Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NUR 318 > module 10 > Flashcards

module 10 Flashcards

1
Q

Postpartum fungus positioning tone hemostasis

A

midline and at umbilicus (directly postpartum) firm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

involution

A

the movement of the uterus back to the pre pregnancy position occurs at a rate of 1 cm per day. contractions allow for this to happen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

subinvolution

A

when the uterus does not recede back to its pre pregnancy position
could be the result of the bladder not being emptied

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what causes the uterus to deviate up and to the right

A

a full bladder. this can even cause the uterus to be boggy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is the role of oxytocin postpartum?

A

oxytocin helps with hemostasis. it allows for the vessels that were once attached to the placenta to clamp off. oxytocin is released from the pituitary gland

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is the sequence of lochia

A 
lochia rubra from day 0 to day 3
lochia serosa from day 4- day 10
lochia alba from day 11-day 14
the lochia should move in a very specific sequence and should not move backward
pads should be changed every 2-3 hours
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

postpartum vagina and perineum

A
  • the vaginal rugae or folds in the vagina will be different. they allow for stretching during labor
  • the introitus is the opening to the body at the vagina. it may be red and swollen. there may be lacerations or an episiotomy(standard practice is moving away from this and it is typically only used with a vacuum or forceps) there can also be a hematoma
  • there may be painful sex
  • and overall dryness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

pelvic muscular support

A

supportive tissues of the pelvic floor torn or stretched during childbirth
may require 6 months to regain tone
kegel exercises encourage healing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

postpartum endocrine system

A
  • pituitary hormones play a role in ovarian function
  • the timing of ovulation is influenced by lactation patterns
  • throughout pregnancy, the placenta is the major producer of hormones however after the placenta is delivered, it takes 2 weeks for placental hormones to drop and for the pituitary to take over.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

the urinary system postpartum

A
  • glomerular filtration rate and renal flow increase for diuresis. within 12 hours diuresis begins increasing urine output. diaphoresis often occurs at night for the first 2-3 days postpartum
  • the risk of infection of UTI if catheterization was necessary. voiding sensations will be affected and the first void should be within the first 6 hours after birth
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

postpartum diuresis

A
  • large amounts of intravenous fluids given during labor
  • decreasing antidiuretic effect of oxytocin as its level declines
  • buildup and retention of extra fluids during pregnancy
  • decreasing production of aldosterone-the hormone that decreases sodium retention and increases urine production
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Gastrointestinal system postpartum

A
  • relief from the pregnant uterus
  • sluggish bowels related to hormonal changes
  • constipation is no longer due to pregnancy but due to fears of pushing. a colace and reassurance are important.
  • hemorrhoids are varicosities that are due to straining
  • avoid suppositories with rectal sutures from lacerations
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

musculoskeletal changes postpartum

A

binder can be used for support

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

integumentary system adaptation

A
  • pigmentation fades
  • stretch marks fade to silvery lines and to lighter brown in women of color
  • temporary hair loss
  • vascular abnormalities, spider angiomas, palmar erythema, and epulis regress with rapid decline in estrogens
  • spider nevi persist indefinitely for some
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

respiratory system

A

tidal volume, minute volume, vital capacity, and functional residual capacity, return to prepregnant values within 1 to 3 weeks of birth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

immune system

A
  • the immune system is mildly suppressed during pregnancy, but it returns to a prepregnant state
  • rebound of the immune system can cause flare-ups of some autoimmune diseases such as lupus erythematosus and multiple sclerosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

thermoregulation postpartum

A
  • uncontrollable shaking chill immediately following birth. this is physiologic: there is a large cascade occurring in the body
  • could possibly be due to nervous system response, vasomotor changes, shift in fluids, and or work of labor
  • normal unless accompanied by elevated temperature
  • nursing intervention: reassurance is key: this is a normal response to birth can also give a warm blanket
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Breasts: human lactation

A
  • secretion of milk by breasts
  • the result of the interaction of progesterone, estrogen, prolactin (milk production), and oxytocin(milk let down)
  • milk supply is dependent on the release of prolactin (the anterior pituitary) and oxytocin (posterior pituitary)
  • begins after the delivery of the placenta because of a decrease in progesterone and estrogen and an increase in prolactin
  • stimulation and release of milk are necessary for the continued release of prolactin. “supply and demand”
19
Q

colostrum

A

is high in fats and calories. it enhances bowel emptying of infants. it is sufficient until breast milk comes in

20
Q

ovulation and return of menstruation

A
  • the interplay of hormones such as estrogen, progesterone, prolactin, and oxytocin
  • nonlactating women see a return of menstruation 7-9 weeks after birth
  • lactating women: return of ovulation and menses dependent on breastfeeding frequency and duration; anywhere from 2 -18 months. should not rely on breast feeding for birth control
21
Q

taking in phase

A

first 24 to 36 hours
focus is on self: rely on other to meet their needs
very dependent- may need to be reminded to eat, shower, sleep
there is a desire to review the birth experience

22
Q

taking hold phase

A

starts 2 days postpartum and lasts approx 10 days
alternates between the need for extensive nurturing and a desire to take charge
responds enthusiastically to opportunities to learn and practice baby care
emotional change: possible experiences with the blues

23
Q

letting go phase of rubins phases

A

focus on the forward movement of the family as a unit with interacting members
reassertion of relationship with partner
resolution of individual roles

24
Q

engrossment: partner psychological adapttation

A

perception of newborn as perfect
strong attraction to the newborn
awareness of distinct features of the newborn
extreme elation by father
three stages of role development: expectations, reality, transition to mastery

25
Q

components of nursing care postpartum

A
  • promote rest and recovery for the mom
  • assessment of postpartum adaptation
  • prevention of complications (important to know clients history)
  • education on self care
  • support
  • preparation for discharch
26
Q

temperature post partum

A

may increase to 100.4 in first 24 hours and is related to dehydration

27
Q

pulse postpartum

A

may decrease to 50 bpm but if it is greater than 100, that could mean a questionable blood loss or infection

28
Q

BP postpartum

A

WNL if low, hypovolemia

29
Q

respirations postpartum

A

no change 16-20

30
Q

length of stay

A

determined after problems are identified and readiness for home is assessed
typically the minimum stay for a vaginal birth is 48 hours and 96 for a c-section
-couplet care is key

31
Q

prevention of complictions

A
  • physical assessment (BUBBLEHEE)
  • routine lab tests
  • RHO(D) immunoglobulin
  • rubella: given post partum if nonimmune
  • uterine tone assessed
  • bladder distension: to prevent a UTI empty bladder frequently
  • to decrease risk of infection: frequent flusing with peribottle after urination or defecation
32
Q

amount of lochia on the pad

A

scant: 2.5 com
light: <10 cm
moderate < 15 cm in < 6”/ hour
heavy: saturated pad in 1 h
excessive: saturated pad in 15 mis

33
Q

interventions postpartum

A
  • maintain uterine tone to prevent hemprrhage
  • prevent infection
  • promote comfort (pain relief with NSAIDS)
    pharmacologic: NSAIDS and percoset(w/ c)
    nonpharm: ice packs, massage, aroma therapy
  • promote normal bowel and bladder function
34
Q

promoting comfort

A
  • afterbirth pains: NSAIDS, binders
  • perineal discomforts related to swelling: NSAIDS and ice packs
  • episiotomy/ perineal lasceration: which hazel and peri bottles
  • breast and nipple discomfort: lanolin, hydorgel
  • constipation: colace or metamusal
35
Q

danger signs postpartum

A
  • fever >100.4
  • foul smelling lochia or unexpeced change in amount or color
  • large blood clots or saturation of pads in an hour
  • severe headache or blurred vision, visual changes
  • calf pain with localization, tnederness, reddnes and swelling
  • dysuria, burning, incomplete emptying of the bladder
  • SOB difficulty breathing
  • depression or extreme mood swings
36
Q

BUBBLEHEE

A

B: reasts inspect and palpate for size contour nipple condition and milk production
U: terus assess fundus consistency, location, tenderness
B: ladder assess for distention, tenderness, adequate emptying
B: owels has mother moved bowels?, bowel sounds in all 4, assess for abdominal distension
L: ochia type, amount, color, odor, does change of activity change flow?
E: episiotomy and perinum: assess for episiotomy and or lascerations every 8 h, approximation, ecchymosis, D/C and pain
H: omans sign of DVT
E:tremities assess for maternal risk, edema, varicosities
E: emotional status

37
Q

emotional assessment

A 
interactions with fmaily
level of independence
energy levels
eye contact with infant
posture and comfort level with instant
sleep and res patterns
mood swings, irritability, or crying episodes
38
Q

perinatal mood and anxiety disorders

A 
1 in 8 women may experience emptional symptoms known as perinatal mood and anxiety disorders.
trouble sleeping or too much sleeping
changes in appetite
feeling exhausted
pain with moving
feelings of being a bad mother
lack of interest in the baby
thoughts of harming self or baby
39
Q

bonding

A

close emotional attration to a newborn by the parents that develops in the first 30 to 60 mins after birth.
unidirectional from parent to infant

40
Q

attachment

A

development of a strong affection between an infant and a significant other (mother father sibling)

41
Q

transition to aparetnhood

A

stages

factors affecting attachment: parents background, infant, care practices

42
Q

health promotion

A
  • rubella
  • variella
  • Tdap to prevent pertussis (whooping cough) in the baby
  • Rogam if applicable
  • psycho social needs: birth experience, maternal self image and sexual adjustment, adaptations to parenthood
43
Q

contraception

A

factors that influence timing and quality of sex: dypareunia and perineal pain due to 3rd and 4th degree lascerations OASIS(obstetric and anal sphincter injuries)

44
Q

follow up after discharge

A

routine: 6 weeks normal vaginal delivery and 2 weeks c-section
- home visits, telephone followup, warmlines, support groups, community referrals

NUR 318 (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions