6.2i Immune

Question 1

Hemorrhoid

Answer 1

• Anal Varicosity

Question 2

Oxytocin

Answer 2

• Responsible for let down reflex

- Responsible for uterine contraction

Question 3

Prolactin

Answer 3

• Secreted by pituitary of lactating patients

Question 4

Postpartum Diaphoresis

Answer 4

• Sweating after birth (especially at night) to rid body of excess fluid gained during pregnancy

Question 5

Autolysis

Answer 5

• Self destruction of hypertrophied uterine tissue

- Causes decrease of estrogen and progesterone after birth

Question 6

Atony

Answer 6

• Failure for uterine muscles to contract firmly

- Causes fundus to be soft/boggy and most frequent cause of postpartum bleeding

Question 7

Dysparenuia

Answer 7

• Discomfort during sex

Question 8

Involution/Subinvolution

Answer 8

Involution - Normal return of uterus to prepregnant state

Subinvolution - Failure of uterus to return to prepregnant state

Question 9

Episotomy

Answer 9

• Surgical incision to perineum to facilitate vaginal birth

Question 10

Afterpains

Answer 10

• Uterine cramping that occurs early postpartum

Question 11

Diastasis Recti Abdominus

Answer 11

• Separation of abdominal wall muscles due to enlarged uterus during pregnancy

Question 12

Retained Placental Fragments and Infection

Answer 12

• Reason for uterus not returning to normal after birth

Question 13

Exogenous Oxytocin

Answer 13

• Administer IV/IM
• Given after expulsion of placenta to ensure uterus remains firm and contracted
• Reduces postpartum hemorrhage

Question 14

Postpartum Period

Answer 14

• After birth until body organs return to normal state

Question 15

Uterine Involution Process

Answer 15

• Begins immediately after expulsion of placenta

- Estrogen and Progesterone cause increase in uterine growth

Question 16

Postpartum Hemostasis

Answer 16

• Achieved through compression of blood vessels as uterine muscles contract
• Oxytocin promotes uterine contractions which compress the vessels to promote hemostasis
• Exogenous oxytocin can also be administered to promote this

Question 17

CASE STUDY

Answer 17

• Fundus 2 cm above umbilicus and displaced to right. Pads are completely saturated with lochia rubra. Is this expected 3 hours after birth
• No fundus should be at level of umbilicus after 12 hours and lochia flow should decrease
• 3rd stage of labor fundus 2cm below umbilicus
• 12 hours after umbilicus should be at level of umbilicus
• 2 hours lochia should reduce to heavy menstrual period amount

Question 18

Extensive Bleeding Postpartum

Answer 18

• Can be due to distended bladder

Question 19

Hemorrhage

Answer 19

• Gush of blood is not hemorrhage when standing
• Lochia flow is increased with ambulation and breastfeeding
• Lochia pools while lying down and standing they may have a pool of blood

Question 20

Oxytocin

Answer 20

• Stimulated when infant breast feeds

- Recommended early postpartum to stimulate contractions