Exam 3 MOM BABY Flashcards
(49 cards)
What is included in the BUBBLELE assessment and what are you looking for in each area?
Breast-cracks, e/inverted, tenderness
Uterus-firm, boggy, measure
Bowel-movements
Bladder-
Lochia- bleeding
Episiotomy/laceration- 3rd/4th cannot receive rectal meds (cytotec)
Legs for DVT- swelling, temp, pain?
Emotions
What is normal involution of the fundus, right after birth, at 12 hours after birth
and each day PP till discharge?
-palpable at midline & 2cm below umbilicus
-12 hr after, rise to level of umbilicus
-every 24 hrs, should descend 1-2 cm
What are normal stages of lochia
Lochia Rubra 1-3 days (Dark/Bright Red)
Lochia Serosa 4-10 days (Pinkish Brown)
Lochia Alba 11 days - 6 wks (yellowish white)
When it is abnormal and what patient
education would you give regrading lochia assessment
Clots Larger than a golf ball or egg, or heavy flow
What are the assessments for an episiotomy or laceration? Use REEDA
Redness
Edema
Ecchymosis (bruising)
Discharge
Approximation
What is taking in stage of motherhood
Occurs first 3 days postpartum
Dependent on others for her and her infant’s needs
Speaks about birthing experience
Focus on personal comfort and physical changes and healing
Nurse/Lactation consultant helps with breast feeding
Not a good phase to teach…It’s all about her!
Taking hold stage of motherhood
3-10 days postpartum
Moving between dependent and independent behaviors
Begins to initiate action and make decisions
Assumes care of the infant and shows more interest
Offer reassurance and praise
Give guidance or instruction as needed
Taking hold of her life again… great time to teach!
Letting go stage of motherhood
Occurs 10 days to 6 weeks Postpartum
Movement from independent to role of mother is easy-interdependent
Mother adjusts to her new role.
Establishes and accepts the new image of her baby, family and role.
Focus on family unit
Resumes role of individual
At home you won’t see it in the hospital
What is in colostrum?
High in protein.
Antibodies leukocytes, IgA, IgG, IgM
What is Engrossment?
fathers gazing at heir newborn for prolonged periods of time
What is En face?
Position that allows eye-to-eye contact between the newborn and a parent.
What are afterpains? Who are more likely to get them?
Uncomfortable uterine cramping;
LGA/marcosomnia mothers
Postpartum diuresis
What causes it?
excess fluid accumulated during pregnancy
What causes postpartum chills?
fluid loss
heat loss
hormonal changes
What discharge information is important to discuss and what signs and symptoms
should be reported the physician?
Signs and symptoms of possible complications
Excessive lochia or return of bright red bleeding
Foul-smelling lochia
Increased temperature
Pelvic/abdominal tenderness
Signs of UTI
Breast tenderness
Blurry vision
Leg pain
Thoughts of self harm
Explain postpartum blues, what are the causes and symptoms
a transient, self-limiting mood disorder that starts within 2 or 3 days after delivery and resolves within 2 weeks.
Hormone changes, normal
sadness, crying, lack of appetite, insomnia, fatigue, dysphoria, and impaired concentration
Explain postpartum depression, what are the symptoms
major depression with an onset during pregnancy or in the first 4 weeks after the birth up to 12 months
feeling of guilt, flat affect, rejection of infant, insomnia, fatigue, dysphoria, and impaired concentration.(same as blues)
What medications might we need to give during the postpartum period and why
Hemorrhage Management
oxytocin - top of uterus
Methergine- both segments of uterus
hemabate (causes bronchospasm)
Misoprostol (diarrhea, abdominal pain)
antibiotics for Metritis (most common pp infection)
Contraception: IUD
vaginal insertion
Contraception: diaphragm
Barrier method; Diaphragm must stay in for 6hrs after intercourse
Contraception: Depo-Provera
IM or SQ
suppresses ovulation
safe w/breast feeding
good for 3 months
-can cause osteoporosis-
What are the risk factors of subinvolution (Late PPH)
-full bladder
-prolonged labor
-overdistention
-retained placenta
-uterine atony
-fibroids
-metritis
PPH What are the sign and symptoms? How can we educate our patients?
Prolonged or excessive lochia flow saturating > than 1 pad per hour; foul smelling lochia
Fundus higher level than normal for postpartum time and palpable beyond 7-10 postpartum
Tenderness of the fundus
Lochia fails to change color from serosa to alba within a few weeks
Increased bleeding after increasing activity at home
Fever, pelvic pain
teach women how to assess for themselves
Metritis- What are the risk factors
Occurs more commonly after cesarean birth
Prolonged rupture of membranes
Prolonged labor
Internal fetal and uterine monitoring
Multiple cervical examinations
Obesity
Meconium-stained fluid
