painful, edeatous, and bruised sitz bath helps pelvic floor dysfunction PFMT: pelvic floor muscle training

POST-Partum Flashcards by Nurse Anesthetist

Natural proces that involves uterus return to its PRE-PREGNANCY state
Regeneration of uterine epithelium

Involution

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Uterine weight begins to

decrease in weight.
1000grams - 60grams in 6 weeks.

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Fundal height should be in

pelvic cavity after 6 weeks.

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Cervix goes back to prepregnant state in

6 weeks.

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which one closes sooner?
Internal os or external os?

internal Cervix os
prevent infection.

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VAgina adaptations post partum

prepregnant by 6-8 wekks
localized dryness

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perineum post partum

painful, edeatous, and bruised
sitz bath helps
pelvic floor dysfunction
PFMT: pelvic floor muscle training

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What type of cardiovascular activity REQUIRES ATTENTION

TACHYCARDIA >100 BPM
(ABNORMAL)

Bradycardia is normal

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WBC remain

high for 1-6 days

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Normal functions begin

1-3 weeks

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Endocrine Post partum:

if mom is NOT BREASTFEEDING what happens

Within 2 weeks:
* Estrogen INCREASES
* Prolactin DECREASES

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Endocrine Post partum:

if mom IS BREASTFEEDING what happens

Estrogen and Prolactin both REMAIN LOW.

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most placental hormones are gone within a

week.

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A mom is constipated POST PARTUM

this is normal.
increase fluid intake
INCREASE diets.

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When inspecting abdomen the nurse should do what first

AUSCULTATE BOWEL SOUNDS first!!! then palpate fundus.

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Urinary system Post partum

large amounts of fluids.
diuresis in 12 hrs
3000 mL/day (normal)!!! (due to trauma)

Normal pee for person is 30/mL/hr

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Sexual health POST PARTUM

4-6 weeks.

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Contraceptions after POST PARTUM to be used

Progestin ONLY!!
bc it has no effect on breastmilk.

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Combined contraceptions can be started until

6 weeks.

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What stimulates Milk production

Prolactin
Oxytocin
skin to skin
supply and demand
breast crawl.

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Is enfoged breast an infection?

NO!!
just large collection of milk and not feeding baby soon enough.

How to supress lactation (milk production) for HIV, DRUGS, still birth, etc resons.

cessation
tight support bra 24 hrs/day
ice packs on breast
avoid breast stimulation
avoid warmth on breasts

is breastfeeding a TOTAL RELIABLE METHOD of contraception?

No…

Unless:
1. Exclusively breastfeeds
2. no PMS since birth
3. infant < 6 monts

Bubble- EE for postpartum ASSESSMENT

B: BREASTS
U: UTERUS
B: BOWELS
B: BLADDER
L: LOCHIA
E: EPISIOTOMY/ lacerations/C-Section
E: extremities
Emotional status

Discharge assessment

describe and docment if it is NOT colostrum (creamy yellow) or Foremilk (bluish white)

fundal should go down how many cm per day?

1 cm per day.

Uterus should NOT be

boggy or displaced.

what can cause URINARY RETENTION

1 cause epidural (medications)

WHat are most common causes for CONSTIPATION

HIGH iron (due to prenatal vitamin)

vaginal discharge that occurs AFTER birth

LOCHIA

LOCHIA CONTINUES for how long AFTER BIRTH

4-8 weeks.

Lochia for the first 3-4 day after birth.

Lochia rubra

Lochia that is PINK-BROWN and is expelled 3-10 days POSTPARTUM

LOCHIA SEROSA

LOCHIA on final stage Can last 10-14 days or 3-6 weeks.

lochia ALBA

THINGS TO REPORT with Lochia

* foul smelling = infection * Large clots= poor uterine involution, retained placental fragments.

Assess Lochia pads used. WHat is considered large or heavy lochia

Saturating 1 or more pads per hr. **1in - 4in stain on pad (10mL-25mL**

Episiotomy in perineum area should be assesed every

8 hrs. (lithotomy or side-side position)

REEDA

score chart for healing of Episiotomy in perineum

REEDA is considered heel with what score

0= healed 1-5= moderate healed 6-10 mild healed 11-15 not healed.

REEDA is for

* REdness * Edema * Ecchymosis (bruising) * Discharge * Approximation

* Large area, swollen, bluish skin * Severe pain * Redness, swelling * Purulent drainage * NO noticeable BLEEDING

Hematomas (blood outside the vessel)

* A boggy or relaxed uterus * Failure of uterus to contract * excessive clots * bloddy red flow

UTERINE ATONY

WHAT causes uterine atony

* full bladder * overdistension of uterus * retention of placental fragments * Inducing labor with Oxytocin

What is the number one cause of postpartum hemorrhage

uterine atony

* TRICKLING or STEADY STREAM of red blood * excessive bleeding w/ FIRM fundus.

LACERATIONS

S/S for VTE

* tightness * redness * aching * edema * warmth * BILLATERALLY * low grade fever..

To prevent VTE/ DVT POSTPARTUM what would the nurse have the pt do

ambulation compressing socks report abnormal findings

Nutrition should

increase for mom. no sodas

IF mom is RH Neg and baby is RH POS what should be the NEXT step?

administer mom. RhoGAM within 72 hrs of delivery.

Women receive 2 doses of RhoGam .. when is this

28 weeks gestation and 72 hrs after birth. * need consent * Blood product so get consent and b careful with Jehovas witnesses.

do PP mood changes (baby blues) interfere with ability to care for SELF AND INFANT?

NO.