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N3 Provider EXAM 2 > Well Postpartum > Flashcards

Well Postpartum Flashcards

1
Q

*BUBBLE HE

A 
Breast
Uterus
Bladder
Bowel
Lochia
Episiotomy

Homan’s sign
Emotional

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2
Q

*What is being asses breast wise?

A

Size, symmetry, trauma/bruising, aerolar, nipple, dimpling

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3
Q

*What do dimpling and/or thickening of the breast indicate?

A

Tumor

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4
Q

*Trauma of the breast may look like and indicate what?

A

look: blisters, redness, bruising
indicate: the baby is not positioned correctly while being fed

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5
Q

*What is abnormal for breast tenderness and what ma it indicate?

A

Tenderness—

Lumpy– milk ma not be evenly distributed

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6
Q

*Potential issue for a flat or inverted nipple?

A

Issues with attachment and breast feeding.

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7
Q

*What may be caused by oxytocin release other than milk production?

A

Stimulation of the uterus to contract

  • helps return it to normal size
  • may cause the mother discomfort
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8
Q

*What are we assessing regarding the uterus?

A

Is it shrinking back to normal

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9
Q

*What three things help/lead to the uterus shrinking?

A
  • Contraction of the muscle fibers
  • Converting of cells into simple compounds
  • Epithelial regeneration
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10
Q

*By what day at the latest should the uterus no longer be palpable?

A

14

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11
Q

*What is the size/weight of the uterus right after birth?

A

large grapefruit

about 2.2lbs

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12
Q

*What is a soft (boggy) uterus at an increased risk for?

A

Bleeding

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13
Q

*What can be done to firm up a boggy uterus

A
  • Massage until it firms up
  • Take oxytocin
  • DNC (not first option)
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14
Q

*What are we concerned about regarding the bowels postpardum?

A

Constipation

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15
Q

*Why may constipation occur postpartum

A
  • epidural
  • reduced muscle and bowel tone from pregnancy
  • decreased fluid and food intake during labor
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16
Q

*When should mom have her first stool after giving birth/

A

2-3 days post birth

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17
Q

*What leads to increased potential for urinary retention post birth?

A
  • increased bladder capacity due to no more pressure from baby
  • decrease in the sensitivity to fluid pressure
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18
Q

*What can be caused by a distended bladder?

A
  • Displacement of the uterus. Which can cause an increase in bleeding.
  • infection/UTI
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19
Q

*Signs of a distended bladder

A

-Fundus is displaces off mid-line and baseline
-Excessive lochia
-Bladder discomfort
Void <150ml

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20
Q

*What is asses in regards to lochia (3)?

A

Amount
Type
Odor

21
Q

*What does a foul odor of the lochia indicate?

A

Suggest an endometrial infection

22
Q
  • Lochia rubra
  • appearance
  • when is it seen
A

Red/Brown color

1-3 days post birth

23
Q
  • Lochia serosa
  • appearance
  • when is it seen
A

Pink, possibly with a brown tinge

4-10 days post birth

24
Q
  • Lochia alba
  • appearance
  • when is it seen
A

Light cream/yellow color

day 11

25
Q

*What makes us worried about the amount of lochia/

A

When the pad is heavily saturated in 15min

or, according to simulation, the mom is changing her pad every hour

26
Q

Risk factors for postpardum hemorrage

A
  • grand multiparity (uterus is like a baloon)
  • Big baby/overdistention of uterus
  • Retained placenta
  • Too fat or too slow of labor
  • Placenta previa
  • Placenta abrupto
  • Medications (tocolytics, oxytocin)
  • C-section
  • Coagulation defects
27
Q

Placenta previa

A

Part of the placenta is over the cervix

28
Q

Placenta abrupto

A

Placenta breaks from the uterine wall before the baby is born

29
Q

*What is an episiotomy?

A

When a cut is made to increase the vaginal opening.

30
Q

*Why is an episiotomy done?

A

Baby is coming too fast and before the mom has been completely dilated

31
Q

*Is a medio-lateral or mid-line episiotomy preferred? Why?

A

Medio-lateral

-less risk to cut tearing to the anus, which would increase the risk for infection

32
Q

How long does it take the vagina to return to its normal size and contour?

A

6-10 weeks

33
Q

What does REEDA stand for and what is it assesing

A 
Assessing episiotomy healing
Redness
Edema
Ecchymosis
Discharge, drainage
Approximation
34
Q

*What is the purpose of homan’s sign

A

To asses for DVT

35
Q

*When should homan’s sign not be done?

A

When signs of a DVT are present

  • redness
  • swelling
  • warm to touch
36
Q

*How to preform homan’s sign and what indicates a DVT

A

supine, leg bent at 90 (like trying to make the side and top of a box), flex the foot

If there is a pain in the back of the leg that indicate a DVT

37
Q

Risk associated with the separation of the rectus muscles postpardum

A
  • hernia
  • Muscle aches
  • Muscle fatigue (constipation)
38
Q

What position should a women maintain postpartum and why?

A

Semi-fowlers

-to promote lochia drainage

39
Q

Considerations regarding menstruation/ovulation postpardum

A
  • ovulation may occur before first period postpartum

- breastfeeding may delay ovulation and menstruation

40
Q

Why may breastfeeding mothers experiance vaginal dryness?

A

Decreased estrogen

41
Q

Risk factors for postpartum infection

A
  • Operative birth procedures
  • multiple cervical examinations
  • prolonged labor
  • manual extraction of the placenta
  • diabetes
  • catheterization
42
Q

Symptoms of postpartum depression

A
  • change in sleep pattern
  • anger/rage
  • weeping/sadness
  • difficulty concentration
  • changes in appetite
  • anxiety
43
Q

What is bonding?

A

initial attraction felt by parents towards the infants. Unidirectional from parent to child

44
Q

What is attachment?

A

Process by which an enduring bond between a parent and child is developed. Starts in pregnancy and extends many months after birth

45
Q

Name some reciprocal attachment behaviors. (6)

A
  • Eye contact
  • Attempts of infant to “track” parents face or voice
  • Grasping/holding parents’s finger
  • Successful breastfeeding
  • Being comforted by parent’s voice
  • Movements in response to parents voice
46
Q

what are the 3 puerperal phases

A

Taking-in
Taking-hold
Letting-go

47
Q

What does the taking-in phase entail and when does it occur?

A

birth-1/1.5 days postpartum

  • mom is focused on herself and her needs
  • has to process and deal with not being prgnante anymore.~~ seen throug talking about the birth details
  • Is happy to let others take care of her child
48
Q

What does the taking-hold phase entail and when does it occur?

A

Lasts a few days after the taking-in phase

  • shift of focus to baby and its behaviors
  • most teachable time
  • time of anxiety for new moms
  • mom may compare herself and her skill to the nurse
  • mom is independent in care
  • there is concern about what is happening in her own body
49
Q

What does the letting-go phase entail and when does it occur?

A

not told when

  • relinquishing life without baby
  • can’t do things you used to
  • new things you have to do

N3 Provider EXAM 2 (7 decks)

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