Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

OB > Exam 1: Postpartum lecture 3 > Flashcards

Exam 1: Postpartum lecture 3 Flashcards

Care/coping of the postpartum patient Assessment- BUBBLEHE Postpartum depression/blues Postpartum medications Postpartum Hemorrhage

1
Q

Postpartum: what is it?

A

critical transitional time
-last about 6 weeks

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

Postpartum: Materanal physiologic Adaptations - Involution

A

NORMAL
the return of the uterus to a non-pregnant state after birth
- begins immediately after the placenta is delivered (decrease of estrogen+ progesterone) with contractions of the uterine muscle

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

Postpartum: Materanal physiologic Adaptations - SUBinvolution

A

ABNORMAL
The failure of the uterus to return to the non-pregnant state
-common causes are retained placental parts + infx

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

Postpartum: Materanal physiologic Adaptations - Lochia

A

NORMAL
right after delivery
-vaginal discharge lasting 4-8 weeks
-color changes result from the changing composition of the tissue expelled

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

Postpartum: Materanal physiologic Adaptations - Lochia Types

A

-Lochia rubra
-Lochia serosa
- lochia alba

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Lochia: what patient should know

A

-color
-smell
-amount to expect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Lochia normal findings

A

-lochia at any stage SHOULD have a fleshy smell

-amounts that are normal: scant, light, + moderate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Lochia abnormal findings

A

-Offensive oder usually indicates an infx

-amount that is abnormal: Heavy amount (saturated in 1 hr)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Lochia rubra: color + lasts for how long?

A

NORMAL
-bright red
-lasting 1-4 days
-within hospital setting

(remember R comes before S)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Lochia serosa: color +lasts for how long?

A

NORMAL
-pinkish brown color
-containing old blood + serum tissue debris
-occurring AFTER rubra lasting 3-10 days

(remember R comes before S)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Lochia alba: color + lasts for how long?

A

NORMAL
-creamy white/light brown
-containing leukocytes + decidual tissue
-lasting 10-14 days + can last 3-6 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Postpartum Maternal physiologic adaptations: Afterpains

A

breastfeeding + IV or IM oxytocin stimulate contractions

-for 1st time pregnancies: mom’s uterine tone is good w/mild contractions

-subsequent pregnancies (more than 1 pregnancies): more acute + uncomfortable cramping.
-more cramping when uterus has been over distended.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Postpartum Maternal physiologic adaptations: Cervix expected findings

A

-internal cervical os gradually closes + returns to normal BY 2 WEEKS

-external os widens + NEVER regains it pre-pregnancy appearance (it appears as a jagged slit-like opening)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Postpartum Maternal physiologic adaptations: Vagina + Perineum

A

-estrogen deprivation that occurs after birth is responsible for causing the thinness of the vaginal mucosa + absence rugae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Postpartum Maternal physiologic adaptations: Vagina normal findings

A

-vagina gradually decreases in size + regains tone over serval weeks (4-6w)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Postpartum Maternal physiologic adaptations: Vagina + Perineum -
teaching

A

water-soluble lubricate during intercourse is recommended for estrogen deficiency

-estrogen deficiency is responsible for decreased lubrication

-Pelvic floor muscle training exercises
-pelvic floor tone + promote healing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Postpartum Maternal physiologic adaptations: Perineum normal findings

A

-Perineum stretches + most women will have some degree of perineal trauma during childbirth
-edema + busing first few days
-Episiotomy or laceration may take as long as 4-6 weeks to heal
-Hemorrhoids d/t pushing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Postpartum Maternal physiologic adaptations: Cardiovascular normal findings

A

-CV system undergoes dramatic changes after birth
-blood volume increases during pregnancy + drops after birth + returns to normal within 4 weeks pp

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Postpartum Maternal physiologic adaptations: Cardiovascular - Average blood loss for vaginal delivery + c/s

A

-vaginal delivery 300-500 ml
-c/s 500-1000 ml

*if loss more than those than it is considered hemorrhage + can become anemia (tx:iron &/or blood transfusion)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Postpartum Maternal physiologic adaptations: Urinary system normal findings

A

-gradual return of bladder tone + normal size + function of bladder, utters + renal pelvis
-difficulty voiding after delivery can lead to urinary retention, bladder distension, + UTI
-pp diuresis begins within 12 hrs AFTER childbirth + continues throughout the 1st week pp (such as alot of peeing + sweating)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Postpartum Maternal physiologic adaptations: vital signs normal findings

A

-cardiac output returns to prepregant levels by 3 months pp

-a decrease in BP is an expected change in early pp (may suggest hemorrhage or infx)

-temp of 100.4 F in 1st 24 hrs may be d/t dehydration (SHOULD be normal AFTER 24 hrs)

-RR 12-20 bpm @ rest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Postpartum Maternal physiologic adaptations: vital signs abnormal findings

A

-tachycardia/pulse (above 100 bpm) warrants investigation suggest hypovolemia, dehydrations, or hemorrhage

-increase BP (higher than 140/90) may indicate preEclampsia

-BP lower than 85/60 may indicate hemorrhage

-

23
Q

Postpartum Maternal physiologic adaptations: coagulation normal findings

A

-clotting factors increase in pregnancy + remain elevated early pp
-the hyper-coagulable state combined with vessel damage during birth + immobility places women at risk for blood clots

24
Q

Postpartum Maternal physiologic adaptations: musculoskeletal system normal findings

A

-joints stabilized within 6-8 weeks pp
- may notice permanent increase in shoe size

25
Postpartum Maternal physiologic adaptations: Integumentary normal findings
-straie gravidarum (stretch marks) -profuse diaphoresis -linea nigra (pregnancy line) -melasma (freckles/dark spots on the face) -hair loss is temporary
26
Postpartum Maternal physiologic adaptations: endocrine normal findings
- With delivery of placenta there is a rapid clearance of placenta hormones. -Estrogen & progesterone drop quickly -Prolactin levels increase and remain increased with lactating women. -Estrogen levels remain low until breastfeeding frequence decreases. -Lactating and non-lactating women differ for first ovulation and establishment of menstruation. -Persistence of elevated serum prolactin levels in breast feeding women; suppress ovulation. -Ovulation can occur before menstruation.
27
Postpartum Maternal physiologic adaptations: sexual health
-birth control -resuming sexual activity (4-6 weeks) -discussing sexual activity with patient + partner before discharge is important bc they may resume sexual activity before the 1st pp visit
28
Lactation
-After birth: fall in estrogen and progesterone triggers release of prolactin from anterior pituitary gland -Prolactin levels are highest during the first 10 days PP/remain above baseline for duration of lactation -Prolactin produced in response in infant suckling and emptying of breasts -Oxytocin is essential to lactation -Nipple is stimulated and the posterior pituitary is prompted by hypothalamus to produce oxytocin. -Oxytocin responsible for the milk ejection reflex or let-down reflex.
29
Postpartum psychological adaptations: normal findings
-time of vulnerability to psychiatric disorders -disrupts family life -mood/anxiety disorders likely to recur at this time during pp (these meds are not safe for baby intrpartum) -failure to address may result in tragic consequences
30
Postpartum coping
-Assess level of anxiety -Assess sources of concern -Identify unmet needs and expectations -Assess support system of family -Assess past coping mechanism -Assess emotional reactions of birth
31
Postpartum emotional reactions: normal findings
baby blues
32
Postpartum emotional reactions: abnormal findings
-Postpartum depression -Postpartum anxiety/Panic disorder -PPD with OCD -Postpartum Psychosis
33
Baby blues: common signs seen in pp moms
*due to hormone changes* should go away within 2 weeks* -seen in 85% of new mothers -sadness -tear-fullness -crying spells -irritability, anxious -mood swings -fatigue/sleep caused by sleep deprivation -appetite disturbance
34
Postpartum depression: risk factors
*occurs in about 15% of time* goes beyond 2 weeks* -increase risk of PPD among teenage mothers; 50% higher thank older mothers increased incidence with: -hx of personal or family of mood disorder Negative life event such as: -loss of loved one -poor marital support -divorce -financial difficulties -thyroid disorders
35
Postpartum depression: common signs seen in pp moms
-Depressed mood *Functional impairment* *Lack of affectionate bonding* -Changes of sleep pattern or eating pattern -Excessive fatigue -Psychomotor agitation -Feelings of worthlessness *Suicidal ideation* *Loss of interest in pleasurable activities*
36
PPD: medical management (nonpharm)
-Natural course is one of gradual improvement over the six months after birth Nonpharmacologic options -Psychotherapy -support groups
37
PPD: medical management (pharm)
Pharmacologic intervention: - antidepressants - anti-anxiety agents - mood stabilizers - antipsychotics (pharm interventions done w/nonpharm interventions)
38
PP psychosis
*most severe of mood disorders in PP period-psychiatric emergency* *screening tools to prevent or detect it early* 1-2/1000 births -occurs 1-4 weeks after birth or up to 90 days after birth
39
PP psychosis: characteristics
-severely impaired ability -agitation -hallucinations ** -delusions** -paranoia** -severe mood depression to look for: depression-sleep, energy level, + fatigue
40
PP assessments: VS, physical, psychosocial done when ?
done in L&D 1st hr: Q15 mins 2nd hr: Q 30 mins done in PP 1st 24hrs after: Q4 hrs After 24 hrs: Q8 hrs
41
Pain scale: nursing interventions
anything 4 or higher want to give tx
42
What does BUBBLE-EE stand for?
B- breasts U- uterus B- bladder B- bowels L- lochia E-episiotomy /perineum/ epidural site ----- E- extremities E- emotional status
43
What does BUBBLE-EE used for?
Focus assessment for pp patient
44
Breast assessment normal findings
*for breastfeeding moms only* nipple status -erect nipples for good lactation + easy for baby to attach to
45
Breast assessment abnormal findings
abnormal nipple status -nipples are flat or inverted (call for lactation consult) -any redness, cracks, soreness (give cream)
46
Uterus assessment normal findings
*important check for hemorrhage or lacerations* normal -firm uterus -1st hr fundus is firm @ the umbilicus -FF @ U FF -1 FF-2
47
Uterus assessment abnormal findings
abnormal -not firm uterus is called Boggy or uterine acne (massage fundus to firm it) -uterus is going up to the right side, high up d/t full bladder (encourage mom to use restroom) -FF+2 FF+1
48
Episiotomy/Perineum/Epidural Site: assessment + nursing interventions
-roll pt on their side and look (lift cheek) to check for infx, hemorrhoids, swelling -keep ice on 1st 24 hrs + apply cream + witch hazel or numbing spray -still swelling after 24 hr try steam from under toilet + have them sit on seat
49
extremities assessemnt
*mainly in calves* -no sign of blood clots d/t increase risk -any SOB or redness/swelling on calves (call provider ASAP)
50
Emotional status assessment
-are they attaching w/ baby? -screening tools for PPD
51
Maternal nutrition
-fluids** -nutrient dense diet for lactating moms *500 extra calories a day*
52
infant nutrition: who should not breastfeed?
-HIV -PKU -Drug abuse
53
prior to discharge immunizations
-rubella -Tdap -Influenza - Rh status Rhogam shot (if the mom is Rh - and the baby is Rh + )
54
causes of PPH
-tone:uterine atony** -trauma: laceration/rupture** -tissue:retained placenta -thrombin: coagulopathy (bleeding disorder)

OB (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions