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Mother Baby > WEEL 11 > Flashcards

WEEL 11 Flashcards

postpartum period- ATI

1
Q

what are some systems that adaptations take place in during postpartum

A

cardiovascular
pulmonary
hematological
gastrointestinal
renal
musculoskeletal
neuro
endocrine
reproductive
integumentary

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2
Q

average vital signs the first 24 hours following birth

A

BP: 116-79
O2: 96%
RR: 15/min
temp: 98.1
HR: 84

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3
Q

what can PP clients with long second stage of labor experience

A

PP neuropathy

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4
Q

define postpartum neuropathy

A

Nerve damage from vaginal childbirth that can include weakness and loss of sensation in the lower limbs.

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5
Q

endocrine system: hormones

A

estrogen and progesterone

hCG

prolactin

oxytocin

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6
Q

PP endocrine: estrogen and progesterone

A

drop

signals the anterior pituitary gland to produce prolactin

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7
Q

PP endocrine: hCG

A

drop drastically since the explosion of the placenta

be at zero at end of first week of PP

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8
Q

PP endocrine: prolactin

A

progestrone levels drop with allows prolactin to increase

need nipple stimulation to have this hormone

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9
Q

PP endocrine: oxytocin

A

increases in the PP period in response to breastfeeding

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10
Q

postpartum thyroiditis

A

hypothyroidism

manifestations: mild or none but…

constipation
dry skin
fatigue
cold intolerance
paresthesia

low T3 and T4 levels

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11
Q

PP endocrine: insulin

A

decrease

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12
Q

what does oxytocin signal?

A

the milk ejection reflex

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13
Q

PP cardio: CO

A

increase in circulating blood so increase CO

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14
Q

define varicosities

A

Enlarged veins that commonly develop in the third trimester of pregnancy. Varicosities develop when the walls and valves of the veins become weak, and the blood can back up and pool, causing the vein to swell and protrude.​​​​​​​

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15
Q

PP hema system: blood volume

A

increases in pregnancy but declines RAPIDLY during PP period

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16
Q

definition of OB hemorrhage

A

1000 mL of blood loss OR manifestations of hypovolemia

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17
Q

PP hema system: clotting factors

A

will remain elevated for weeks following birth, which places clients at risk for thromboembolism

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18
Q

PP hema system: WBC

A

during labor they increase, but during PP return to normal in about a month

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19
Q

does Hgb and Hct decrease or increase during PP

A

decrease

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20
Q

PP GI system: common disorders

A

PP constipation
hemorrhoids
incontinence

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21
Q

PP renal: kidney function

A

GFR, blood flow, and creatinine

decrease

22
Q

define PP diuresis

A

A drop in estrogen after the placenta is delivered causes an elimination of extracellular fluid through urination.

23
Q

PP renal: voiding

A

should pee 6 hours after birth or removal of catheter

can be challenging due to pain and maybe epidural

24
Q

PP renal: incontinence

A

urge incontinence (stress of birth)

dont cath them if they have a Hx of inconvenience

25
Q

PP fundus

A

go down about 1 cm a day

26
Q

A nurse is assessing fundal height in a client who is 6 hr after birth. Which of the following is where the nurse should expect the fundus of the uterus to be?

A

Between the umbilicus and the symphysis pubis

27
Q

PP lochia

A

first few days: dark red with some blood clots

days 4-10: pink to brown and less thick

days 10-14: white to yellow

28
Q

define lochia

A

Vaginal bleeding and discharge that occurs in the postpartum period as the uterus sheds debris from pregnancy.

less following a c section than a vaginal delivery

29
Q

PP cervix

A

vaginal birth: cervix will be a transverse line instead of an open circle and stay like this permanently

30
Q

PP ovaries

A

gonadotropins and sex steroids will remain low for 2-3 weeks

31
Q

If there is adequate nipple stimulation from breastfeeding or pumping all or most of the time

A

there might not be ovulation for the first 6 months PP

32
Q

PP breasts

A

colostrum

33
Q

hyperlactation

A

Too much supply of breast milk.

related to excess mammary glandular tissue growth; overstimulating of the breasts/nipples

34
Q

hypolactation

A

Too little supply of breast milk.

PCOS, diabetes, thyroid, Hx of brest surgery

35
Q

PP muscle tone

A

diastasis recti

36
Q

PP integumentary system

A

chloasma/melasma: brownish spots on face

darked areola: darkened nipples

linea nigra: dark line on belly

striae gravidarum: stretch marks

hair loss

37
Q

Which of the following integumentary changes of pregnancy commonly persists postpartum?

A

striae gravidarum

38
Q

dark red lochia

A

lochia rubra

39
Q

what factors contributed to PPH

A

uterine atony, retained placenta or placental fragments, uterine inversion, subinvolution, genital tract lacerations, hematomas, induction of labor, prolonged labor, operative vaginal birth, polyhydramnios, multiparity, macrosomia, and other factors that increase uterine size

40
Q

what is the primary cause of PPH

A

uterine atony

41
Q

clinical presentation of PPH

A

500 mL for vaginal and 1000 mL for C section is considered a PPH

boggy, uncontracted uterus

tachycardia and low BP

42
Q

quantifying blood loss

A

weighing 1g=1 mL lost

obviously subtract dry from wet

EXAMPLE:

200g pad, dry was 30g, how many mL lost?

170 mL

43
Q

Four T’s of PPH and Their Causes

A

Tone
Trauma
Tissue
Thrombin

44
Q

PPH lab testing

A

Hglb and Hct: decreased

Fibrinogen: low

D-Dimer: elevated

Electrolytes; decreased

BUN; elevated

45
Q

define retained placenta

A

if after 30 mins of delivering baby and placenta is still not expelled

46
Q

how to confirm retained placenta

A

ultrasound to confirm products of conception remaining in uterine cavity

47
Q

clinical presentation of retained placenta

A

painless, bright-red vaginal bleeding with the lack of placental separation,

the provider may suspect a MAP

48
Q

postpartum retained placenta treatment

A

provider insert one hard and scrap off placenta from uterine wall

49
Q

define subinvolution of the uterus

A

Subinvolution of the placental implantation site is the primary cause of secondary PPH, occurring generally during the second postpartum week.

type of PPH

50
Q

clinical manifestations of subinvolution of the uterus

A

enlarged, boggy uterus with sudden onset vaginal bleeding occurring between 24hr to 6 weeks postpartum

51
Q

interventions for PPH (primary and secondary)

A

insert two large-bore IV catheters

lab testing

frequent vital sign checking

pulse O2 monitoring

place indewelling cath

admin uterotonics

admin potentional blood

education to client

52
Q
A

Mother Baby (9 decks)

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