Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

NURS 372 > Week 8 - Postpartum Care > Flashcards

Week 8 - Postpartum Care Flashcards

1
Q

Postpartum period

A

approximately 6 weeks after birth

interval between the birth and return of repro organs to normal nonpregnant state

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

Another name for the postpartum period

A

4th trimester

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

Approach to care during the postpartum period

A

wellness orientated

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

1st degree perineal laceration

A

lacerations extend through the skin and structures superficial to muscles

heal without intervention

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

2nd degree laceration

A

lacerations extend through muscles of perineal body

stitches required

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

3rd degree laceration

A

lacerations continues through anal sphincter muscle

further down perineal body

monitor for complications

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

4th degree laceration

A

lacerations also involve the anterior rectal wall

anal sphincter + mucous membrane

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

Most common types of lacerations

A

1st and 2nd degree

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

More severe types of lacerations

A

3rd and 4th degree

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Considerations for assessment of lacerations (many)

A

good lighting

lithotomy or turn on side

healing

edema common

incision

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

Laceration repair length

A

2 - 3 weeks

complete by 4 - 6 weeks

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

Risk factors for 3rd and 4th degree tears (many)

A

Passenger
-macrosomic (large passenger)

Passageway
-perineum
-primigravida

OP
-more lacerations to urethra

Shoulder dystocia

Forceps

Anxiety

Prolonged pushing

Very quick delivery

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

OASI meaning

A

obstetrical anal sphincter injuries

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

Obstetrical anal sphincter injuries

A

3rd and 4th degree tears

refer to pelvic floor therapist

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

Management of laceration injuries

A

want regular BMs to minimize pushing and straining

fluid

fibre

ambulation

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

Considerations for suturing

A

adequate pain control

self-dissolving sutures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

T or F: Tears are often smaller than episiotomy

A

TRUE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

T or F: Routine episiotomy is recommended in Canada

A

FALSE

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

Episiotomy

A

incision in the perineum to enlarge the vaginal outlet

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

Midline episiotomy

A

surgical cut along the midline

most common

effective, easily repaired, least painful

minimize blood loss

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

What does a midline episiotomy increase the risk of?

A

3rd and 4th degree lacerations

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

Mediolateral episiotomy

A

prevent 4th degree lacerations
-decreased risk of going to anal sphincter

greater blood loss

repair more difficult, painful

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

Vaginal lacerations

A

occur in conjunction with perineal lacerations

extend up the lateral walls and high in the vaginal vault

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

When do cervical lacerations occur?

A

result when cervix retracts over advancing head

delivering the fetus before full dilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
T or F: Cervical lacerations have adverse effects on future pregnancies and childbirths
TRUE e.g. incompetent cervix
26
Normal BP postpartum
consistent BP orthostatic hypotension for 48 hours
27
Nursing consideration for orthostatic hypotension
dangle legs on bed before standing
28
Potential BP complications
hypertension (anxiety, preeclampsia) hypotension (post-partum hemorrhage)
29
Normal HR postpartum
60 - 100 bpm may be slightly elevated, should return to normal
30
Potential HR complications postpartum
tachycardia (pain, fever, dehydration, postpartum hemorrhage)
31
Normal RR postpartum
16 to 24 resp/min no significant decrease
32
Potential RR complications postpartum
tachypnea (anxiety, respiratory distress) bradypnea (narcotic medications, spinal, epidural, mag sulf)
33
Rare complication evidenced by sudden SOB and tachypnea
embolism of amniotic fluid in blood
34
Normal temp postpartum
36.2 - 38C may be elevated in the first 24 hours related to dehydration
35
Potential temp complication postpartum
febrile infection
36
Normal pain postpartum
mild pain from uterine cramping
37
Potential pain complication postpartum
severe pain
38
Normal blood loss with vaginal delivery (mL)
up to 500 mL
39
Normal blood loss with C-section (mL)
up to 1 L
40
Hematocrit levels
drop for 3 - 4 days begin to increase to prepregnancy levels by 8 weeks
41
WBC levels
increase inflammatory response that peaks in 3rd trimester may obscure diagnosis of acute infection
42
Clotting factors and fibrinogen levels
remain elevated in the immediate postpartum period
43
What do elevated clotting factors and fibrinogen levels increase the risk of?
thromboembolism
44
Nursing interventions to prevent thromembolism
encourage early ambulation some clients require anticoagulants
45
Indications for LMWH
previous embolisms increased BMI excessive blood loss preeclampsia emergency C-section smoking
46
What happens to endocrine system/hormones in the post-partum period
rapid decrease in most hormones!
47
Which hormone INCREASES after birth
prolactin influenced by method of feeding
48
1st cycle when lactating
6 months after birth
49
1st cycle when not lactating
12 weeks after birth
50
What is very important when client is being transferred from birthing to postpartum room?
communication during transfer* clear and concise
51
BUBBLLEE acronym
B - breast (tenderness) and nipples U - uterine fundus B - bladder function (amount, frequency, disfunction) B - bowel (passing gas or BM) L - lochia (amount, odour) L - legs (edema) E - episiotomy/laceration/C-section incision E - emotional status (mood, fatigue)
52
Postpartum assessment: Breasts - normal
day 1-2: soft day 2-3: filling day 3-5: full, soften with breastfeeding nipples intact, no soreness
53
Signs of breast engorgement
firmness heat pain
54
Signs of mastitis
infection in milk ducts when breasts not emptied unilateral* redness of breast tissue heat streaking pain fever body aches
55
Treatment for mastitis
antibiotics
56
Signs of trauma from latching
redness bruising cracks fissures abrasions blisteres
57
Colostrum
yellow contains antibodies
58
Important consideration with colostrum
quality > quantity
59
Day by which milk matures
25 days
60
System that controls the initial production of colostrum
endocrine
61
What happens in the breasts of non-breastfeeding clients?
breast tenderness and engorgement may occurs (milk drying up) temporary congestion of veins and lympatic discomfort normally lasts 24 - 36 hours
62
T or F: To relieve engorgement, non-breastfeeding clients should be encouraged to hand express.
FALSE tells body to produce more milk
63
T or F: Fresh cabbage can be applied to the breasts of non-breastfeeding clients.
TRUE anti-inflammatory
64
T or F: Mild analgesia such as Tylenol and Ibuprofen are effective treatment options.
TRUE
65
T or F: Clients should be encouraged to wear a well-fitted sports bra.
TRUE supports decreased inflammation
66
The uterus at full term weighs approximately ___ times its prepregnancy weight.
11 times non-pregnant = 60-80 g full-term = 1000 g
67
Purpose of uterine contractions postpartum
stops bleeding myometrial vessels needs to vasoconstrict
68
Hormone that helps uterine contractions
oxytocin! released during labour, breastfeeding immediately after birth
69
How normal uterine contractions should feel
coordinated strong mild - menstrual-like
70
Uterine involution
return of the uterus to nonpregnant state
71
Uterine involution begins with...
the expulsion of the placenta
72
What causes autolysis of the hypertrophied tissue in the uterus?
rapid decreased in estrogen and progesterone
73
Technique for palpating and massaging fundus
upper hand is cupped over the fundus lower hand dips in above symphysis pubis and supports uterus while it is massaged gently
74
What you want to see when assessing uterus involution
midline firm immediately after birth, fundus at umbilicus to 2cm below within 12 hours, fundus may rise to 1cm above the umbilicus at 24 hours after birth, uterus is equal to the same size as 20 weeks gestation
75
Fundus continues to descent __ to ___ cm every 24 hours
1 to 2 cm
76
Where fundus should be at day 6
halfway between umbilicus and symphysis pubis
77
At how many weeks should the uterus not be palpable abdominally?
2 weeks
78
Subinvolution
failure of the uterus to return to a nonpregnant state
79
Common reasons for subinvolution
retained fragments infection
80
What is the cause of the majority of post-partum hemorrhages?
uterine attony
81
Uterine attony
failure of the uterus to contract firmly
82
Risk factors for uterine attony
anything that increases stretch of the uterus multi gravida large baby polyhydramnios mag sulf
83
Normal progression of lochia/bleeding
rubra (dark red) serosa (brownish red or pink) alba (yellowish white)
84
T or F: The amount of lochia is usually less after a C-section.
TRUE lots of suctioning removes initial bleeding
85
T or F: The flow of lochea often increases with ambulation.
TRUE
86
A perineal pad saturated in how many minutes or less is of immediate concern?
15 minutes ask patient how long they've had pad on for most accurate to weigh
87
Where to assess for lochia that often gets missed
under buttocks
88
Size of clot that is bad
large than a toonie
89
C-section incision assessment acronym
R = Redness E = Edema E = Ecchymosis D = Drainage A = Approximation
90
Activity restrictions after a C-section
no heavy lifting for 6 weeks
91
Health teaching after birth
frequent hand hygiene before and after peri care frequently change peri pads ice packs (first 24 hours) use WARM water in the peri bottle with each void gently pat dry from urethra to anus no use of tampons Kegel exercises Sitz baths topical applications (hemmys)
92
Kegel exercise instructions
pretend they are trying to stop the flow of urine midstream hold contraction for at least 10 seconds, rest for 10 seconds 15 minutes BID (2x)
93
Urinary system
initial decrease in kidney function resumes to normal by 1 month
94
What causes decrease in kidney function
decreased estrogen causes a large fluid shift increase in output profuse diaphoresis for the first 2-3 days
95
What can decrease the urge to void
birth-induced trauma increased bladder capacity following childbirth epidural/spinal
96
Alert - urinary thing that can cause excessive bleeding
if bladder is overdistended pushes the uterus up and to the side prevents it from contracting firmly increases risk of infection
97
KHSC Bladder Management Protocol
monitor all inputs and outputs for a minimum of 8 hours post-delivery should be able to fully empty void at least 4 hours after at least 200 mL/less than 600 mL
98
BM not occur for how many days postpartum?
2 to 3 days
99
Rubella vaccination recommendation
for clients that are non-immune (titer of 1:8 or enzyme immunoassay levels less than 0.8) SQ live-attenuated -can't get pregnant for 1 month after can breastfeed
100
Rh immune globulin
within 72 hours 300mcg Rh - client Rh + baby promotes lysis of fetal Rh-positive blood cells before the client can form their own antibodies against them
101
Discharge criteria
health of dyad is stable client is able and confident to provide care for the infant adequate support systems in place access to follow up care
102
Ovulation may occur as soon as _____
1 month postpartum especially if not breastfeeding
103
Recommended Interpregnancy Intervals (IPI)
at least 6 months increased risk of loss and preterm labour

NURS 372 (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions