Postpartum Flashcards
(30 cards)
What is the assessment schedule for postpartum monitoring for a normal vaginal birth?
-Every 15 min for 1hr
-one at 2 hours after birth
-then once per shift
Indicates the frequency of vital sign checks in postpartum care.
What is the assessment schedule for postpartum monitoring for a C-section birth?
-Every 15 min for 1hr
-two hours afterwards
-then every 4 hrs for 24 hours
-then Qshift (start Qshift vitals 30 hours after giving birth)
What does BUBBLLEE stand for in postpartum assessment?
Breasts, Uterus, Bladder, Bowels, Lochia, Legs, Episiotomy/Laceration, Extremities
A mnemonic for the key areas to assess in postpartum nursing.
What are the characteristics of breasts postpartum?
- Soft
- Filling
- Full
- Engorged
- Presence of colostrum
Engorgement is temporary and usually resolves within 24-48 hours.
What should be checked if the uterus is not midline?
Check bladder distension
A distended bladder can displace the uterus.
What is the typical urinary behavior postpartum?
May not void for 8 hrs after birth
Monitoring input/output is essential to assess bladder function.
What does Lochia refer to?
The vaginal discharge after giving birth, including amount, color, odor, and clots
Lochia changes in color and consistency over time.
What are the components of the REEDA assessment?
- Redness
- Edema
- Ecchymosis
- Drainage
- Approximation
Used to assess the perineum or surgical site for healing.
What is involution in the context of postpartum care?
Changes in the uterus to return to pre-pregnancy size and condition
Subinvolution indicates failure to return to normal size.
What is subinvolution
failure of the uterus to return to normal size postpartum
What is the expected timeline for the descent of the fundus postpartum?
Approximately at the level of the umbilicus at 12 hours, descends about 1-2 cm/day
The fundus should no longer be palpable by 2 weeks postpartum.
What are the different types of Lochia and their timelines?
- Rubra: 3-4 days, bright red
- Serosa: 4-10 days, pinkish brown
- Alba: 10 days-6 weeks, yellow white
A foul odor indicates potential infection.
what are medications that stimulate uterine contraction
-Oxytocin
-Ergot
-prostaglandins
What are the signs of postpartum hemorrhage?
-Persistent bright red bleeding,
-soaking a pad in < 1 hour,
-passing clots larger than a golf ball
Hemorrhage thresholds are > 500 mL vaginal and > 1000 mL C-section.
What is the primary cause of early postpartum hemorrhage?
Tone (uterine atony)
Uterine atony leads to a boggy fundus and increased lochia rubra.
What are the symptoms of deep vein thrombosis (DVT)?
- Pain calf tenderness
- Leg edema
- Colour changes
Confirmed via ultrasound or MRI.
What is the typical time frame for menstrual cycles to resume postpartum?
About 7-9 weeks post, or 6-12 months if breastfeeding
Birth control should be considered based on breastfeeding status.
What is the expected change in cardiovascular function postpartum?
- Increased circulating volume
- Increased cardiac output
- Body rids excess volume via diuresis and diaphoresis
Pulse may increase for the first hour postpartum.
what are risk factors for PPH
-Subinvolution
-prolonged labour or very quick labour
-induced/augmented labor
-grand multiparity
-birth assisted by forceps or vacuum extractor)
What are the 4 most common causes of PPH
-Tone
-Tissue
-Trauma
-Thrombin
what are the most common causes of PPH within the first 24 hours
-Tone
-Thrombin
-Trauma
What is the main cause of PPH after 24 hours
-retained tissue
how long after a rubella vaccine do you need to wait to get pregnant
have to wait one month before you can become pregnant
What are the different stage of lactation
-Secretory differentiation
-Secretory activation
-Galactopoiesis
-Involution
