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NUR 230 MATERNITY & PEDIATRICS > UNIT 4 POSTPARTUM ASSESSMENT/PHYSIOLOGIC CHANGES CHAPTER 18 > Flashcards

UNIT 4 POSTPARTUM ASSESSMENT/PHYSIOLOGIC CHANGES CHAPTER 18 Flashcards

1
Q

How long does the Post Partum Period last?

A. 12 weeks
B. 6 weeks
C. 7 weeks
D. 24 weeks

A

B. 6 weeks

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2
Q

What does the Post Partum Assessment consist of?

A

Breast - check for cracking/engorgment
U- check fundus firm/ midline at umbilicus
B- bladder (assess for dysuria,
B- ask about bowel movement date/consistency/size
L- lochea amount/ color
E- check extremities ,dvt-unilateral swelling(OR EPISIOTOMY)
H- assess hemmroids use interventions for comfort
E- check mom’s emotional status

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3
Q

A post partum mother whose G- 4 T- 3 P-0 A-1 L-2 is currently experiencing chills and a decreased level of consciousness ? Which of the following assessment finding would indicate her current state?

A. Temp of 110 Farenheight
B. Hematocrit 38
C. WBC 15,4000
D. Sodium level 144

A

A. Temp of 110 Farenheight

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4
Q

Can Preeclampsia occur after delivery?

A. Yes
B. No

A

A. Yes

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5
Q

Is tachycardia a expected fin ding in a post delivery/ Post-partum mom?

A. Yes
B. No

A

B. No

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6
Q

Which of the following is a sign and symptom of Preeclampsia?

A. inconsistent headache mild in intensity
B. Blurry vision
C. Decreased level of consciousness
D. Hypoglycemia

A

B. Blurry vision

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7
Q

FILL IN THE BLANK

Within 24 hours of delivery the uterus should be at _________
(the level of a 20 week gestation)?

A

umbilicus

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8
Q

What is Involution?

A

return of uterus to
prepregnant state

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9
Q

What is Subinvolution?

A

Subinvolution is the failure of the uterus to return to a nonpreg- nant state due to ineffective uterine contractions.

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10
Q

Assessment of the nipples and breast?

should they be hard and cracked?

A. No
B. Yes

A

A. No

Should be soft may be heavy due to milk instruct mom to wear supportive bra

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11
Q

Benefits of Pitocin Post Partum

A

The uterus is very sensitive to oxytocin during the first week or so after birth. Breastfeeding immedi- ately after birth and in the early days postpartum increases the release of oxytocin, which promotes uterine contractions, thereby decreasing blood loss and reducing the risk for postpartum hemorrhage.

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12
Q

All of these finding are a infection that occurs in the breast , what is it called

  1. Localized heat and swelling
  2. Pain; tender axillary lymph nodes
  3. Elevated temperature
  4. Complaints of flulike symptoms
A

Mastitis

Mastitis is inflammation of the breast/chest as a
result of a blocked duct and infection.

Mastitis occurs primarily in breast-feeding/chest- feeding parents 2 to 3 weeks after delivery but
may occur at any time during lactation.

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13
Q

TRUE OR FALSE

the assessment of Uterine Atony is a firm uterus?

A

FALSE

Assessment: A soft (boggy) uterus noted on palpa- tion of the uterine fundus

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14
Q

All of these finding are a infection that occurs in the breast , what is it called

  1. Localized heat and swelling
  2. Pain; tender axillary lymph nodes
  3. Elevated temperature
  4. Complaints of flulike symptoms
A

Mastitis

Mastitis is inflammation of the breast/chest as a
result of a blocked duct and infection.

Mastitis occurs primarily in breast-feeding/chest- feeding parents 2 to 3 weeks after delivery but
may occur at any time during lactation.

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15
Q

Is pain an expected finding after delivery?

A. No
B. Yes

A

B. Yes

Mother may complain of “Afterpain” after delivery educate them that it is a normal finding, and administer pain medications as prescribed

Why does afterpains occur?
Occur as a result of contractions of the uterus
2. Are more common in multiparas, breast-feed-
ing/chest-feeding parents, clients treated with oxytocin, and clients who had an overdistended uterus during pregnancy, such as with carrying twins.

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16
Q

Is pain an expected finding after delivery?

A. No
B. Yes

A

B. Yes

AFTERPAIN
Occur as a result of contractions of the uterus
2. Are more common in multiparas, breast-feed-
ing/chest-feeding parents, clients treated with oxytocin, and clients who had an overdistended uterus during pregnancy, such as with carrying twins.

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17
Q

What is the priority intervention when a pt is experienced Uterine Atony(BOGGY SOFT UTERUS)?

A

MASSAGE THE FUNDUS

Massage the uterus until Firm (Fig. 27.2).

Empty the client’s bladder (by voiding or catheteri-
zation) if that is contributing to the uterine atony.

Notify the obstetrician (OB) or primary health care provider (PHCP) if interventions do not re- solve the atony, because this could be an indica-
tion of hemorrhage.

18
Q

Your 3 day Postpartum patient has reported that she has not had a bowel movement after receiving Docusate on her first day of delivering her baby prior to the planned discharge today. What would be your priority action?

A. Confirm or ask the patient did they pass gas after delivery.
B. Continue with discharge plans
C. Educate the patient on the importance of having a bowel movement after delivery.
D. Notify the HCP

A

A. Confirm or ask the patient did they pass gas after delivery.
Assessment for GI
Color, Odor, Last Void/BM,
and Amount

19
Q

What can a distended Bladder do to the uterus?

A

The uterus will not be midline
The uterus will be deviated

20
Q

FIRM
MIDLINE

A

The uterus should be

firm and midline

21
Q

Should a post partum women pass gas in order to be discharged when there are no present complications in mother or baby?

A. Yes
B. No

A

A. Yes

22
Q

What is the proper way to assess the bowels ?

A

1.Inspect
2.Ascultate
3.Palpate

23
Q

What is Lochia?

A

vaginal discharge you have after giving birth.

24
Q

What are the three consistencies of Lochia?

A

Rubra-Rubra is bright red discharge that occurs from day of birth to day 3.

Serosa-Serosa is brownish pink discharge that occurs from days 4 to 10.

Alba-Alba is white discharge that occurs from days 11 to 14.

25
Q

What type of Lochia is a common finding 1 day post partum?

A. Rubra
B. Serosa
C. Leukorhhea
D. Alba

A

A. Rubra

26
Q

Should Lochia increase in amount over time

A. Yes
B. No

A

B. No

-Discharge should smell like normal menstrual flow.
-Discharge decreases daily in amount. Discharge may increase with ambulation.
-To determine most accurately the amount of lochia low, weigh the perineal pad before and after use and identify the amount of time between pad changes; also note the color,

27
Q

How is the amount of Lochia measured(3 categories)

A

1 pad per hour saturated = heavy

1 pad saturated every 2 hours = light

1 pad saturated than 4 hours saturated = scant

28
Q

Is a presence of clots a. normal finding in ruby lochia?

A. No
B. Yes

A

B. Yes

Clots should not be bigger than a size of a quarter may indicate hemorrhage

29
Q

What are somethings you should check for after the C-section inaction ad Epsitotomy incision?

A

-REDNESS
-EDEMEA
-ECHHYMOSIS
-DISCHARGE
-APPROXIMATION

30
Q

A mother who is disregarding and doesn’t engage with her newborn baby. How would you define her emotional Status to be?

A. Well
B. may be sign of postpartum psychosis
C. may indicate a decrease in emotional status and well being
D. Excellent

A

C. may indicate a decrease in emotional status and well being

Take into account that the mother may be exhausted after delivering baby.

Family Interaction
Infant Interaction

31
Q

Return to Non-Pregnant state

A

Hematological and Metabolic
Decreased Blood Volume
Estrogen, Progesterone, and
Prolactin
Neurological
Fatigue and Discomfort
Renal, Fluid, and Electrolytes
Natriuresis and Diuresis
Respiratory
Decrease in Intra-abdominal
Pressure
Integumentary
Stretch Marks
Cardiovascular
Cardiac Output, Diuresis
Immune
Elevated WBC, RhoGAM, MMR, Tdap
Reproductive
Return of Ovulation and Menstruation
Musculoskeletal
Muscle Fatigue, Diastasis Recti-
abdominis

32
Q

Nipples normal finding vs abnormal finding

A

NORMAL
Skin intact; no soreness reported

ABNORMAL
Redness, bruising, cracks, fissures, abrasions, blisters: usually associated with latching problems

33
Q

Uterus (fundus) normal finding vs abnormal finding

A

NORMAL
Firm, midline; first 24 h at the level of umbilicus;

ABNORMAL
Soft, boggy, higher than expected level: uterine atony
Lateral deviation: distended bladder

34
Q

Perineum normal finding vs abnormal finding

A

NORMAL
Minimal edema
Laceration or episiotomy: edges approximated
Pain minimal to moderate: controlled by analgesics, nonpharmacologic
techniques, or both

ABNORMAL
Pronounced edema, bruising, hematoma
Redness, warmth, drainage: infection
Excessive discomfort first 1–2 days: hematoma; after day 3: infection

35
Q

Rectal area normal finding vs abnormal finding

A

NORMAL
No hemorrhoids; if hemorrhoids are present, soft and pink\

ABNORMAL

Discolored hemorrhoidal tissue, severe pain: thrombosed hemorrhoid

36
Q

Bladder normal finding vs abnormal finding

A

NORMAL
Able to void spontaneously; no distention; able to empty completely;
no dysuria
Diuresis begins 12 h after birth; can void 3000 mL/day

ABNORMAL
Overdistended bladder possibly causing uterine atony, excessive lochia
Dysuria, frequency, urgency, burning: infection

37
Q

Abdomen and bowels normal finding vs abnormal finding

A

NORMAL
Abdomen soft, active bowel sounds in all quadrants
Bowel movement by day 2 or 3 after birth
Cesarean: incision dressing clean and dry; suture line intact Deep tendon reflexes (DTRs) 11 to 21

ABNORMAL
No bowel movement by day 3 or 4: constipation; diarrhea
Abdominal incision—redness, edema, warmth, drainage: infection

38
Q

Legs normal finding vs abnormal finding

A

NORMAL
Deep tendon reflexes (DTRs) 11 to 21
Peripheral edema possibly present

ABNORMAL
DTRs  31: preeclampsia
21 or more pitting edema: possible fluid overload

39
Q

Energy level normal finding vs abnormal finding

A

NORMAL
Able to care for self and infant; able to sleep

ABNORMAL
Lethargy, extreme fatigue, difficulty sleeping: postpartum depression

40
Q

Emotional status normal finding vs abnormal findings

A

NORMAL
Excited, happy, interested, involved in infant care

ABNORMAL
Sad, tearful, disinterested in infant care: postpartum blues or
depression

NUR 230 MATERNITY & PEDIATRICS (40 decks)

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