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OB Exam Two > Chapter 11 and 12 > Flashcards

Chapter 11 and 12 Flashcards

1
Q

what is the timeframe for post partum

A

Immediately after birth of baby and in six weeks after birth

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2
Q

how long does the hospital stay postpartum

A

mom stays 48 hours for vaginal birth and 72 hours for C-section

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3
Q

what are some common fears postpartum

A

newborn abduction and newborn switching

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4
Q

what are some interventions you can do for fear of newborn abduction and newborn switching

A

ID bracelets right when the baby is born, it is checked every time in and out of the room, security system a sensor on the ankle umbilical clamp it locks down the unit if sensor gets too close to the door, the baby could stay in the room, the nurse badge needs to be visible and have identifier that shows that they work on the floor

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5
Q

how often do you assess postpartum

A

vaginal birth Q 15 minutes X2 hours, then queue 4hours for 8 hours then Q8 to 12 hours for C sections Q 30 minutes for four hours then Q1 hour for three hours then queue 4 to 8 hours

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6
Q

what are the ss of postpartum chills

A

uncontrollable shaking within two hours postpartum, sometimes not cold it is normal and will go away

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7
Q

what is the treatment for postpartum chills

A

warm drinks more blankets

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8
Q

what is the blood pressure do postpartum

A

decrease blood pressure can be normal or mean uterine hemorrhage

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9
Q

what are the signs of a preeclampsia headache

A

headache, blurred vision, epigastric pain, edema, photophobia, proteinuria

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10
Q

what are the signs of leaking cerebral spinal fluid headache

A

headache when sitting up and goes away when laying down

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11
Q

what is the temperature do postpartum

A

increase temp within first 24 hours as normal because exertion from delivery, dehydration from no food or water, after the first 24 hours the patient should be afebrile 100.4 or more could mean infection

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12
Q

what is the heart rate do postpartum

A

bradycardia normal and 1st 6 to 10 days

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13
Q

how do you diagnose postpartum preeclampsia with blood pressure

A

increase systolic blood pressure of 30, 15 in diastolic or 140 / 80

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14
Q

what do respirations do postpartum

A

may have increased because of fear, pain, excitement, exertion, excessive blood loss

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15
Q

what are the signs of pulmonary embolism

A

sudden tachypnea, abnormal lung sounds, chest pain, anxiety, call rapid and give O2

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16
Q

what in the breasts produce milk

A

mammary glands

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17
Q

what happens to the areola in breasts during postpartum

A

darkens and enlarges with pregnancy main ducks coverage and open into the nipple

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18
Q

what does the quantity of milk depend on

A

how the baby feeds the more nursing the more milk that will be produced

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19
Q

what are the milk production cells

A

alveoli ducts that collect milk from the alveolus and transport it towards the nips

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20
Q

when does breast firming happen and what does it mean

A

milk coming in about 3 days postpartum the breast will start to fill can cause increase in temperature four to five days milk will leak

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21
Q

what are Montgomery tubercles

A

emit waxy substance that lubricates the nips it acts as an anti infective to protect the nips

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22
Q

how should you wash the nips

A

water only soap will dry them out and cause cracking

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23
Q

what are some uterus complications postpartum

A

uterine atony meaning lack of muscle tone causes boggy uterus

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24
Q

what is involution

A

process of uterus returning to pre pregnancy state results from decrease in size of myometrial cells

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25
why are there contractions after delivery
prevent hemorrhage the contraction is sealing off for the placenta was implanted into the uterine lining
26
when should the mom void postpartum
6 to 8 hours of 150 MLS/hr, to avoid urinary retention or stasis by the 2nd to 5th day should be getting 3000 milliliters per day
27
what causes decreased bladder tone
edema from pressure of presenting part and labor, effects of progesterone on smooth muscle, mucosa hyperemia from increased blood vessel size
28
how long does it take placental implantation to heal
six to seven weeks postpartum via exfoliation and results in uterine scarring
29
what does the relaxin hormone do
slows bowel activity causing Constipation
30
when should the mom have a bowel movement postpartum
first two to three days postpartum
31
besides relaxing what are some other causes of Constipation
meds, abdominal muscles have been stretched, hemorrhoids, sore, episiotomy or laceration, dehydration, decreased gastric motility related to hormones
32
what is lochia comprised of
erythrocytes, epithelial cells, blood, fragments of decidua (uterine tissue), mucus or bacteria
33
when do the edges of an episiotomy become fused
1st 24 hours
34
what is the treatment for Constipation
increase fiber, ambulate, drink more water, stool softeners
35
what color is lochia ruba and when do you see it
one to three days bright red
36
what color is lochia serosa and when do you see it
4 to 10 days pinkish brownish color
37
what color is lochia Alba and when do you see it
over 10 days white to yellow color
38
what is the treatment for hemorrhoids
ice packs, which Hazel, laying on side, topical ointments, sit on firm surface because soft surfaces will decrease blood flow and increase pain
39
what is after pain postpartum
intermittent uterine contractions it is worse for multi Paris, pain or worse when breastfeeding because of the release of oxytocin
40
what are some interventions you can do for pain postpartum
sitz bath, cold first 24 hours then heat, topical creams and sprays can also use non pharmacological methods
41
when should postpartum pain end
5 to 7 days
42
what medication can you give prior to breastfeeding for pain
Motrin give 30 minutes before
43
what should you document for postpartum pain
onset, location, type, duration, factors that make it better or worse
44
what is hemorrhage and when do you see it
first one to two hours observe closely for hemorrhage it is blood loss over 1000 MLS for C-section or 500 MLS for vaginal birth
45
when is late postpartum hemorrhage
after first 24 hours and up to 12 weeks
46
what is postpartum hemorrhage caused by
retained placenta fragments, sub involution of uterus
47
when is early postpartum hemorrhage
within the 1st 24 hours postpartum more likely in the first four
48
What is early postpartum hemorrhage caused by
laceration, uterine atony, hematoma
49
what are the signs of early shock
restlessness, increased heart rate, pallor, cold clammy hands, decrease UOP
50
what is the management done for hemorrhage
stop the blood loss, first you want to massage the uterus, IV fluids, blood transfusion, O2, Foley Cath vital signs including fundus and lochia Q 15 minutes till stable, uterine packing, balloon tamponade, ligation of uterine arteries, hysterectomy, give oxytocin/methergine/hemabate
51
what could bleeding without clots mean
retaining placental fragments
52
what could bright red bleeding with clots mean
laceration
53
after the dangers of hemorrhage and shock have passed what are you worried about now
infection especially uterine infection
54
what are the risks for infection
the uterine cavity because it's an open wound, placental site because it's an open wound, surgical incision, cracks in the nips, increased pH in vaginal secretions
55
how do you prevent infection postpartum
wash hands, keep incisions clean with Perry bottle frequent pad changing after every feed, check incisions, pat after voiding from front to back, sitz bath
56
what do hemoglobin levels do postpartum
decrease one gram from vaginal, 2 grams for C-section normal is 12 to 16
57
what does estrogen and progestrogen do postpartum
dramatically decrease after delivery of placenta, also signals pituitary gland to release prolactin which prepares for lactation
58
what does hematocrit do postpartum
should return to pre pregnancy levels by four to six weeks normal is 36 to 48%
59
what is a hematoma
localized collection of blood under the skin following injury or laceration of blood vessels without injury to outer tissue, often in vulva but can occur in vaginal wall
60
what are the risks for hematoma
lacerations, episiotomies, operative vaginal deliveries like forceps, difficult or prolonged second stage of delivery, nulli para
61
what is the treatment for hematoma
if three to five centimeters palliative care with ice packs for first 24 hours, pain meds and observation if over 5 centimeters then incision and drainage which will increase the risk for infection
62
what are the signs of the hematoma
swelling, redness, warmth, pelvic pain, increased pulse, decreased BP, decrease HCT, fundal check is normal, moderate to scant lochia which is normal
63
what happens with ovulation postpartum
menstruation usually resumes 6 to 8 weeks for non breastfeeding if they are exclusively breastfeeding they may not ovulate for three months most men straight by 12th week first cycle is anovulatory but ovulation can proceed menstruation
64
what is mastitis
usually two to three weeks postpartum, milk stasis or infection entering cracks in the nips
65
what are the signs of mastitis
redness, heat, tenderness, edema
66
what is the treatment for mastitis
antibiotics, removing milk from breasts, lots of hydration, applying heat or cold for comfort
67
What is the appearance postpartum
they still look pregnant because abdominal muscles have been stretched takes 6 to 8 weeks to get back to pre pregnancy
68
What is diastasis
separation of abdominal muscles
69
what is the teaching of exercise postpartum
If they exercise before and during they could probably go back to a modified workout they're starting a new routine that could take 10 to 12 weeks
70
what is rubella vaccine given postpartum
if not immune then it is given immediately postpartum to prevent complications for future pregnancies teach that you should not get pregnant at least one month after
71
who gets RhoGAM
given to RH- mom who has Rh+ baby gets 128 weeks and another one 72 hours postpartum
72
what is the taking in phase
it is early in postpartum the mom is passive with care, reliving birthing experience, focusing on food fluids and restorative sleep
73
what is the taking hold phase
mom cares for infant, increased concern for body function, cares for herself, interested in learning to care for baby
74
what is the letting go phase
mom lets go of previous role and sees parenting as primary role, reconciles with how birth went and how she wanted it to go
75
what are postpartum Blues
normal to feel a little down but overall happy with life related to withdrawal of estrogen and progesterone and cortisol
76
what is the treatment for postpartum Blues
support and reassurance
77
what is postpartum depression and when does it happen
two to four weeks postpartum persistent mood of unhappiness, mom can't care for herself or baby
78
what are signs of postpartum depression
sleep issues, guilt, fatigue, helplessness, worthlessness feeling
79
what is the treatment for postpartum depression
referred promptly for eval
80
what are the signs of postpartum psychosis
delusions, hallucinations, agitation, inability to sleep, irrational behavior
81
what assessment is done for postpartum psychosis
Edinburg assessment
82
how often should a mom pee postpartum
Q4 hours need to change Perry pad every time
83
what are the signs of a UTI
painful urination, foul odor to urine, lower abdominal pain
84
how often should you use a Peribottle or sitz bath
three times a day should be used until bleeding stopped or perineal discomfort relieved
85
what should you teach a mom who had a vaginal delivery when to call the doctor
temp 100.4 or more, flu like symptoms, assess for bleeding like soaking a pad in an hour or more bright red bleeding, large clots, foul smelling discharge
86
what should you teach the mom to avoid postpartum
tampons, douches, sex or anything up the vagina for six weeks
87
what is the teaching involved for C sections postpartum
pat incision dry, steri strips will eventually fall off, call the doctor of signs of infection including temp, drainage, swelling, watch for dehiscence
88
what should you encourage postpartum for nutrition
well balanced diet including healthy low fat diet with protein carbs fruit and veggies
89
when is follow up postpartum
two weeks and six weeks for C-section six weeks for vaginal

OB Exam Two (8 decks)

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