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OB NUR 359 > OB Lecture 2 Postpartum > Flashcards

OB Lecture 2 Postpartum Flashcards

1
Q

Gravida

A

Number of times pregnant regardless of duration or outcome

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2
Q

Para

A

Number of pregnancies completed past 20 weeks (Must have been delivered)

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3
Q

Abortion

A

Any loss of pregnancy before 20 weeks or weight less than 500gms.

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4
Q

Spontaneous vs Induced abortions

A

Spontaneous = miscarriage

Induced = Planned

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5
Q

Term birth

A

Birth occurring between 38 and 42nd weeks

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6
Q

Preterm birth

A

Birth after the 20th week but before the 38th week

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7
Q

Postterm birth

A

Birth after the 42nd week

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8
Q

Trimester

A

Division of pregnancy into 3 equal parts of 13 weeks each

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9
Q

4 digit PARA (TPAL)

A

T: All births complete after 37wks

P: All births at preterms (20-37weeks)

A: Abortions either SAB or TAB (Before 20 weeks)

L: Current living children

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10
Q

Multipara

A

Women who gave birth more than 2 times over 20 weeks

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11
Q

Multigravida

A

Women who has been pregnant more than once regardless of outcome

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12
Q

Nullipara

A

A woman never completed pregnancy past 20 weeks

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13
Q

Nulligravida

A

Women who have never been pregnant

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14
Q

Primipara

A

Women who gave birth for first time of pregnancy that lasted 20 weeks

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15
Q

Primigravida

A

Woman who is pregnant for the first time

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16
Q

Postpartum coagulation for women?

A

Increased clotting factors expected. Clotting where placenta was.

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17
Q

Cardiac output for pulse and BP?

A

Low pulse and high BP

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18
Q

How may fluid be excreted and whats expected?

A

Increased urination
Diaphoresis
Expect wet bed sheets and frequent urination

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19
Q

What to expect during first void postpartum?

A

Expect patient to be dizzy, do not leave her first void - risk for falls

First few voids must be measured

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20
Q

What is normal WBC count for women postpartum?

A

25-30

Normal is usually 5-10

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21
Q

How much blood is lost during vaginal and c-section deliveries.

A

200-300 vaginal

700-1000 C-Section

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22
Q

When will RBC return to normal postpartum?
Hgb/Hct?

A

Within 2-3weeks

Hgb - 12-16

Hct 37-47%

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23
Q

Inspection of breast should consist of what?

A

Bra, Shape, contour, general symmetry, and nipples

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24
Q

What to look for in temperature of breasts?

A

Red and Hot can indicate mastitis so pay attention to temperature and color

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25
Where to palpate the breast for milk?
The upper outer quadrant to feel for firmness indicating milk production
26
What begin milk production in the breasts? What is it called before its breast milk?
Placental delivery Colostrum
27
When teaching new mothers how long to breast feed what do we tell them?
Breast feed or pump every 2-3 hours no matter for how long but at least for 10-15minutes on each side.
28
What is the 8 day rule?
8th day of life: 8 feedings a day 8 wet diapers 8oz of gained weight 8 glasses of water for mom
29
How long for breast milk to start producing postpartum?
2-3 days after placental delivery
30
When does colostrum begin to develop during pregnancy?
Around 13 weeks
31
If baby is premature what happens to breast milk?
It increases in calorie count and protein
32
Nutritional essentials for a breast feeding mother?
2800 calories Increase in fluid (8glasses a day) Calcium intake
33
How to position baby during breastfeed?
Parallel to moms breast Tickle the lower lip Place babys entire mouth over the areola
34
How often to feed baby?
Every 2 to 3 hours Baby may sleep longer is fed more frequently IF BABY IS SLEEPING MORE THAN 3 HOURS WAKE THE BABY UP
35
Advantage of breast feeding?
Bonding Immunity - up to 6 mos Natural feeding Less ear infections & illnesses for baby FREE
36
Why does nipple crackling occur?
Tongue is on areola it should be under it to help milk the nipple
37
LATCH L stands for?
Latching can be separated Is baby?: Too sleepy or reluctant to latch Repeated attempts Hold nipple to mouth Simulate to suck Grasps breast Tongue down Lips flanged Rhythmic sucking
38
LATCH A stands for?
Audible swallowing None A few with stimulation Spontaneous or intermittent <24 hours old Spontaneous & frequent >24 hours old
39
LATCH T stands for?
Type of nipple Inverted Flat Everted (after stimulation)
40
LATCH C is for?
Comfort (Breast/Nipple) Is it: Engorged Cracked, bleeding, blisters, bruising. Filling Redness, small blisters or bruising Soft and tender
41
LATCH H is for?
Hold (Positioning) Full assist (staff holds baby or breast) Minimal assistance staff teaches and mom takes over No assistance from the staff Mother able to position and hold infant.
42
Three types of Lochia?
Rubra - Bright red 2-3 days Serosa - Pink to brown 4-10 days Alba - White to yellow up to 6 weeks
43
Amount of lochia?
Scant Light Moderate Heavy - changes pad every hour, think of hemorrhaging
44
Texture of lochia?
Is it easily able to seperate or not? If yes it is a clot if no it is placenta and needs to be checked ASAP
45
Assessment of legs postpartum?
Homans sign - No pain = normal Peripheral edema - normal Variscosities
46
Uterus involution What is occuring?
Uterine contractions to help shed the endometrium, heal the placenta location, and allow it to be smooth with no scars for the next pregnancy
47
What are afterpains? How to relieve the pain?
Intermitted uterine contractions that are uncomfortable Place in prone position with pillow on abdomen, helps center uterus
48
How long for involution period to last?
6 weeks
49
Assessing the fundal height, and position?
Fundus should be below umbilicus and go down 1cm a day Should be midline, if left or right = full bladder
50
Assessment of bowels postpartum?
Hypoactive bowel sounds is normal She can eat whatever she wants First stool is 2-3 days after May need laxative or stool softener
51
How long until fundus is no longer palpable?
No longer palpable after 14 days
52
Assessing bladder postpartum?
Woman must empty bladder within 6-8 hours if she cant she needs foley.
53
Risks of distended bladder?
Risk of uti r/t urinary retention Risk of hemorrhaging as it interferes with contractions
54
What to look for in distended bladder?
Fundus location Excessive lochia Discomfort in the bladder region Symphysis bulge Frequent voids less than 150mL
55
Pericare - sitz bath and peribottle recommendations?
Sitz - 4x daily for 20 min Peribottle - Warm water and use front to back after using the restroom
56
Emotional status - Dependent -Taking in
First 24 hours last 1-2 days Reviews experience Basic needs and self-care Excited to talk
57
Emotional status - Dependent/Independent - Taking hold
Starts 2nd to 3rd day and last up to 10 days or several weeks Takes charge Baby blues Engaged to learn and be competent mother Physical discomfort and emotional changes
58
Emotional status - Interdependent - Letting go
Sees baby as a separate person Moves forward with family as a unit
59
Bonding
Unidirectional bond from parent to baby
60
Attachment
Baby becomes attached to parents Begins during pregnancy and lasts for months after
61
Postpartum musculoskeletal system?
Muscles and joints are fatigued and achy for 1-2 days Risk of diastasis recti adominis
62
How to reduce musculoskeletal discomfort
Exercises to strengthen the abs Good posture Body mechanics - When picking up and placing baby down using the abdominal muscle for support
63
How long before returning to exercises postpartum?
6 weeks
64
How does breastfeeding affect menses and ovulation?
Ovulation and menses may be delayed Ovulation can happen before their first menses
65
Breastfeeding mothers are more likely to experience what symptoms?
Vaginal dryness due to low estrogen
66
How long after should they be using protection?
Up to 6 weeks
67
Parental role of attainment? Anticipatory
Anticipating the perfect parenting
68
Parental role of attainment. Formal
Reality hits, proper way of doing things with parents
69
Parental role of attainment. Informal
Change how you do things and do them the way you decide (Ex: 3. point turn)
70
Parental role of attainment. Personal
Doing it my way. May follow the rules but to my own way
71
Bleeding medications postpartum?
Oxytocin Methergine - methylergonovine - If still issue with hemorrhaging after pitocin Prostaglandin F
72
Side effects and contraindications to postpartum bleeding medications
Oxytocin - Watch for fluid overload & hypertension Methergine - Used if pitocin doesn't work. Do not give in hypertensive patients Prostaglandin F - Do not give to asthmatics
73
Rubella vaccine eductation
Tite 1:10, do NOT get pregnant for 3 months after vaccine Depo Provera shot may be given to avoid pregnancy
74
Pain medications postpartum
NSAIDs Oxycodone/Acetominophen (Percocet) PCA - Morphine for C - section
75
Laxative for postpartum use?
Docusate (Senna) -Causes diarrhea
76
When is RhoGAM given?
Rh (-) mom Rh (+) Baby Do not give if both baby and mom are negative Do not give rubella vaccine for 3 months
77
What to palpate for in breasts postpartum?
Thickness-engorgement Temperate - mastitis Tenderness
78
What are risk factors foor postpartum hemorrhage?
1. Grand multiparity 2. Overdistended uterus -(Twins/triplets/hydramnios) 3. Rapid, precipitous or prolonged labor 4. Retained placenta 5. Placenta previa or abruptio placenta 6. Meds (tocolytics, oxytocin) 7. Operate procedures 8. Coag defect

OB NUR 359 (4 decks)

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