Wk 10 Postpartum Assessment

Question 1

Define: Afterpain

Answer 1

cramping pain after childbirth, caused by alternating relaxation and contraction of uterine muscles

Question 2

Define: Bonding

Answer 2

Development of a strong emotional tie of a parent to a newborn

Question 3

Define: diastasis recti

Answer 3

separation of the longitudinal muscles of the abdomen during pregnancy

Question 4

Define: engorgement

Answer 4

swelling of the breast resulting from increased blood flow, edema and the presence of milk

Question 5

Define: episiotomy

Answer 5

surgical incision of the perineum to enlarge the vaginal opening

Question 6

Define: involution

Answer 6

retrogressive changes that return the reproductive organs, particularly the uterus to their nonpregnant size and condition

Question 7

Define: lochia alba

Answer 7

white cream colored or light yellow vaginal discharge that follows lochia serosa

Question 8

Define: lochia rubra

Answer 8

reddish or red brown vaginal discharge that occurs immediately after childbirth; composed mostly of blood

Question 9

Define: lochia serosa

Answer 9

pink or brown vaginal discharge that follows lochia rubra; composed largely of serous exudate, blood and leukocytes

Question 10

Define: oxytocin

Answer 10

hormone produced by the posterior pituitary gland that stimulates uterine contractions and the mild ejection reflex; also prepared synthetically

Question 11

Define: puerperium

Answer 11

period from the end of childbirth until involution of the reproductive organs is complete, approximately 6 weeks

Question 12

Define: REEDA

Answer 12

redness
ecchymosis
edema
discharge
approximation

Question 13

Define: engrossment

Answer 13

intense fascination and close face to face observation between father and newborn

Question 14

Lochia assessment
color
amount
clots
days

Answer 14

Lochia Rubra: dark red, 1-3 days
Lochia Serosa: pinkish brown, 4-10 days
Lochia Alba: whitish yeallo, 11-21 days

Question 15

Fundal assessment

NORMAL findings

Answer 15

• firmly contracted
• remains firm when massage is discontinued
• located at the level of the umbilicus and midline

Question 16

Fundal Assessement

ABNORMAL findings

Answer 16

• soft, boggy, uncontracted, difficult to find
• becomes soft when massage is stopped
• above the umbilicus and/or displaced from midline

Question 17

Fundal Assessment

Nursing Interventions

Answer 17

• support lower uterine segment, massage until firm
• continue to massage and apply pressure, notify provider, begin Oxytocin as ordered
• assess bladder elimination, reassess fundas after voiding, notify provider if fundas remains displaced/above the umbilicus

Question 18

Focused postpartum assessment findings
B U B B L E
L E P

Answer 18

BUBBLE:
Breast
Uterus (firm)
Bladder (non palpable)
Bowels (active, flatus)
Lochia (no clots)
Episkiotomy/laceration/incision (REEDA)
LEP:
Lower extremities (calf or LE swelling, redness, warmth, pain)
Emotion
Pain

Question 19

Define: taking-in phase

Answer 19

• First 1-2 days
• Focused on her own needs
• Integrate birth experience into reality

Question 20

Define: taking-hold phase

Answer 20

• Becomes more independent
• Manages her own care
• Begins to shift some attention over to the infant
• Fathers should be encouraged to actively participate in infant care

Question 21

Define: Letting-go phase

Answer 21

Relinquish:

• previous childless life
• preconceived expectation of childbirth
• “fantasy baby

Question 22

Most significant postpartum problems

Answer 22

Postpartum hemorrhage
Vaginal hematoma
Body image
Smoking
Postpartum blues (normal fluctuations in emotions and mood swings, last 1-2 weeks)
Perinatal mood disorders (postpartum depression, anxiety, psychosis, lasting longer than 2 weeks to one year)