Postpartum

Question 1

What is the most productive cardiac change postpartum?

Answer 1

diuresis
Decreases extravascular fluid and weight

Question 2

respiratory changes postpartum

Answer 2

Increased respiratory rate due to fever or pain

Decreased respiratory rate due to respiratory compromise

Question 3

What’s the most common neural complaint postpartum?

Answer 3

Headache
Due to fluid shift after birth, leakage of CSF from epidural

Question 4

treatment for leakage of CSF from epidural

Answer 4

Blood patch

Question 5

if headache is pregnancy related what is the treatment option?

Answer 5

Acetaminophen
Caffeine

Question 6

how to suppress lactation

Answer 6

Compression wrap
Cold compress
Cabbage leaves
No warm water on breasts
Anti-inflammatory meds

Question 7

Intervention for insufficient milk amount

Answer 7

Increase fluids to 2 L per day

Question 8

intervention for sore nipples

Answer 8

Lanolin cream
Let dry open to air

Question 9

intervention for plugged ducts

Answer 9

frequent nursing
Change positions
Manual warm massage
Pumping

Question 10

mastitis

Answer 10

Infection of breast tissue

Question 11

sx of mastitis

Answer 11

sudden onset fever around 101
Chills
Red, painful, sore

Question 12

Treatment for mastitis

Answer 12

warm compress, analgesics
7–10 days of antibiotics (PCN)
Supportive bra without underwire
Complete emptying
Report flu like symptoms

Question 13

Engorgement

Answer 13

venous stasis in breasts
Overfilled with milk

Question 14

Does engorgement mostly occur in one or both breasts

Answer 14

both
Gradual onset

Question 15

treatment for engorgement

Answer 15

Don’t miss feedings
Pumping
Warm compress
Cabbage leaves
Cold application between feedings

Question 16

Diastasis rectus abdominous

Answer 16

Abdominal muscles separate till our room for large uterus

Question 17

interventions for after pains

Answer 17

Rest prone
Motrin/ibuprofen

Question 18

When should ibuprofen or Motrin not be given

Answer 18

platelet count less than 70,000
Preeclampsia

Question 19

involution

Answer 19

Pre-pregnancy state of uterus
Decreases weight

Question 20

endometritis

Answer 20

Infection of lining of the uterus

Question 21

sx endometritis

Answer 21

Tender
104° fever
Chills
Foul smelling lochia

Question 22

treatment for endometritis

Answer 22

Broad-spectrum antibiotic, such clindamycin and gentamycin

Question 23

at what rate does involution occur

Answer 23

One finger breaths per day
Fundus decreases 1 cm per day

Question 24

what color hair is oddly common for postpartum hemorrhage

Answer 24

Redheads

Question 25

Bowel changes postpartum

Answer 25

sluggish due to progesterone, decreased tone, anesthesia, hemorrhoids, fear of tearing Stool softeners!

Question 26

does the bladder capacity increase or decrease during pregnancy?

Answer 26

Increase

Question 27

Lochia

Answer 27

Vaginal discharge, blood, mucus, atrophied cells Uterine debris

Question 28

Lochia rubra

Answer 28

2–4 days postpartum Red

Question 29

Lochia serosa

Answer 29

4–10 days postpartum Pink

Question 30

Lochia alba

Answer 30

10–20 days postpartum White

Question 31

how is total blood loss measured?

Answer 31

Weighing pads 1 g equals 1 mL

Question 32

what measurement classifies a hemorrhage risk

Answer 32

Saturating one pad within one hour

Question 33

Causes of postpartum hemorrhage

Answer 33

boggy uterus lacerations, episiotomy Retained placental fragments Hematoma Uterine prolapse, rupture Decreased platelets

Question 34

sx postpartum hemorrhage

Answer 34

Excessive bright, red bleeding Abnormal clots Increased HR , temp Decreased BP, LOC

Question 35

treatment for postpartum hemorrhage

Answer 35

oxytocin Uterine massage Frequent voiding/catheter Hemabate/carboprost Misoprotol Methergine

Question 36

which medication should not be used with high blood pressure

Answer 36

Methergine, can cause rebound, hypertension

Question 37

Which medication has a side effect of extreme diarrhea

Answer 37

Carboprost

Question 38

T/F a diaphragm needs to be refitted for birth control after having a baby

Answer 38

True

Question 39

what location of pain can also relate to gas pain?

Answer 39

Right shoulder pain

Question 40

Homans sign

Answer 40

sign of thrombophlebitis Dorsiflex foot to assess

Question 41

“taking in”

Answer 41

1-2 days PP focused on herself and her needs

Question 42

“taking hold”

Answer 42

2-3 days PP ready to help others and assume control of body

Question 43

postpartum blues

Answer 43

Resolves naturally in 10–14 days Mood swings, sad then happy Episodic tearfulness with no cause

Question 44

Postpartum depression

Answer 44

Considered a mood disorder after four weeks

Question 45

risk factors of postpartum depression

Answer 45

First pregnancy History of depression Lack of support Adolescent History of abuse

Question 46

postpartum psychosis

Answer 46

Insomnia, confusion, delusions, illogical, thinking

Question 47

What’s the first line treatment for postpartum depression and psychosis

Answer 47

seek referral order Cognitive behavioral therapy

Question 48

en face

Answer 48

by mom, direct eye contact close to face

Question 49

engrossment

Answer 49

Done by partner, absorption and interest

Question 50

T/F, heavy lifting, frequent stair, climbing, and strenuous activity can be done right after delivery

Answer 50

False

Question 51

when can sexual activity be resumed postpartum

Answer 51

4–6 weeks episiotomy/laceration should be healed

Question 52

discharge criteria

Answer 52

Rubella- non immune or equivocal, must receive vaccine RhoGAM Able to avoid and pass flatus No difficulty with foods or fluids

Question 53

abnormal expected Postpartum changes

Answer 53

low-grade fever Profuse night sweats Intense shivering one hour after