healthy postpartum

Question 1

uterine involution

Answer 1

process of uterus returning to pre pregnant state (6 weeks)

Question 2

healing time for placental site

Answer 2

6 weeks

Question 3

return of menstruation

Answer 3

variable 6-10 weeks (if not breastfeeding)

if breastfeeding, period is often delayed while nursing until introduced to solid foods

Question 4

can a patient get pregnant is she hasn’t had a period yet?

Answer 4

if she ovulates and hasn’t had a period yet, she can get pregnant at this time

Question 5

what is the initial milk called?

Answer 5

colostrum (liquid gold), begins to be produced while pregnant before baby’s born

Question 6

milk may come in…

Answer 6

3-5 days postpartum

Question 7

postpartum lab values

Answer 7

• H&H: initially difficult to interpret (EBL); depends on mode of delivery
• WBCs: may initially be elevated bc of stress associated w/ labor
• PLTs: initially decrease bc placenta is given away

Question 8

postpartum vitals

Answer 8

• Temp: up to 38.0 for the 24 hrs d/t exertion and dehydration
• BP: slightly elevated
• HR: slightly decreased

Question 9

what is the initial weight loss postpartum?

Answer 9

10-12 lbs (infant, placenta, and fluid)

Question 10

weight loss by 6-8 weeks postpartum

Answer 10

if gained average weight, 25-30 lbs

Question 11

when can a client reestablish exercise regimen?

Answer 11

once patient has seen their doctor for a follow up PP –> typically 4-8 weeks PP

Question 12

psychological adjustment to parenthood: “taking in-“

Answer 12

• passive (goes along w/ care being provided for her)
• allows others to make decisions for her

Question 13

psychological adjustment to parenthood: “taking hold-“

Answer 13

• assumes more active role (may get more critical of herself during this period)
• provide her with reassurance (reassure that she is doing a good job)

Question 14

postpartum nursing assessment

Answer 14

B: breast
U: uterus
B: bowel
B: bladder
L: lochia
E: episiotomy

H: homan’s (possibility of DVt)
E: emotional status

Question 15

interventions for boggy uterus

Answer 15

massage uterus, monitor bleeding, vitals, LOC

Question 16

what is lochia?

Answer 16

uterine debris from placental site

Question 17

rubra colored lochia lasts…

Answer 17

2-3 days
red

Question 18

serosa colored lochia lasts…

Answer 18

3-10 days
pink

Question 19

alba colored lochia lasts…

Answer 19

1-2 weeks
clear/white

Question 20

when assessing the perineum…

Answer 20

have patient turn to side
R: redness
E: edema
E: ecchymosis
D: drainage
A: approximation

Question 21

postpartum perineal care

Answer 21

• change pad w/ every void and prn
• peri bottle while bleeding continues
• avoid tampons
• ice packs for comfort and decrease swelling
• sitz bath increases blood flow to aid in healing, soothing, cleansing

Question 22

postpartum blues

Answer 22

transient period of depression that may start in the hospital 2-3 days PP and can last 10-14 days PP

Question 23

what kind of patients are high risk for postpartum blues?

Answer 23

patients who lack social support systems

Question 24

common medications ordered postpartum

Answer 24

• pitocin
• stool softeners
• pain meds
• rubella vaccine
• rhogam (if mom is Rh-)