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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
PP fundus
go down about 1 cm a day
26
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?
Between the umbilicus and the symphysis pubis
27
PP lochia
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
define lochia
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
PP cervix
vaginal birth: cervix will be a transverse line instead of an open circle and stay like this permanently
30
PP ovaries
gonadotropins and sex steroids will remain low for 2-3 weeks
31
If there is adequate nipple stimulation from breastfeeding or pumping all or most of the time
there might not be ovulation for the first 6 months PP
32
PP breasts
colostrum
33
hyperlactation
Too much supply of breast milk. related to excess mammary glandular tissue growth; overstimulating of the breasts/nipples
34
hypolactation
Too little supply of breast milk. PCOS, diabetes, thyroid, Hx of brest surgery
35
PP muscle tone
diastasis recti
36
PP integumentary system
chloasma/melasma: brownish spots on face darked areola: darkened nipples linea nigra: dark line on belly striae gravidarum: stretch marks hair loss
37
Which of the following integumentary changes of pregnancy commonly persists postpartum?
striae gravidarum
38
dark red lochia
lochia rubra
39
what factors contributed to PPH
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
what is the primary cause of PPH
uterine atony
41
clinical presentation of PPH
500 mL for vaginal and 1000 mL for C section is considered a PPH boggy, uncontracted uterus tachycardia and low BP
42
quantifying blood loss
weighing 1g=1 mL lost obviously subtract dry from wet EXAMPLE: 200g pad, dry was 30g, how many mL lost? 170 mL
43
Four T's of PPH and Their Causes
Tone Trauma Tissue Thrombin
44
PPH lab testing
Hglb and Hct: decreased Fibrinogen: low D-Dimer: elevated Electrolytes; decreased BUN; elevated
45
define retained placenta
if after 30 mins of delivering baby and placenta is still not expelled
46
how to confirm retained placenta
ultrasound to confirm products of conception remaining in uterine cavity
47
clinical presentation of retained placenta
painless, bright-red vaginal bleeding with the lack of placental separation, the provider may suspect a MAP
48
postpartum retained placenta treatment
provider insert one hard and scrap off placenta from uterine wall
49
define subinvolution of the uterus
Subinvolution of the placental implantation site is the primary cause of secondary PPH, occurring generally during the second postpartum week. type of PPH
50
clinical manifestations of subinvolution of the uterus
enlarged, boggy uterus with sudden onset vaginal bleeding occurring between 24hr to 6 weeks postpartum
51
interventions for PPH (primary and secondary)
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

Mother Baby (9 decks)

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