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Nurs 368 > Postpartum > Flashcards

Postpartum Flashcards

1
Q

What stage is postpartum?

A

Stage 4

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2
Q

How long is the postpartum period?

A

6 weeks up to 1 year

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3
Q

which systems go through changes in the mother’s postpartum period?

A

Every system

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4
Q

Frequency of a postpartum Assessment

A

Every 15 minutes for first hour, then every 30 minutes for 1 hour, the every hour for two hours

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5
Q

How to do fundal massage

A

One hand on top of fundus, one above pubic symphysis

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6
Q

What should be assessed in a postpartum assessment?

A

Vital signs, fundus, bleeding, IV with added pitocin/oxytocin

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7
Q

When can a CBC be done on a postpartum patient?

A

1st postpartum day

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8
Q

What is a common WBC postpartum?

A

15,000-25,000/mL

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9
Q

What is the Hgb decrease postpartum?

A

1.0-1.5 g/dL per 500ml of blood loss

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10
Q

What will happen to fibrinogen, clotting factors, and platelets in a postpartum patient? What needs to be monitored because of this?

A

They increase. Respiratory function should be monitored to know if there is a pulmonary embolism

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11
Q

How should a patient be positioned for a uterine assessment?

A

Laying flat

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12
Q

What does bubblehehe stand for?

A

B- breasts
U- uterus
B- bladder
B- bowels
L- lochia
E- episiotomy/laceration
H- hemorrhoids
E- extremities
H- hemorrhage
E- emotional assessment/education

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13
Q

What should you assess on breasts?

A

Soft, filling, engorgement, colostrum

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14
Q

What are nipple shells used for? The smaller hole? The larger hole?

A

Everting the nipples
Sore nipples

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15
Q

Symptoms of mastitis

A

Fever, malaise, unilateral breast pain, and tenderness in the infected area

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16
Q

Treatment for mastitis

A

Antibiotic therapy, analgesia, rest and hydration

17
Q

If a uterus is firm, how much bleeding would be expected?

A

Scant

18
Q

What should be done if the uterus is boggy?

A

Express clots and note bleeding amounts, give pitocin or other uterotonic, empty bladder or insert a foley, do vital signs as needed

19
Q

How long should a fundus be massaged?

A

Until firm

20
Q

What is the first vital sign that changes during a postpartum hemorrhage?

A

Heart rate becomes tachycardic

21
Q

How many days after childbirth should the uterus no longer be palpable?

A

14 days

22
Q

How much smaller does a uterus become each day following childbirth?

A

1cm per day

23
Q

What should be assessed when assessing the bladder?

A

Assess for pain or difficulty voiding: burning, difficulty starting stream or odor, frequency
Is the bladder palpable?

24
Q

What is cystitis?

A

Bladder inflammation/infection

25
Q

When should bowel sounds be checked?

A

Before fundal check

26
Q

When should a woman have a bowel movement after childbirth?

A

2nd or 3rd day postpartum

27
Q

What should be assessed with lochia?

A

Color, odor, amount and presence of clots or tissue

28
Q

When should lochia be assessed?

A

With each fundal assessment

29
Q

What kind of lochia is present on days 1-3? 4-10? 11-21?

A

Lochia rubra, lochia serosa, lochia alba

30
Q

How much lochia is seen at scant, light, and moderate levels? What is it called if the pad is completely soaked?

A

<1 inch, 1-4 inches, 4-6 inches, saturated

31
Q

What is the most common cause of postpartum hemorrhage?

A

Uterine atony

32
Q

What should be done for a postpartum hemorrhage?

A

Start 2 large bore IVs, anticipate uterotonicmedications, anticipate hangingblood, monitor vital signs and breath sounds, foley to monitor output, prep for surgery if uterine atony is not resolved

33
Q

What are the 4 Ts of postpartum hemorrhage etiology?

A

Tone, tissue, trauma, thrombin

34
Q

What does REEDA stand for?

A

R=redness, E= edema/swellings, E=ecchymosis or bruising, D=drainage/discharge
A= approximation

35
Q

When is the REEDA scale used?

A

To assess episiotomies and lacerations

36
Q

What should be assessed when assessing extremities?

A

Edema, pedal pulses, capillary refill, signs and symptoms of DVT

37
Q

What % of women experience perinatal mood disorders?

A

20%

38
Q

What needs to be done if Duramorph is administered?

A

Respiratory assessment q1 hr

Nurs 368 (20 decks)

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