OB ch 12 - post partum woman Flashcards

1
Q

what does a post partum cervix look like as compared to a nullipara cervix

A

slightly open with a small slit

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2
Q

how does the cardiovascular system change during pregnancy and how does it return to normal post partum

A

increased blood volume, increased circulation, increased clotting factors

heart rate slows down, blood clots faster

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3
Q

what are some ways the body rids itself of excess fluid from excess blood volume

A

skin, urinary tract, blood loss

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4
Q

what happens to the blood post partum and what is the woman at risk for because of this

A

clotting - Deep Vein Thrombosis(DVT)

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5
Q

what are symptoms of thrombophebitis

A

redness, swelling, warmth, pain

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6
Q

what happens to the GI system and what symptoms might the woman have

A

decreased peristalsis, decreased bowel tone

-constipation

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7
Q

what are some treatments for constipation

A

fluid, stool softener, exercise, fiber

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8
Q

what is the main concern and what should the nurse assess for in the immediate post partum period

A

hemorrhage - assess for uterine atony

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9
Q

how would you assess for hemorrhage post partum

A

VS(low BP, tachycardia)
boggy uterus
bleeding

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10
Q

how often would you assess for hemorrhage immediately post partum

A

every 15 minutes

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11
Q

what is the most common cause of hemorrhage

A

uterus not contracting

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12
Q

how much blood loss is typical for a vaginal birth

A

300-500 mL

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13
Q

how much blood loss is typical for a c section

A

500-1000 mL

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14
Q

How does the nurse determine the amount of blood loss by looking at hg and hct results

A

subtract 1 from hg
subtract 2 from hct
for every 250 mL

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15
Q

why are UTI’s so common post partum and what are the symptoms of this

A

they just had lots of foreign stuff up there

-painful perineum and urination

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16
Q

what is the benefit of Kegel exercises

A

increase tone and enhance sexual excitement

17
Q

how would you instruct a new mom to use the peri bottle

A

warm water - front to back

every time you go to bathroom

18
Q

what is the average weight loss immediately post partum

A

12-14 lbs

19
Q

how long will it take to lose the rest of the “baby weight”

A

6 months

20
Q

describe the 3 phases of lochia - what might be going on if it does not go in order

A

lochia rubra - moderate, red fleshy odor, 1st 3-4 days
lochia serosa-day 4-10, pinkish
lochia alba-after day 10 - white/pale yellow

-probably a hemorrhage

21
Q

describe the amount of lochia on a pad.

A

scant, little, moderate, heavy

22
Q

what is considered too much blood

A

fill a pad in 1 hr

23
Q

what is important to note when assessing a pad

A

clot size - HOW LONG PAD WAS IN

24
Q

what are afterpains and what is causing these

A

pain after birth - uterus remains contracted

25
Q

what increases afterpains

A

breastfeeding, multiple children

26
Q

what should the nurse do if the fundus is soft and boggy

A

fundal massage

27
Q

know where the fundus should be immediately post partum and in the following days until it disappears

A

slightly above belly button - each day one finger breadth lower

28
Q

what are some other treatments for perinea pain

A

ice packs

29
Q

what is a priority assessment to any patient that has received an opioid

A

respiratory assessment

30
Q

what additional medication should be kept on hand if a patient is receiving opioid medications

A

naloxone - narcane

31
Q

what are common side effects of opioids

A

dizziness, nausea, vomiting, constipation

32
Q

what is the name of the first breasts secretions

A

colostrum

33
Q

why is colostrum important

A

antibody rich

34
Q

when does colostrum start and end

A

right after birth-3rd day post partum

35
Q

when does the milk “come in” and the breasts have a possibility to become engorged

A

3rd day

36
Q

what are good signs of maternal infant bonding

A

call by name, eye contact, talking to, smiling

37
Q

what is en face position

A

face to face with baby

38
Q

what are concerning signs that maternal infant bonding might not be taking place

A

don’t talk, turn away, don’t call by name