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Maternal OB > week 6 > Flashcards

week 6 Flashcards

1
Q

placenta needs to be delivered within

A

30 minutes

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2
Q

breast fed babies require what supplementation

A

vitamin D

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3
Q

B.U.B.B.L.E — post-partum assessment

A

B = breasts
U = uterus
B = bowel
B = bladder
L = lochia
E = episiotomy

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4
Q

how often should the patient be assessed when post-partum

A

BP & pulse checked every 15 min for the first 2 hours after birth

then every 4 hours for the first 8 hours

then every 8 hours

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5
Q

oxytocin

A

strengthens uterine contractions

*stimulated by breastfeeding

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6
Q

HcG can be detected for how long when in post partum

A

up to 4 weeks

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7
Q

result of decreased estrogen

A

*diminishes vaginal lubricancy = local dryness & intercourse discomfort

breast engorgement

diaphoresis

diuresis of excess extracellular fluid

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8
Q

when does ovulation occur in lactating moms

A

lactation delays return of ovulation
approx 6 months
infants suck affects prolactin

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9
Q

when do non lactating moms ovulate

A

ovulation occurs 7 to 9 weeks after birth\

menses resume in 12 weeks

prolactin decline reaching pre-pregnant levels by week

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10
Q

on the 6th post partum day the uterus should be

A

halfway between the symphysis pubis and umbilicus

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11
Q

uterus location during third stage of delivery

A

midline & 2cm below umbilicus

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12
Q

1 hour after delivery the fundus should be

A

at the level of umbilicus

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13
Q

after 2 weeks the uterus should be

A

within the true pelvis and not palpable

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14
Q

interventions to assess the uterus

A

patient supine w knees slightly flexed
palpate fundus & observe lochia flow
document fundal height

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15
Q

when assessing fundus

A

never palpate w/o cupping

fingers between fundus & umbilicus

firm or boggy

location

(+) = above umbilicus
(-) = below umbilicus

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16
Q

oxytocics

A

*administered after placenta delivery

oxytocin
methylergonovine
carbopost

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17
Q

prostglandin med

A

misprostol

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18
Q

lochia rubra

A

occurs 1 to 3 days post-partum

dark red, small clots, fleshy odor

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19
Q

lochia serosa

A

occurs day 4 to 10 post p

serosanguinous, pinkish-brown

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20
Q

lochia alba

A

day 10 to 8 weeks post p

yellowish white, mucus, luekocytes

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21
Q

3 types of lochia

A

lochia rubra
lochia serosa
lochia alba

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22
Q

5 types of lochia amount

A
  1. scant = less than 2.5cm
  2. light = 2.5 to 10cm
  3. moderate = more than 10 cm
  4. heavy = one saturated pad within 24hrs
  5. excessive = saturated in 15 min or less
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23
Q

post partum the cervix will appear

A

edematous & bruised

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24
Q

post partum the vagina will appear

A

rugae & increased dryness

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25
Q

post partum it is normal in the perineum to find

A

hemorrhoids and hematomas

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26
Q

in a patient w episiotomy

A

normal to experience a bright red trickle of blood

*initial healing in 2 to 3 weeks
*complete = 4 to 6 months

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27
Q

colostrum appears

A

during and up to 2 - 3 days after birth

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28
Q

breast milk appears

A

3 to 5 days after delivery

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29
Q

4 positions for breast-feeding

A
  1. football hold
  2. cradle
  3. across the lap
    4 side lying
30
Q

avg blood loss in vaginal delivery

A

300 to 500 ml

31
Q

avg blood loss in a c-section

A

500 to 1000ml

32
Q

avg weight los during first 5 days after delivery

A

19 pounds

33
Q

lab values in post partum

A

DECREASED HCT
increased wbc
increased temp

34
Q

Gi and bowel changes during post partum

A

constipation
hemorrhoids
no spontaneous bowel movement for 2-3 days

35
Q

urinary changes during post partum

A

increased urine output within 12 hours of delivery

urinary retention is normal

36
Q

Rh vaccine can be administered

A

within 72 hours of delivery

37
Q

Rubella & MMR vaccine in pregnancy

A

NO RUBELLA / MMR

no pregnancy for 4 weeks

38
Q

tetanus / pertusis vaccine while pregnant

A

any time
okay w breast feedding

39
Q

3 phases of maternal role attachment

A
  1. dependent
  2. dependent - independent
  3. interdependent
40
Q

dependent

A

the “taking in phase”
first 23 to 48 hrs

41
Q

interdependent

A

“letting - go”
family is seen as a unit
role resumptiob

42
Q

dependent - independent

A

“taking hold” phase
begins day 2-3
baby blues
caregiving competency
acceptance from others

43
Q

wiping

A

FRONT TO BACK

44
Q

In 24 hours, a newborn should be fed

A

8 to 12 times a day

45
Q

considerations for breast feeding

A

breast softens as baby feeds
burp in between boobs
WARM = RELEASE
COLD = PAIN
no wire bras

46
Q

intervention for sore nipples

A

apply a small amount of breast milk and allow to air dry after breast feeding

47
Q

considerations for NON-BREAST FEEDING

A

pump every 4 hours to relieve discomfort
NO WARM WATER
cabbage leaves inside bra
cold compress 15 on, 45 off

48
Q

after delivery sex can resume

A

2 to 4 weeks after

49
Q

episiotomy assessment

A

R.E.E.D.A.
R = redness
E = Edema
E = echomyosis
D = discharge
A = approximation

50
Q

postpartum hemorrhage occurs

A

blood loss is greater than
500 ml (vaginal) OR 1000ml (c-section)

quarter sized clots

perineal pads saturated in less than 15 min

51
Q

meds to control post partum hemorrhage

A

methylergovine
misoprostol
carboprost

52
Q

uterine atony

A

inability of the uterine muscle to contract adequately after birth

53
Q

s/s of uterine atony

A

boggy
lateral displacement
larger uterus
excess bleeding
tachycardia
hypotension

54
Q

subinvolution of the uterus

A

uterus remains enlarged w continual lochial discharge — can result in post partum hemorrhage

55
Q

s/s of subinvolution of the uterus

A

boggy
enlarged uterus
prolonged lochia

56
Q

inversion of the uterus

A

PRESENTS AS A MASS
*complete = fundus as a mass in vagina

*prolapse = protrudes 20-30cm outside introitus

*incomplete = dilated cervix

57
Q

terbutaline

A

tocolytic that relaxes uterus

stops pre-term labor

58
Q

4 reasons for post partum hemorrhage (acronym)

A

T.T.T.T (4 T’S)
T1 = tone
T2 = tissue
T3 = trauma
T4 = coagulation

59
Q

to prevent mastitis

A

completely empty each breast
*breast hygiene

60
Q

s/s of mastitis

A

cracked / fissured nipples
nipple trauma
painful localized hard mass
flu like symptoms

61
Q

s/s endometritis

A

*inflammation of the uterus

dark lochia –purulent/malodorus
fever
uterine tenderness / enlargement

62
Q

calories in breast milk / formula

A

20kcal/oz

63
Q

an infant is properly breastfeeding when

A

the breat is touching their nose, cheeks, and mouth

64
Q

when breastfeeding

A

15 to 20 minutes each side
burp when alternating boobs
insert finger into mouth to release suction

65
Q

how long can formula be refridgerated

A

48 hours

66
Q

breast milk in room temperature lasts

A

up to 8 hours

67
Q

refridgerated breast milk can last

A

8 days

68
Q

breast milk frozen
vs
deep frozen

A

frozen 6 mo

deep frozen 12 o

69
Q

considerations for thawing breast milk include

A

lukewarm water
no shaking
no re-freezing
can defrost in refrigerator for 24hrs

70
Q
A

Maternal OB (8 decks)

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