Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NURS 4500: Final Material > Class 7: Post Partum Body System Changes Table > Flashcards

Class 7: Post Partum Body System Changes Table Flashcards

1
Q

what changes occur to the HR, BP, and RR during the postpartum period

A
  • HR and BP return to prepregnancy lvls within a few days
  • return to prepregnancy RR
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what changes to T occur during the postpartum period

A
  • temp may increase to 38*C within 1st 24 hours due to dehydrating effects of labor
  • should be afebrile after 24h
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

describe contractions of the uterus in the postpartum period (2)

A
  • release of oxytocin from pituitary gland strengthens/coordinates muscle contractions in postpartum period
  • continued muscle contractions of uterus support achievement of hemostasis by compression of intra-myometrial blood vessels
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

the relase of oxytocin postpartum is supported by

A
  • breastfeeding
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

the continued uterus contractions in postpartum are experienced as…

A
  • afterpains / cramps
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

define: involution

A
  • the return of the uterus to a nonpregnant state after birth
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

during pregnancy, the uterus enlarges due to hyperplasia and hypertrophy. what occurs after birth?

A
  • autolysis destroys the hypertrophied cells
  • the uterus remains slightly larger in size after each pregnancy due to the additional cells from the process of hyperplasia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

describe changes to uterus size postpartum

A
  • rapidly reduces in size after birth
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

the fundus usually descends ___cm q24h postpartum

A
  • 1-2 cm every 24 hrs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

at the end of the 3rd stage of labor, where is the uterus located? how much does it weight?

A
  • fundus at or 1-2cm below umbilicus
  • 1000 g
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

at 12hrs after birth, where is the uterus located?

A
  • may rise to 1cm above umbilicus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

at 24 hrs after birth, what is the size of the uterus

A
  • uterus is about the same size that it was at 20 weeks gestation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

after 2 weeks, where is the uterus located? how much does it weigh?

A
  • uterus is no longer abdominally palpable
  • lies in true pelvis, below symphysis
  • 350g
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

by 6 weeks postpartum the uterus weighs approx?

A
  • 60-80 g
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

describe uterine placement postpartum

A
  • should be midline on abdomen
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

deflection of the uterus can indicate?

A
  • a distended bladder
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

describe the size and consistency of the uterus postpartum (3)

A
  • ~size of a grapefruit
  • round
  • firm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what is uterine atony?

A
  • loss of tone in the uterine musculature
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what indicates uterine atony?

A
  • large uterus
  • soft/boggy uterus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

uterine atony is the most common cause of? how?

A
  • excessive bleeding in the postpartum period as it means the intra-myometrial blood vessels are not being adequately compressed by the uterine muscle contractions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what is subinvolution

A
  • the failure of the uterus to return to the prepregnant state
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

subinvolution is often related to.. (2)

A
  • retained placental fragments
  • infection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

the unique healing process of the endometrium prevents?

A
  • normal scar formation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

endometrial regeneration is compelte by? except where and when is this compelted?

A
  • complete by postpartum day 16
  • except at placental site where it is completed at 6 weeks
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

expulsion of the placenta leads to? particularly which ones?

A
  • leads to decrease of placental-produced hormones
  • estrogen and progesterone lvls drop markedly
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

in non-lactating birthers, estrogen lvls begin to increase when??

A
  • 2 weeks after birth
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

define: lochia

A
  • the name for the uterine discharge that passes vaginally following birth
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

describe lochia rubra, what can it include?

A
  • bright red or dark bleeding
  • can include small clots, blood, decidual & trophoblastic debris
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

describe the heaviness and duration of lochia rubra

A
  • heaviness: amt of a heavy menstrual period in first 2 hrs after birth, may soak a pad q2-3 h
  • duration: 3-4 days
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

describe the color of lochia serosa, what does it include?

A
  • color: brownish or pinkish color
  • includes: old blood, serum, leukocytes, and debris
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

what is the duration of lochia serosa, heaviness?

A
  • heaviness: mild to moderatr
  • duration: days 4-10 (can last up to 27 days, majority day 10)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

describe the color of lochia alba, what does it include?

A
  • white in color
  • includes: leukocytes, decidua, epithelial cells, mucus, serum, bacteria
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

what is the heaviness of lochia alba? duration?

A
  • heaviness: light flow or spotting
  • duration: day 10 until 4-8 weeks postpartum
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

how large is the cervix within 2-3 days postpartum? 1 week?

A
  • 2-3 days: 2-3 cm
  • 1 week: ~1cm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

describe the appearance of the cervix postpartum?

A
  • outer part of the cervix that opens into the vagina (ectocervix) appears bruised and has small lacerations
  • external os of cervix never returns to its pre-pregnancy appearance = jagged line/slit instead of circular
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

the small lacerations of the cervix postpartum causes what?

A
  • optimal conditions for development of infection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

describe the differences in ovarian function in lactating vs nonlactating persons? why does this occur?

A
  • differ in timing of ovulation and menstruation
  • bc elevated prolactin lvls in lactating persons suppress ovulation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

describe menstruation of non-lactating birthers

A
  • 70% menstruate within the first 12 weeks after birth
  • ovulation can occur as early as 27 days after birth, mean time = 7-9 weeks postpartum
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

describe menstruation of lactating birthers

A
  • return of ovulation depends on breast/chest/pumping patterns
  • mean time = 6 months after birth
40
Q

describe the consistency of the vagina immediately after birth, why?

A
  • vagina is thin and smooth immediately after birth
  • due to edema, increased vascularity
41
Q

describe the consistency of the vagina in 3rd week postpartu,m

A
  • rugae restored
42
Q

describe the size and tone of the vagina postpartum (3)

A
  • decreases in size
  • regains tone
  • may never return to prepregnancy state
43
Q

what impact does decreased estrogen postpartum have on the vagina (3)? how long does this last?

A
  • dry
  • coital discomfort
  • thin vaginal mucosa
  • until return of ovarian function
44
Q

describe mucosa of the vagina postpartum in the lactating person

A
  • may remain atrophic until menses returns
45
Q

perineal lacerations are classified based on?

A
  • tissues/structures involved
46
Q

how many degrees of perineal lacerations are there?

A

4

47
Q

describe 1st degree of perineal laceration

A
  • involves skin and structures superficial to muscles
48
Q

describe 2nd degree of perineal laceration

A
  • extends thru muscle
49
Q

describe 3rd degree of perineal laceration

A
  • extends thru anal sphincter
50
Q

describe 4th degree perineal laceration

A
  • involves anterior rectal wall
51
Q

describe the site of episiotomies/lacerations repairs initially?

A
  • site initially erythematous and edematous
52
Q

describe the healing of episiotomies/lacerations repairs postpartum

A
  • initial healing occurs within 2-3 weeks to the point that the perinum is barely distinguishable from that of a nulliparous person
  • complete healing can take up to 6 months
53
Q

what can occur and be decreased within the postpartum period r/t to the perineum? what can they look like?

A
  • hemorrhoids can occur and decreased within 6 weeks after birth
  • should be pink and soft
54
Q

what stimulates prolactin release after birth? what else stimulates its release?

A
  • fall of progesterone
  • also produced in response to infant feeding and emptying chest/breasts
55
Q

what role does prolactin play postpartum?

A
  • stimulates milk production and secretion
56
Q

what stimulates oxytocin release postpartum? what effect does this have?

A
  • infant sucking at nipple stimulates oxytocin production
  • stimulates the milk-ejection reflex
57
Q

what is the nipple erection reflex

A

-when infant cries or sucks at breast, helps to move thru the ducts to nipple pores

58
Q

what might the person feel as milk ejection occurs?

A
  • tingling sensation
59
Q

birthers w flat or inverted nipples may need?

A
  • additional support to latch infant
60
Q

describe changes to the breasts during the 1st 24 hrs postpartum

A
  • no appreciable changes
61
Q

what is present at birth r/t breasts? at what point does milk production begin?

A
  • colstrum present at birth
  • 72-96 hrs after birth milk production begins
62
Q

describe the firmness of breasts in days 1-2 after birth?

A
  • soft
63
Q

describe the breasts after milk production (6)

A
  • firm
  • tender
  • warm
  • lumps as milk ducts fill
  • painfully full breasts may occur (engorgement)
  • breasts should soften w feedings
64
Q

describe the nipples postpartum (3)

A
  • should have skin intact
  • no sores to area
  • not painful
65
Q

milk production will stop approx _____ after birth if no breast feeding/pumping

A
  • 1 week
66
Q

what is imp to note w breast feeding

A
  • most substances ingested by the birther will pass to the infant thru chest milk
67
Q

what is the average blood loss for a vaginal birth? c-section?

A
  • vaginal: 300-500 mL
  • c-section: 500-1000 mL
68
Q

describe blood volume postpartum

A
  • returns to nonpregnancy lvls within a few days after birth due to diuresis
69
Q

describe cardiac output postpartum

A
  • returns to nonpregnant state after 48 hrs
70
Q

describe position of the heart postpartum

A
  • diaphragm descends = normal cardiac axis is restored
  • point of meximal impulse normalized
71
Q

describe BP postpartum w HTN?

A
  • could stay elevated longer
72
Q

describe resp function postpartum

A
  • rapidly returns to prepregnancy lvls following birth
  • diaphragm descneds
73
Q

pregnancy proteinuria and glycosuria resolves within…

A
  • 6 weeks after birth
74
Q

what occurs postpartum r/t GU system? why?

A
  • diuresis occurs within 12 hrs
  • to rid the body of excess fluid accumulated during pregnancy
75
Q

why does diuresis occur postpartum? (3)

A
  • decreased estrogen
  • removal of increased venous pressure in lower extremities
  • loss of pregnancy induced increase in blood volume
76
Q

after birth, trauma can occur to?

A
  • urinary meatus
  • bladder
  • urethra
77
Q

what impact can trauma to the GU system have d/t birth and anesthesia? what might this require?

A
  • affect voiding reflex = urinary retention and bladder distension
  • may require urinary catheter if bladder distended/full and unable to void
78
Q

most birthers are able to void spontaneously within?

A
  • 8 hrs
79
Q

a full/distended bladder can be a signif contributor to? how?

A
  • postpartum uterine bleeding as it displaces uterus (up and to right)
80
Q

postpartum, bladder tone is usually restored within?

A
  • first week after birth w adequate emptying
81
Q

if client was cathetrized during L&D, what is there an increased risk for?

A
  • UTI in postpartum period
82
Q

describe changes to integ system postpartum

A
  • striae, if present, fade from red to silver but permanent
  • increased pigmentation of areolae and linea nigra may not regress completely
83
Q

describe hbg & hct postpartum

A
  • lvls depend on blood loss
  • usually return to non-pregnancy lvls by 8 weeks postpartum
84
Q

why is there an increased risk of thromboembolism postpartum?

A

due to:
- immobility
- potential vessel damage
- increase in clotting factors and fibrinogen in pregnancy and immediate postpartum (esp w c-section)

85
Q

describe changes to varicosities postpartum

A
  • varicosities of the legs/anus/vulva generally regress entirely following birth
86
Q

describe hunger postpartum, why?

A
  • likely to be quite hungry following initial recovery
  • from birth, general fatigue, anesthesia
87
Q

spontaneous bowel evacuation may not occur for how long after birth? why?

A
  • may not occur for 2-3 days
  • due to: decreased muscle tone, decrease in food/fluids during birth, anticipated discomfort to perineum
88
Q

describe interventions for bowel movements postpartum (2)

A
  • encourage fibre and fluid intake
  • stool softeners generally provided postpartum
89
Q

bowel function should return to normal how long postpartum?

A
  • 1 week postpartum
90
Q

what is a specific intervention r/t GI system with a c-section

A
  • should auscultate for bowel sounds
91
Q

supportive tissues of pelvic floor may be ____ after birth

A
  • may be torn or stretched
92
Q

how long can it take for the tissue of the pelvic floor to regain tone? what can encourage healing?

A
  • can take up to 6 months to regain tone
  • kegel exercises encourage healing
93
Q

describe the abdominal wall postpartum

A
  • relaxed postpartum
94
Q

how long does it take for the abdominal wall to regain muscular tone

A
  • regains tone over several weeks –> can take up to 6 weeks to return to prepregnancy state
95
Q

return to prepregnancy state of abdominal wall depends on? (3)

A
  • previous tone
  • exercise
  • amt of adipose tissue
96
Q

what may persist r/t MSk system following birth? what might this require?

A
  • diastasis (seperation) of the rectus abdominis muscle can persist
  • may require surgery
97
Q

how long does it take for the joints to stabilize following birth? this may cause?

A
  • 6-8 weeks
  • a permanent increase in shoe size

NURS 4500: Final Material (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions