Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

OB > Week 2 Postpartum > Flashcards

Week 2 Postpartum Flashcards

1
Q

What is the most major thing to observe for in a postpartum mom?

A

Hemorrhage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What 5 assessments are done to detect PPH

A
  • VS
  • Fundal location and tone
  • Bladder
  • Lochia
  • Peri and Labial areas
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How often are postpartum VS taken?

A

q15 minutes for the first 4 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

WHat is the most common reason for excessive PP bleeding?

A

Uterus doesnt contract and compress open vessels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What aspects are noted during a fundus assessment?

A
  • Firmness
  • positioning
  • Height
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How do you prevent prolapse or inversion when performing a fundal assessment/ uterine massage?

A

By supporting the lower segment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How often should a fundus assessment be done?

A

With every vital check

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are normal findings for a fundus assessment?

A

at U and ML
or Below the ML
(measured in finger breaths)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

If the uterus is boggy what do you do?

A
  • Assess for hemorrhage
  • Massage uterus
  • Increase pitocin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

A full postpartum bladder can lead to a PPH. Why?

A

Because the full bladder will not allow for an appropriate uterine contraction and thus the uterus will not be able to close the exposed vessels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

If the fundus is _____ upon assesment, a full bladder should be suspected

A
  • Above the U

- Displaced to one side (usually the right)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How much should the post partum mother void?

A

250ml or more

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the guide line for maximum Lochia flow?

A

One fully saturated pad in an hour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What do you assess for when inspecting the postpartum peri and labial areas?

A

-Hematoma formation

if rapidly expanding it will enlarge tissues and cause large amounts of pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the guideline for inspecting episiotomy’s or and other incision?

A

REEDA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What does REEDA stand for?

A 
Redness
Edema
Ecchymosis
Discharge
Approximation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the three main methoids of promoting postpartum comfort

A
  • Ice
  • Analgesics
  • Warmth
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

When/how should ice be applied postpartum?

A
  • Promptly after delivery

- 10-20 min intervals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How is warmth provider postpartum?

A

Warm blankets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

When assessing Abdominal dressings, what should be checked? three things

A

Clean
Dry
Intact

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

If there is drainage on the dressings what do you do?

A

Depending on the amount, you reinforce, or mark the edges and reassess to see if expanding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

When providing post-op pain relief, how long do you follow the anesthesia orders before moving over to OB/FP?

A

24 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

An APGAR score of 0-3 =

A

Severely Depressed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

An APGAR score of 4-6 +

A

Moderately depressed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

An APGAR score of 7-10 =

A

Excellent condition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

When/How often is APGAR assessed?

A

at 1 minute and 5 minutes sometimes at 10 minutes as well

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Whar does APGAR stand for?

A 
Appearence
Pulse
Grimace (reflex irritability)
Appearance
Respirations
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is an APGAR 0 score for activity?

A

Absent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is an APGAR 0 score for Pulse

A

Absent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is an APGAR 0 score for Grimace

A

Flaccid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is an APGAR 0 score for Appearance?

A

Blue, pale

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is an APGAR 0 score for Respirations?

A

absent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is an APGAR 1 score for Activity?

A

Arms and legs flexed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What is an APGAR 1 score for Pulse

A

Below 100

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What is an APGAR 1 score for Grimace?

A

Some flexion of extremities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What is an APGAR 1 score for Appearance?

A

Body pink extremities blue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What is an APGAR 1 score for Respirations

A

Slow, Irregular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What is an APGAR 2 score for Activity?

A

Active movement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What is an APGAR 2 score for pulse?

A

above 100

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What is an APGAR 2 score for Grimace?

A

Active motion (sneeze, cough, pull away)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What is an APGAR 2 score for Appearance?

A

Completely pink

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What is an APGAR 2 score for respirations

A

Vigorous cry

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

An APGAR of at least __ is needed before prolonged skin 2 skin is allowed

A

8

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

How does hypothermia cause respiratory distress in infants?

A

The infants metabolic rate is raised and O2 consumption is higher

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What are some ways to support the thermoregulation of a neonate?

A
  • Warmer
  • Delay bath
  • Dry immedatley
  • Hat on head
  • Skin to skin
  • Swaddle
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What are the three identifications for the neonate?

A
  • Foot print
  • Matching bands (verified at beginning of shift)
  • Ankle security band
47
Q

Discuss the postpartum adaptation of the reproductive system.

A

-Uterine involution
–Muscles contract, Catabolism occurs, Epithelium regenerates
(process begins immediately after placenta delivery)
-Fundus Decends
-Afterpains occur
-Lochia is present
-Cerivx heals
-vagina regenerates
-Perineum heals depending on extent of injury
-

48
Q

Describe the postpartum regeneration of the epithelial lining of the uterus

A
  • Begins within 2-3 days
  • All but attachment site regenerates after 3 weeks
  • Placental site heals after 6 weeks
  • Regeneration occurs at the lower layer of the decidua
49
Q

Describe postpartum descent of the fundus

A
  • 1 cm a day
  • 14th day should be in pelvic cavity and not palpable
  • Documented in relation to the Umbilicus
50
Q

Decribe postpartum afterpains

A
  • Intermittent contractions (caused by Oxytocin from milk production)
  • More acute for Multip d/t loss of tone from overstretching causing extra contractions
51
Q

Describe postpartum Lochia

A

-1-3 days rubia
-3-10 days serosa
-10+ alba
Should end by 14 days but may persist for 6 weeks

52
Q

What is the cause of the common short bleeding episode 7-14 days after birth?

A

-Eschar sloughing from placental healing site

53
Q

When should a mother be evaluated r/t increased bleeding after birth

A

If it is extreme or just persists at a increased rate for 1-2+ hours

54
Q

describe the postpartum cervix

A
  • Heals rapidly

- Should be no more than 1cm after the first week

55
Q

describe the postpartum Vagina

A
  • Rugae reappear at 3-4 weeks
  • 6-10 weeks for full epitheial restoration
  • Regeneration is dependent on the production of estrogen
56
Q

What is Dyspareunia

A

painful sexual intercourse due to medical or psychological causes

57
Q

What are the four common postpartum laceration locations?

A
  • Perineum
  • Periurethral
  • Vaginal Wall
  • Cervix
58
Q

Describe nursing care for lacerations/hemorrhoids

A
  • Sitz bath after 24 hours
  • Perineal bottle (peri bottle)
  • Benzocaine spray/tucks
  • Analgesics
59
Q

Describe postpartum ovulation

A
  • returns by 6 weeks

- if lactating, menses usually resume between 10weeks to 6months

60
Q

When should contraception be used after birth?

A
  • Non-BF = 6months or earlier

- Exclusive BF = asap if active

61
Q

When does lactation begin?

A

-After expulsion of placenta

62
Q

Describe the physiology of lactation

A
  • Estrogen and progestrone decline
  • Prolactin initiates milk production 2-3 days
  • Supply and demand. More feedings=more milk
63
Q

What hormone is responsible for milk ejection? “let-down”

A

Oxytocin

64
Q

Where is milk ejected from?

A

Lactferous ducts

65
Q

At term, the mothers blood volume has increased by____

A

30-45%

66
Q

Describe the postpartum CV system

A
  • CO increases as blood flow returns to mom
  • -return flow also from decreased pressure from uterus
  • Normal CO returns to prelabor within an hour
  • CO returns to prepregnant within 6-12 weeks
67
Q

How is excess plasma volume eliminated postpartum?

A
  • Diuresis r/t decline in adrenal hormones and oxytocin
  • Urinary output increases up to 3L/day
  • Diaphoresis is very common too
68
Q

Describe the Hematologic system postpartum

A
  • Marked Leukocytes: WBC as high as 30k after labor
  • WBC’s normalize within 6 days
  • HgB and HCT normalize within 4-6 weeks
69
Q

Describe the postpartum Coagulation

A

-Clotting Factors increased for the first 4-6 weeks

70
Q

Describe the post partum GI system

A
  • Constipation Common

- First stool in 2-3 days with a normal pattern by 8-14 days

71
Q

An increase in WBCs of ___% in 6hrs after birth is an indication of ___

A

30

infection

72
Q

Describe the UI function postpartum

A
  • Normal Kidney function in 4 weeks

- Protein and acetone may be present due to uterine involution (catabolism)

73
Q

Why are post partem moms at risk for UTI’s?

A

Urinary stasis

74
Q

What type of incontinence is common for up to 8weeks PP

A

Stress

75
Q

Describe the post partem M/S system

A

-Relaxin subsides and Hip/joint pain will subside

76
Q

Describe the postpartum Abdominal wall

A

Possible Diastasis Recti

77
Q

Describe the postpartum integ. system

A
  • Hormonal skin changes will begin to subside
  • Striae lighten
  • Loss of hair at 4-20 weeks is normal Secondary to hormonal changes regrows in 4-6 months
78
Q

What is the most important thing to review in the PP chart

A

Risk factors for PPH

79
Q

What are some common risk factors fror PPH

A
  • Grand multiparity (five or more)
  • Overdistention of the uterus
  • Precipitous labor (< 3 hours)
  • Drugs (Pitocin, mag sulfate, general anesthesia)
  • Hx of C section
  • PROM, PPROM
80
Q

What are six major risk factors for PP infection?

A
  • Operative procedures
  • Multiple cervical exams
  • Prolonged labor
  • Prolonged ROM
  • Manual extraction of placenta
  • DM
81
Q

If a mother is given a Rubella/Varicella vaccine PP, what teaching is done specific to pregnancy

A

-Do not get pregnant for 28days after

82
Q

Describe PP BP

A
  • Abnormal if above 140-90
  • Ortho. Hypo is common
  • MAP 70-100 normal
83
Q

How do you calculate MAP?

A

double the diastolic blood pressure and add the sum to the systolic blood pressure. Then divide by 3.

84
Q

Describe PP pulse

A
  • Bradycardia may occur possibly R/T large volume of return blood D/T increased Stroke volume
  • If tachy. Suspect PPH
85
Q

Describe PP temp.

A

up to 38 (100.4) common in first 24 D/T dehydration and PP leukocytosis

86
Q

Describe the focused PP assessment

8 things

A
  • VS
  • Pain
  • Fundus
  • Lochia
  • Perineum
  • Bladder Elimination
  • Breasts
  • Lower Extrem
87
Q

Describe Normal PP bladder elim. Values

A
  • Frequent small voids (under 150) = retention
  • Measure first 2-3 voids
  • D/C measuring if voiding 300-400ml
88
Q

Describe PP breast assessment

A
  • Should be soft and non-tender
  • Nipples may have redness, blistering, or fissures
  • Nipple should be described as Inverted, Flat, or retracted
89
Q

Describe the PP Lower Extremity assessment

A

-Look for S/S of thrombophlebitis or DVT
-Measure Calf
-Check for edema (cause by fluid redistribution)
Diuresis highest between 2nd and 5th day
-Check DTR’s

90
Q

Breast milk changes in ___ different stages

A

3

91
Q

What are the three stages of breast milk

A

Lactogenesis 1, 2, 3

92
Q

Describe Lactogenesis 1

A
  • Begins during Preg\ and first days after birth
  • Colostrum only (higher in protein and some nutrients)
  • Rich in Immunoglobulin A (protects infants GI tract)
  • Establishes normal intest. Flora
  • Laxative
93
Q

Describe Lactogenesis II

A

2-3 days after birth

  • Transitional between colostrum and mature milk
  • Immuno and Protein decrease
  • Lactose, calories, and fat increase
94
Q

Describe Lactogenesis III

A
  • Mature Milk
  • Thinner and Blueish (mother may think it is not as rich)
  • 20kcal/oz
  • Immunos still present
95
Q

Describe the protein in Breast milk

A
  • High in Taurine (bile conjugation and brain development)
  • Casein and Whey
  • More whey than casein = easier to digest
96
Q

Describe the CHO’s in Breast milk

A
  • Lactose is major CHO

- Improves absorption of calcium and provides energy for brain growth

97
Q

Describe the Fat in Breast Milk

A
  • 50% of calories
  • Easy to digest
  • Hindmilk has more fat
  • Triglycerides are the major fat
98
Q

Describe the vitamin content of Breast milk

A
  • A,E,C are High

- D is low

99
Q

What is the Recommended vit D supplimentation within the first few days of life

A

400iu

100
Q

Describe the enzymes in breast milk

A
  • Aid in digestion
  • Pancreatic amylase present in BM (CHO digestion)
  • Lipase in BM (fat digestion)
101
Q

Describe infection prevention component of Breast milk

A
  • Bifidus Factor promotes growth of Lactobacillus Bifidus

- This produces an acidic environment that retards the growth of pathogens

102
Q

What are the daily calorie needs of a breast feeding infant?

A

85-100 Kcl/kg

103
Q

What are the daily calorie needs of a formula fed infant?

A

100-110kcl

104
Q

___% weight loss in an infant in the first 3 days is considered normal

A

10

105
Q

PP neonate weight loss should is caused by ___

A

fluid shifts and excretion of ECF

106
Q

PP neonate weight should return to BW by ___ days

A

10

107
Q

What are the daily fluid needs of an infant for the first 3-5 days

A

60-100ml/kg

108
Q

What are the daily fluid needs of an infant after the first 3-5 days

A

150-175 ml/kg

109
Q

When is the baby getting enough milk?

A
  • Frequent swallowing
  • smooth suck/swallow
  • See the milk in their mouth
  • feed them 8-12 times a day
  • 2 wet by day 2, 3 by 3, 6 by 4
  • 3+ bm a day after day 3
  • Weight gain
  • Maybe seems satisfied
110
Q

What are the three phases of Maternal adaptation?

A
  • Taking in
  • Taking hold
  • Letting go
111
Q

What is the major task of Taking in?

A
  • INtegrate birth into reality

- Discuss her experience with others

112
Q

Describe a mother in the taking in phase

A

1-2 days

  • Mother is focused on her needs
  • She is passive and dependent
  • Is very observant but trusts others with the neonates care
113
Q

Describe a mother in the taking hold phase

A 
3-10 days
-Independent
-Concerned about managing her own care
-Is receptive to info about her baby
-Should be encouraged to care for the baby
This is prime time for teaching
114
Q

Describe a mother in the letting-go phase

A

10days+

  • Relinquishing of previous roles
  • May be upset about the birth process or the infant
  • May feel grief
  • She refocuses the relationship with her partner
  • Relinquishes the care of the child

OB (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions