Module 3/4 BBB Practice Questions Flashcards
(46 cards)
What cardiovascular changes occur immediately PP?
There is an increase in cardiac output and stroke volume, temporary increase in size of left atrium of the heart
What is the expected shift in stroke volume and cardiac output PP?
an 80% increase
What is the expected vital sign changes in a patient immediately PP?
Decrease in heart rate and no change in mean arterial BP
How long does it take for a PP persons blood volume to stabilize and normalize?
Stabilize: 1-2 days
Normalize: 2 weeks
If a patient loosed 500 ml of blood at delivery, what is the expected drop in hgb?
1gm
If a patient loosed 250 ml of blood at delivery, what is the expected drop in hct?
1%
Describe the stages and times of lochia.
Rubra: 3-5 days bright red/brown
Serosa: 5-22 days mucous/pink
Alba: day 10-6w pp whitish
Eschar: bright red bleeding
What is involution?
Contractions cause the uterus to return to being a pelvic organ/prepregnant state
What is happening during involution in regards to pathophysiology?
- Uterine contractions (“after pains”)
- Autolysis of excess tissue (decreasing the number and size of myometrial cells)
- Placental site/endometrial regeneration
What is the rate at which the uterus shrinks per day?
1 fingerbreadth/cm per day
When would we expect to not to be able to palpate the fundus?
By 14 days PP. At this point it should be in the pelvis
If a fundus is palpable at 14+ weeks, what should we be considering as a possibility?
Subinvolution
Could be due to: Retained products, fibroids, infection (endometritis), exhaustion (not evidence-based), bleeding/clots
What can make afterpains more painful?
Breastfeeding, full bladder, anything that makes the uterus larger (multiple pregnancy, polyhydramnios, retained placenta, multiparas)
What can be done to assist with afterpains?
Empty the bladder before breastfeeding, lay in prone position with a pillow under the abdomen, NSAIDs (ibuprofen)
What education should we provide about NSAIDs?
Encourage patient to eat to avoid stomach upset, may increase bleeding
How long should we expect afterpains to last?
Just a few days, 3 days
What should we consider if a patient has afterpains past three days or has new pain? What should you do?
Retained products, infections or other problems. They need to be seen now.
What symptoms of healing with lacerations and episiotomies may a patient experience?
Itching, burning, tightness, etc.
What is the relationship between estrogen and pain?
Estrogen causes heightened pain sensitivity. Estrogen drops postpartum so patients are less sensitized to pain.
When do we given rhogam in pregnancy?
Without complications, the patient gets 300 at 28 weeks or if there is complications like bleeding, they get 50 earlier.
When do we not give rhogam postpartum?
When the mother and baby are both Rh negative
Why do we care about Rh status of mother and baby?
Rh negative mothers exposed to Rh positive blood from a baby, the mother’s body builds up antibodies to that blood type. This can affect a future pregnancy. There is potential that mothers body will attack a future pregnancy if the baby is Rh positive.
Why do we care about the TDAP vaccine in pregnancy?
Pertussis in the vaccine will protect baby from whooping cough, and it is not made as a solo vaccine.
Do we always give TDAP postpartum?
Only if it has been more than 10 years since their last vaccine.
