PP Assessment Flashcards
what 3 processes contribute to the involution of the uterus
- cxn of the muscle fibers
- catabolic processes
- regen of uterine epithelium
how does the site of placental attachment heal?
- exfoliation
benefit of exfoliation
leaves the endometrium smooth and w/o scars
how is involution evaluated?
by measuring the descent of the fundus
how much does the fundus descend per day
1 cm
how long after birth should the fundus no longer be palpable
14 days
describe afterpains
- intermittent uterine cxns
- cause discomfort
afterpains are worse for which women
have had multiple pregnancies
name the lochia classifications
rubra
serosa
alba
how do we assess lochia
amt
type
odor
if lochia has a foul odor, what does that indicate?
endometrial infec
name the different amts of lochia
scant
light
moderate
heavy
scant lochia
<2.5 cm
light lochia
2.5-10 cm
moderate lochia
10-15 cm
hevay lochia
saturated in 1 hr
if pads saturate with lochia more often than every hour, what should we suspect
bleeding
hemorrhaging
how long does it take the vagina to return to pre preg size
6-10 weeks
pernieal trauma and hemorrhoids can interfere with what
activity
bowel elim
what happens with the blood from the uterus and placenta
returns to the central circ
ECF moves to
vascular compartment
after birth, CO _____
increases
how is excess fluid expunged from the body after birth
diuresis/diaphoresis
describe coag after birth
incr in clotting factors
incr in clotting factors after birth puts mom at risk for
clots
constipation occurs due to the following factors
- decr food intake during labor
- decr muscle and bowel tone
- fear of pain during defacation
by when should a mom have a bm after birth
2-3 days post birth
moms may experience urinary retention due to
- incr bladder capacity
- decr semse to fluid pressure
what factors contribute to UTI
-stasis of urine
describe what happens if a mom experiences bladder distention
- displaces the uterus
- can interfere w/ uterine cxn
bladder distention can cause
extensive bleeding
s/s of distended bladder
- fundus above baseline level
- fundus displaced from midline
- excessive lochia
- bladder discomfort
- bulge of bladder above symphysis
- freq voidings of < 150 mL
muscle fatigues/aches occurs for how long PP
1-2 days after birth
breastfeeding may cause a delay in
ovulation and menses
can ovulation occur before the first menses
yes
breastfeeding moms are more likely to experience what and why
vaginal dryness
-due to inadequate estrogen
focused asssesments PP
VS fundus lochia perineum bladder elim breasts lower extrem homans sign edema DTR's
what VS do we check PP
BP OH Pulse RR Temp Pain
risk factors for PP hemorrhage
grand mulitparity overdeistention of uterus rapid, precip, or prolonged labor retained placenta placenta previa/abruptio meds: tocolytics, oxytocin C sec vacuum coag defects
risk factors for PP Infec
c sec mult cervical exams prolonged labor prolonged ROM manual extraction of placenta DM Cath
def bonding
initial attraction felt by parents for their infants
bonding is _____
unidirectional
def attachment
process by which an enduring bond bx a parent and child is developed
when does attachment begin and end
beginning of pregnancy to many moths after birth
