L1: intro

Question 1

Explain GTPA

Answer 1

G: gestations, T: term (37w or more), P: preterm, A: abortion, L: living

Question 2

What are the categories of vaginal discharge that nurses use to describe the amount of lochia on a maternity pad

Answer 2

Scant, light, moderate, heavy

Question 3

First Breast in BUBBLLEEP

Answer 3

Breasts: During the first 24hr, breasts should be soft, maybe a little tender, nipple should look normal. The secretion is colostrum. After 72-96hr, the breasts get heavier and lumpier as they fill with true milk (white-blueish milk). After the first 3 days, the breasts should be full

Question 4

Explain engorgement

Answer 4

Engorgement is when the breasts are overfilling with milk. Breasts will fill heavy and sore. The condition should resolve within 1-2days with frequent breastfeeding

Question 5

U in BUBBLLEEP

Answer 5

Uterus: The uterus should be midline, contracted (firm), and the fundus height should be appropriate to day. Height starts at 1cm above or below the umbilicus and lowers 1-2cm everyday.

Question 6

After 2 weeks should the uterus be palpable

Answer 6

no

Question 7

Where is the fundus 24hrs after birth

Answer 7

halfway bw the umbilicus and the pubis symphysis

Question 8

During involution the fundus (uterus) descends how many cm every 24hrs

Answer 8

1-2cm/day

Question 9

Involution is

Answer 9

The return of the uterus back to it’s normal state

Question 10

Postpartum is also known as:

Answer 10

puerperium or 4th trimester

Question 11

What is the postpartum period

Answer 11

time between birth and the return of the reproductive organs to there normal state (lasts about to 6 weeks)

Question 12

A uterine massage is done to

Answer 12

contract the uterus

Question 13

Bladder in BUBBLLEEP

Answer 13

Assess amt and frequency of pee. Full bladder can prevent uterus from contracting. If patient is not peeing within 8hrs, we will put a catheter in. C-section moms will get a catheter in right away for 12hrs.

Question 14

Bowel function in BUBBLLEEP

Answer 14

Listen for bowel sounds esp for c-section pts. Ask if they had a bowel movement and if they are passing gas. Should have one by 2-3 days. Women may not have bowel movements for many reasons (loss of muscle tone, dehydrated, not eating enough, scared, etc..)

Question 15

Lochia in BUBBLLEEP

Answer 15

Lochia: lochia should be decreasing everyday.
1. Rubra: red with small clots in first 4 days
2. Serosa: pink and will last ~10days
3. Alba: whitish and will last ~10-14 days
Clots should be smaller than plum and should break apart.
There shouldn’t be an offensive odour

Question 16

What is abnormal lochia amts

Answer 16

Patients should not be soaking a pad in an hr. For vaginal birth, the avg is 500ml and for C-section the avg is 1000mL

Question 17

Legs in BUBBLLEEP

Answer 17

Check for edema (some is normal) and pain. A warm, red, tender area could be a sign of a blood clot.

Question 18

Episiotomy in BUBBLLEEP

Answer 18

episiotomy is an incision in the perineum. Assess using REEDA. Give pt ice and peri-bottle for comfort

Question 19

Emotional status in BUBBLLEEP

Answer 19

check for postpartum distress such as tearful, sad, fatigued, depressed, etc…

Question 20

P in BUBBLLEEP

Answer 20

Assess pain using PQRST, provide intervention measures

Question 21

Postpartum vitals

Answer 21

BP: Should be normal (around 80/120mmHg)
Respirations: 16-24 breaths/min
SPO2: above 90%
Pulse: 60-100 bpm
Temp: 36.2-38 C

Question 22

Postpartum hypotension or hypertension could be caused by:

Answer 22

Hypotension: hemorrhage
Hypertension: orthostatic hypertension, pre-eclampsia (hypertension due to organ damage), anxiety

Question 23

T or F: Women should use contraception when they start ovulating.

Answer 23

FALSE. 1 month after birth.

Question 24

T or F: Only an Rh (-) women who gives birth to am Rh (+) baby needs to have WinRho within 72 hrs after birth

Answer 24

True

Question 25

Signs of hypovolemic shock

Answer 25

• BP drops when mom has 30-40% blood volume.
• Tachycardia
• cool an clamy
• grey complexion
• looks lethargic
• Soaking through pad in an 1hr (hemorrhage)

Question 26

Vital signs for newborns

Answer 26

• Resp: 30-60 breathpm
• pulse: 110-180 bpm
• Temp: 36.5-37.2 C
• BP: 60-80/40-50mmHg

Question 27

what are typical newborn measurments

Answer 27

Head circumference: 33-35 cm

Head to heel length: 45-55 cm

Question 28

The frequency that newborn should be eating

Answer 28

Every 2-3hrs for breastmilk.
Every 3-4hrs for formula
At least 8 feeds/day

Question 29

If a newborn is feeding well how many wet diapers should there be

Answer 29

Day 1: 1 and up
Day 2: 2 and up
Day 3: 3 and up
Day 4: 4 and up
Day 5 and up: 6 or more

Question 30

If a newborn is feeding well how many soiled diapers should there be

Answer 30

Day 1-2: 2 and up (meconium: black)
Day 3-4: 3 and up (Transition stool: brown, yellow)
Day 4 and up: 3 (milks stool: yellow, soft)

Question 31

What positions should babies sleep in

Answer 31

On back

Question 32

Newborns follow ups

Answer 32

2-3 day check up after birth
Follow up at 2-4 weeks
Every 2months until 18m
Annually afterwards