 days pp, then will decrease

Question 18

EBL for vag and csection birth

Answer 18

vag - 500

c-sect - 1000

Question 19

What do coagulation factors do during pregnancy?

Answer 19

they increase and can put you at risk for thrombophlebitis

Question 20

What is the placenta doing during pregnancy ?

Answer 20

releasing progestrone estrogen hormones. Once its out, levels drop markedly.

Question 21

What is BUBBLE-E

Answer 21

checks to do on pp mom.  
Breast
Uterus
Bladder
Bowel
Lochia
Emotional status
Episiotomy

Question 22

Breast assessment

Answer 22

breast or bottle, palpate for engorgement or tenderness, inspect nipples for redness, cracks and erectility, if nursing

Question 23

Uterus

Answer 23

palpate fundus, firmness, height of fundus and posititon in relation to midline of the abdomen, correlate fundal location w/ expected descent of 1 cm/day

Question 24

Bladder

Answer 24

should void w/in 6-8 hrs after delivery, assess frequency, burning or urgency, able to empty, palpate bladder for distension (incase they can’t empty)

Question 25

Bowel

Answer 25

Assess distention, flatus, bowel sounds. May not have a bowel movement before leaving hospital

Question 26

Lochia

Answer 26

ask how many soaking in an hour. should be a little heavier than reg. period. note color, odor, clots other debris. C-section will still bleed, just less

Question 27

Emotional status

Answer 27

check that they are appropriate for situation, assess for signs of pp depression, how are they interacting with baby

Question 28

Episiotomy/laceration tear

Answer 28

Inspect perineum as well as any other repaired tears. Use REEDA to assess

Question 29

What is REEDA?

Answer 29

perineum inspection:
Redness
Edema
Ecchymosis
Discharge
Approximation