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NCLEX-PN® > NCLEX-PN (7) Maternity > Postpartum > Flashcards

Postpartum Flashcards

Review postpartum complications, fundal and lochia changes, breastfeeding, and physical changes.

1
Q

What are 2 life-threatening postpartum complications of cesarean section?

(Immediate complication)

A

Bleeding and Infection.

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2
Q

How many saturated pads per hour is considered hemorrhage?

(Immediate complication)

A
  • > than 1 pad per hour or
  • one pad that gets saturated within 15 minutes
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3
Q

How much blood loss is considered hemorrhage for a vaginal delivery and a cesarean delivery?

(Immediate complication)

A
  • Vaginal delivery: > 500 mL after delivery
  • Cesarean delivery: > 1000 mL after delivery
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4
Q

How should pads be measured for postpartum hemorrhage?

A
  • weigh pad before and after use
  • note time in between pad changes
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5
Q

Interventions:

Postpartum hemorrhage

A
  • measure pads
  • give oxytocin
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6
Q

What maternal temperature is considered normal during the first 24 hours after birth?

A

98.6o - 100.4o F (36o - 38o C)

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7
Q

Interventions:

Postpartum infection

A
  • assess vital signs
  • get cultures of blood, sputum, or lochia
  • antibiotics
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8
Q

What are the normal assessment findings for the fundus on day one after delivery?

A

Should be firm, midline, and at the umbilicus.

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9
Q

How far down should the fundus decrease per day?

A

1 cm downward per day.

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10
Q

What are the interventions if the fundus is boggy or NOT midline?

A
  • have the client urinate
  • gently massage the fundus until firm
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11
Q

What is lochia?

A

The vaginal discharge after pregnancy.

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12
Q

Describe:

Lochia rubra

A

The first vaginal discharge that is red that occurs from birth of baby to about 5 days postpartum.

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13
Q

Describe:

Lochia serosa

A

The second vaginal discharge that is brownish-pink or brown that occurs from 4 - 10 days postpartum.

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14
Q

Describe:

Lochia alba

A

The third vaginal discharge that is yellow to white in color that occurs from about 11 - 14 days postpartum.

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15
Q

Describe abnormal postpartum lochia that indicates infection.

A
  • a very bad odor
  • yellow/green/gray in color
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16
Q

When do postpartum clients start ovulating again?

A

Soon after birth even without having their period yet and while breastfeeding.

Teach clients about contraceptives to prevent pregnancy too soon.

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17
Q

What is colostrum?

A

The first milk that comes in for breastfeeding:

  • it starts about 24 - 72 hours after birth
  • it is a yellow-ish color
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18
Q

What is engorgement?

A

When the breasts are very full of milk.

It can be painful and uncomfortable for the mother.

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19
Q

How can engorgement be prevented in a breastfeeding mother?

A

Breastfeed the baby every 2-3 hours to prevent the breasts from over-filling.

20
Q

What are the interventions for engorgement if the client will not be breastfeeding?

A
  • wear a binder and/or a very snug bra
  • apply ice packs
  • analgesics
21
Q

When will engorgement resolve?

A

About 36 hours after it started.

22
Q

What is the correct way a newborn should latch onto a breast?

A

Newborn mouth should be over entire areola.

23
Q

How long should a breastfeeding baby feed for each breast?

A

Baby feeds on each breast for 15 - 20 minutes.

A breastfeeding session would last between 30 and 40 minutes.

24
Q

How often should moms breastfeed a newborn?

A

Every 2 - 3 hours.

25
Q

How often should caretakers bottle feed a newborn?

A

Every 3 - 4 hours.

26
Q

If a newborn has to breastfeed every 2 hours and the client started breastfeeding at 1 PM, when would the next breastfeeding session start?

A

At 3 PM.

Start at the time of when the client started breastfeeding, not when it ended.

27
Q

How does the mom break the suction from a breastfeeding baby?

A

By inserting a finger between the mouth and the breast.

28
Q

How long is breastmilk or formula the only food given to the baby?

A

For 4 - 6 months.

Nothing else should be given up until that time.

29
Q

Can breastfeeding mothers take medications?

A

When breastfeeding, all medications and over-the-counter medications need to be approved by the HCP first before taking.

30
Q

What are the complications of breastfeeding?

A
  • cracked nipples
  • mastitis
31
Q

What are the interventions for cracked nipples?

A
  • no soap (dries out the skin)
  • expose breasts to air for part of the day
  • use different breastfeeding positions for baby
  • apply lanolin (emollient)
32
Q

Describe:

Mastitis

A

An infection of the breast with clogged milk ducts.

33
Q

Interventions:

Mastitis

A
  • heat or cold packs (to decrease inflammation)
  • supportive bra (no wire bras - too much constriction)
  • still breastfeed or pump every 4 hours
34
Q

Medications:

Mastitis

A
  • analgesics
  • antibiotics
35
Q

What are the general assessments postpartum?

A
  • bleeding
  • infection
  • pain
  • perineal hematoma
  • incision for cesarean delivery
  • depression
  • DVT (thrombophlebitis)
  • fungal height
36
Q

What are the general interventions postpartum?

A
  • vital signs
  • intake and urinary output
  • encourage fluids/fiber/walking
  • pain relief
37
Q

What are the specific assessments and interventions for the renal system postpartum?

A
  1. assess urine output
  2. may have retention if anesthesia was used - encourage urination or straight cath

Client will have frequent urination to get rid of extra fluids.

38
Q

What are the specific assessments and interventions for the gastrointestinal system postpartum?

A
  1. assess for constipation
    • encourage fluids/fiber/walking
    • stool softeners
  2. give extra 500 calories per day due to breastfeeding
  3. multivitamin for deficiencies
39
Q

What are the specific assessments and interventions for mental health postpartum?

A
  1. assess for postpartum depression - therapeutic communication, possible group therapy, and medications
  2. assess for mom/baby bonding
40
Q

What are the specific assessments and interventions for the cardiac system postpartum?

A

If client underwent a cesarean section: assess for DVT (thrombophlebitis) and pulmonary embolism.

Provide life-saving interventions and notify HCP.

41
Q

What are the specific assessments and interventions for pain postpartum?

A
  • ice packs to perineum
  • sitz baths
  • analgesics
  • suppositories if client had episiotomy
42
Q

What are the specific assessments and interventions for Cesarean delivery?

A
  1. assess incision
  2. encourage walking - prevent DVT and constipation
  3. encourage cough and deep breathing - prevent pneumonia
43
Q

What is the teaching to a client that needs to get the MMR vaccination postpartum?

A

Teach client to use contraceptives for 1 - 3 months after vaccination due to risk of harm to fetus.

43
Q

How can engorgement be prevented in a breastfeeding mother?

A

Breastfeed the baby every 2-3 hours to prevent the breasts from over-filling.

44
Q

After birth of a baby, when can sex be resumed by the woman?

A

Woman can resume sex when bleeding has stopped and client is on contraceptives (if woman does not want to get pregnant).

NCLEX-PN (7) Maternity (5 decks)

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