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Flashcards in Post Partem Deck (24):
0

Pitocin

Usually in first liter postpartum
Stimulates contraction to expel placenta
Emptying bladder helps
Palpate after infusion stops for firmness

1

Endometrium healing

2 layers separate
inner becomes new endometrium.
Outer cast off

2

Outer layer composition

Blood fragments, mucus, bacteria , clots

3

Lochia assessment

Color
Amount- no more than 1 an hour
Presence of clots- good thing

4

Lochia rubra

Bright red and first couple days

5

Serosa

Until 12th day
Brownish

6

Alba

After 12th day
Clear

7

Blood loss

300-500mL vaginal birth
500-1000mL C section

8

Blood loss protocol

C section is NPO until bowel sounds return
High fall risk
Mean Arterial pressure over 60

9

Mean arterial pressure

1/3 systolic
2/3 diastolic

10

Perfusion changes

Increased blood to heart because decrease to uterus
Fibrinogen and WBC increase
DVT risk

11

Perfusion interventions

Incentive spirometery
Deep breathing
Assess exit location

12

Perfusion assessments

Cap refill
Pulse will decrease because higher stroke volume
HGB, Fe, HCT
DVT
Dangle for orthostatic

13

Urinary elimination

Incontinence not normal
Decrease in tone and sense to void
Diuresis expected

14

Constipation

Progesterone decreases peristalsis
PAIN
Medication
Rectal protrusions

15

Constipation interventions

Assess bowel sounds
Stool softeners
Comfort

16

Postpartum assessment

BUBBLE-HE
Respirations
Fall risk
Homans sign/DVT
Labs
Bladder

17

Postpartum labs

HCT, HGB, WBC, PLT, FBR, SG

18

Postpartum vitals

Decrease HR, and RR
Slight Increase in temp

19

Postpartum breasts

True milk 3-4 days with engorgement

20

Breast feeding breast care

Encourage PT/Child to breast feed
Warm compress/shower
Lactation consult/teach
Lanolin on nipples
Wash daily with no soap

21

Bottle feeding breast

Cold compress
Face away from shower

22

Pericare interventions

Ice pack
Badet
Sitz bath
Epifoam
Witch Hazel

23

Involution

Uterus returns to pregestational size
Contracts below umbilicus initially
Rises to umbilicus at 24 hr
Finger a day decrease