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Maternity > Module 5 > Flashcards

Module 5 Flashcards

(59 cards)

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1
Q

Components of PostPartum Assessment

A
  • Vitals -Emotional
  • Fundus - Lochia
  • Bladder - Perineum
  • Breasts -Cardiovascular
  • Pain - Bowels
  • Extremeties
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2
Q

Involution

A

Changes of the reproductive organs to return to prepregenancy state. After birth
Mostly Uterus
Can take 5-6 weeks

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3
Q

Subinvolution

A

Failure of the uterus to return to prepregnancy state after 6 weeks

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4
Q

Common Causes of Subinvolution

A
  • Infection

- Retained fragments of placenta

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5
Q

Signs of Subinvolution

A
  • Bigger then expected Fundal Height after 6 weeks
  • Continued Lochia Rubra
  • Pelvic pain
  • Heaviness
  • Fatigue
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6
Q

Nursing care for Subinvolution

A
  • Teach about normal changes to expect
  • Report fever, persistent pain, Red lochia , foul smelling vaginal discharge
  • Teach how to palpate fundus and what is normal

If admitted to hospital:

  • Assist with medical therapies
  • Providing analgesics
  • Comfort measures.
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7
Q

Fundus

A
  • Should be felt midline at or below umbilicus
  • Grapefruit size mass
  • Should descend at predictable rate
  • Descend 1cm/day
  • no longer palpable after 10 days
  • Full Bladder can displace fundus
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8
Q

Afterpains

A
  • Intermittent contractions similar to mestrual cramps
  • Decreases in 48hrs
  • More common in women who have had more then 1 pregnancy
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9
Q

Why does breastfeeding sometimes cause afterpains

A
  • Releases oxytocin causing the uterus to contract.
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10
Q

Lochia

A
  • Vaginal discharge after delivery
  • Composed of lymph, blood and endometrial tissue
  • Menstraul or fleshy odor
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11
Q

3 types of Lochia

A
  • Lochia Rubra
  • Lochia serosa
  • Lochia Alba
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12
Q

Lochia Rubra

A
  • Red
  • Composed mostly of blood
  • Lasts 3 days after birth
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13
Q

Lochia Serosa

A
  • Pink
  • Blood and mucous
  • 3rd - 10th day after birth
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14
Q

Lochia Alba

A
  • Clear, Colorless or white
  • Mostly Mucous
  • 10th-21st day after birth
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15
Q

Components of Lochia Assessment

A
  • Character
  • Color
  • Odor
  • Consistency
  • Clots Number + Size
  • Amount
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16
Q

Scant Amount

A

Less then 5cm soiled

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17
Q

Light Amount

A

Less then 10 com soiled

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18
Q

Moderate Amount

A

Less then 15 cm Soiled

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19
Q

Large Amount

A

Larger then 15 cm soiled or full pad in 2 hours

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20
Q

Excessive Amount

A

Pad saturated in 15 min

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21
Q

Lochia Nursing Considerations

A
  • Assess fundus at routine intervals
  • Explain purpose of fundal assessment and interventions
  • Teach how to assess fundus
  • Message soft or boggy fundus to promote contractions
  • Urinary status: full bladder could prevent contractions
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22
Q

Normal Lochia Sequencing teachings and what to report

A
  • Foul Smelling Lochia
  • Lochia Rubra that lasts more then 3 days
  • Unusually Heavy Flow
  • Lochia that turns bright red after already progressing to serosa or Alba
  • Large clots, specially if followed by lochia Rubra.
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23
Q

Cervix

A
  • Soft immediately after birth
  • Regains muscle, not as tight as prepregnancy state
  • 2-3 days to shorten, firm and regain form
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24
Q

Ectocervix

Study These Flashcards
A
  • Bruised with lacerations

- Can cause infections

25
Vagina
- Rugae dissapear and vaginal walls become smooth to allow for expansion - Reappear 3 weeks postpartum - Regains most prepregnancy form after 6 weeks - Vaginal mucosa thickens when ovarian function reoccurs.
26
Patient Teachings of Vagina
- Safe to resume sex when bleeding stops and episiotomy heals - Vagina does not lubricate well before 6 weeks postpartum and longer when breastfeeding.
27
Episiotomy or lacération of Perineum
- Heals within 2-3 weeks - Assess for REEDA - Vulvar hematoma/bruising - Hemmerrhoids worsen from pressure during birthing
28
Nursing Considerations for Perineum Episiotomy
- Cool compress for 1st 24hrs - Heat application after 24 hrs (site bath warm packs) - Hygenic measures ( peri bottle after each void) - Topical medications ( witch hazel, benzocaine, hydrocortisone with promoxine - Donut ring pillows for sitting.
29
Normal Blood loss at delivery
500 mL vaginal | 1000 mL csection
30
Post Partum Bradycardia
50-60 BPM | Can last 48 hrs
31
Excess Fluid is excreted by..
- Diuresis ( increased urination) | - Diaphoresis ( profuse perspiration)
32
Diuresis
Increased Urination | 3L /day
33
Diaphoresis
Profuse perspiration most common at night last 2-3 days
34
Post Part Blood Values
- Stabilize after 12 days | - Fully stabilized by 8 weeks
35
Coagulation
- Blood Clotting higher during pregnancy/4-6 weeks postpartum - Ability to Lyse does not increase - Risk of blood clot formation
36
Risks of blood clot formation
- Csection - Vericose veins - Delayed abulation - Venous Stasis
37
Postpartum Blood Clot assessment
- Presence of dyspnea - Tachycardia - unilateral calf swelling/pedal edema - Positive Homans sign
38
Blood Clot prevention Teachings
- Encourage ambulation - Rational for prophylactic VTE therapy - Encourage use of pneumatic Compression Devices.
39
Heart Rate Assessment
Brady cardia is NORMAL | Tachycardia is ABNORMAL
40
Nursing care for Diaphoresis
- Provide frequent showers/sponge baths | - Educate that this is temporary
41
Assessment of Legs for Thrombosis
- Redness - Warmth - Tenderness to touch - Homans sign
42
Teaching for Orthostatic Hypotension
- Assist with ambulation | - Sit at the edge of bed before standing
43
Post Partum Diuresis
- starts within 12 hours postpartum | - up to 3000 mL / 24 hrs
44
What does urinary distention cause
- Can cause excessive bleeding
45
Bladder Assessment
- Distention | - Urination Frequency
46
Urination assessment
- Frequency - Color - Amount - Odor
47
Postpartum Bladder Distention
- Decrease Muscle tone of bladder and ureters - Bladder fills quickly but it does not completely empty - May not feel urge to void or feel her full bladder
48
Breastfeeding mothers
- Colostrum expressed before lactation | - Tenderness persists for 48 hours after lactation begins
49
Non-Breastfeeding Mothers
- Engorgement resolves and discomfort decreases in 24-36 hours - Breast binder or tight bra, ice packs, fresh cabbage leaves, mild analgesics used to relieve discomfort.
50
Breast Assessment
- Size Shape and Symmetry - Engorgment - Check Nipples for cracks, redness, blisters, size and shape
51
Engorged breast
- Breast is hard, erect and uncomfortable | - Nipple maybe to hard and erect for newborn to grasp
52
Patient teaching for Breasts
- Comfortable bra - avoid nipple stimulation if not breast feeding - Wash with water to avoid drying effect of soap.
53
Bowels Postpartum
- Normal activity as progesterone levels decrease | - Constipation
54
Bowel Assessment
- Flatus - Bowel Sounds - Bowel Movement
55
Nursing care for postpartum Bowel
- Encourage fluid - Add fibre to diet - Ambulate - Administer stool softener
56
Homans Sign
Calf pain experienced upon dorsiflexion of the foot, indication of thrombophlebitis
57
Emotional Assessment
- Bonding - Family Interaction - Support - Physical contact with newborn
58
BUBBLE-HE
- Breasts - Uterus - Bladder - Bowel - Lochia - Episiotomy - Homans Sign - Emotions/Bonding
59
postpartum Blues
- conflicting feelings of joy and emotional let down - May feel let down bu overall finds pleasure in life - Reassure mom that these are normal feelings and temporary.

Maternity (6 decks)

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