Ch 21 Nursing Care of the Family During the Postpartum Period

Question 1

The placenta should be delivered within…

Answer 1

30 minutes of the newborn

Question 2

How long does the postpartum period last?

Answer 2

Approximately 2 hrs

Question 3

Delayed delivery of the placenta puts the mother at risk for…

Answer 3

Postpartum hemorrhage

Question 4

Puerperium

Answer 4

6 weeks after childbirth where mother’s organs return to non pregnant state

Question 5

Postpartum vital signs: Normal BP

Answer 5

Slightly increased first few days OR can have orthostatic hypotension first 48 hrs

Question 6

Postpartum vital signs: Hypertension indication

Answer 6

Anxiety, pre eclampsia, essential hypertension (undiagnosed)

Question 7

Postpartum vital signs: Hypotension indication

Answer 7

Hemorrhage

Question 8

Postpartum vital signs: normal temp

Answer 8

97.2-100.4

Question 9

Postpartum vital signs: febrile indication

Answer 9

Infection

Question 10

Postpartum vital signs: HR

Answer 10

50-90

Question 11

Postpartum vital signs: Tachycardia

Answer 11

Pain, fever, dehydration, hemorrhage

Question 12

Postpartum vital signs: RR

Answer 12

16-20

Question 13

Postpartum vital signs: Bradypnea

Answer 13

effects of opioid medications

Question 14

Postpartum vital signs: Tachypnea

Answer 14

Anxiety, respiratory disease

Question 15

Postpartum assessment frequency: Vaginal

Answer 15

8 hrs

Question 16

Postpartum assessment frequency: c section

Answer 16

4-8 hrs

Question 17

Assessment: BUBBLE HERP stands for

Answer 17

B - breasts
U - uterus
B - bladder
B - bowel
L - loch/legs
E - Episiotomy
H - hemorrhoids
E - emotion
R - rubella
P - pain

Question 18

What is included in the postpartum assessment

Answer 18

BUBBLE HERP
Vitals
Assess incision, breath sounds, bowel sounds

Question 19

Postpartum assessment: Breasts day 1-2

Answer 19

Soft (colostrum)

Question 20

Postpartum assessment: Breasts day 2-3

Answer 20

Filling

Question 21

Postpartum assessment: Breasts day 3-5

Answer 21

Full, soften with breast feeding

Question 22

Postpartum assessment: Breasts abnormal

Answer 22

Engorgement: firmness, heat, pain

Question 23

Postpartum assessment: Nipples abnormal

Answer 23

Latching problems: Redness, bruises, soreness, pain, blisters

Question 24

Postpartum assessment: Uterus normal

Answer 24

Firm, midline
First 24 hrs at level of umbilicus
Involutes 1 cm a day

Question 25

Postpartum assessment: Uterus abnormal

Answer 25

Uterine atony: Soft, boggy, higher level than expected | Lateral deviation: distended bladder

Question 26

Uterine atony means..

Answer 26

Without tone, failure of uterus to contract

Question 27

How can we maintain uterine tone?

Answer 27

Fundal massage

Question 28

Inflammatory infection of the breast almost always caused by infection

Answer 28

Mastitis

Question 29

Symptoms of mastitis

Answer 29

Breast: Tender, hot, localized redness, pain swollen axillary lymph nodes on affected side Pain with breast feeding or expressing

Question 30

Patients with mastitis milk can be

Answer 30

Clumpy or gelatinous, or have pus or blood in it

Question 31

Possible systemic symptoms of mastitis

Answer 31

``` Fever of 101 or higher Chills Headache Malaise Nausea Myalgia Lethargy Fatigue ```

Question 32

How is mastitis treated?

Answer 32

Rest, increased fluids, increased feedings, abx

Question 33

Risk factors for mastitis

Answer 33

``` Infrequent or insufficient milk removal Being less than 6 weeks postpartum Feeding a baby colonized with staph aureus Nipple damage or trauma Plugged ducts Delayed initiation of breast feeding Stress/Fatigue Nipple shield use Extended pressure on the breast, bra or stomach sleeping ```

Question 34

Engorgement

Answer 34

Hard, firm, excessive milk in breasts, tender. Common finding

Question 35

Mastitis can lead to...

Answer 35

Septicemia