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NURS 320 - Final > Postpartum > Flashcards

Postpartum Flashcards

(58 cards)

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1
Q

When is postpartum?

A

6 weeks after birth

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2
Q

When does breast engorgement occur?

A

2 - 4 days postpartum

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3
Q

What type of breast milk is present for the first 2 - 5 days of postpartum?

A

Colostrum (yellow color) - full of antibodies and nutrients

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4
Q

When is the best time to breastfeed?

A

Overnight - highest levels of prolactin

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5
Q

Describe education associated with lactation (3)

A
  • Wear supportive bra for 5 - 10 days - remove only for showers
  • Apply ice to axilla for 20 minutes QID (vasoconstriction of milk ducts)
  • Avoid warmth (no hot showers)
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6
Q

What is mastitis?

A

Infection of mammary glands - often associated with a blocked milk duct

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7
Q

When is mastitis most common?

A

2 - 3 weeks postpartum

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8
Q

A mother with mastitis should feed from the ______ breast first

A

Affected

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9
Q

Describe education associated with mastitis (3)

A
  • Alternate feeding position
  • Make sure breasts are empty after feeding
  • Warm shower to facilitate milk flow
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10
Q

What intervention should take place if the fundus is deviated to the right upon palpation?

A

Empty the bladder

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11
Q

When does involution of the uterus begin?

A

Immediately after delivery

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12
Q

Where is the uterus 6 - 12 hours after delivery?

A

Above the umbilicus

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13
Q

Where is the uterus 10 days after delivery?

A

Deep in the pelvis - not palpable

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14
Q

What is the rate of uterus descent / involution?

A

1 cm / day (slightly less for c-section)

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15
Q

How often should the bladder be emptied postpartum?

A

Q 2 hours

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16
Q

Describe lochia on days 1 - 3

A

Rubra - bright red (heaviest flow on first day)

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17
Q

Describe lochia on days 4 - 10

A

Serosa - pink / brown

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18
Q

Describe lochia on days 10 - 14

A

Alba - yellow / white

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19
Q

______ is a key assessment along with the fundus postpartum

A

Evaluation of lochia

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20
Q

How much lochia is a concern?

A

> 1 pad saturated per hour

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21
Q

How much blood loss is considered postpartum hemorrhage? (2)

A
  • > 500 cc for vaginal delivery
  • > 1000 cc for c-section
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22
Q

What are the causes of early postpartum hemorrhage? (4)

A
  • Tone - soft / boggy uterus
  • Tissue - retained placenta
  • Trauma - lacerations / uterine rupture
  • Thrombin - ineffective clotting (DIC)
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23
Q

What are the manifestations of early postpartum hemorrhage? (3)

A
  • Ears ringing
  • Headache
  • Hypotension
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24
Q

What are the manifestations of uterine atony? (4)

Study These Flashcards
A
  • Boggy fundus
  • Fundus higher than expected
  • Bright red / heavy lochia
  • Excessive clots
25
What is the most important nursing intervention for uterine atony?
Massage the fundus
26
What medications are given for postpartum hemorrhage if the uterus fails to maintain contraction? (4)
- IV Pitocin - IM Methergine - IM Ergotrate - IM Hemabate
27
What is the primary side effect of Methergine?
Hypertension
28
Which medication for postpartum hemorrhage CANNOT be used for patients with asthma?
Hemabate - use Ergotrate instead
29
A firm fundus with bright red bleeding indicates ______
Uterine trauma
30
Describe postpartum hematoma
Bleeding into vulva, vaginal wall, or retroperitoneal tissue
31
Describe the treatment of ineffective clotting / DIC (2)
- Fluid replacement - NSS / LR - Blood replacement - fresh frozen plasma / platelets / packed RBCs
32
When does late postpartum hemorrhage occur?
7 - 14 days after delivery
33
Describe the treatment of hemorrhoids postpartum (4)
- Apply ice - Sitz baths - Topical treatment - Stool softeners - Colace
34
First menses cycle after birth is ______
Anovulatory
35
How much weight loss occurs during the postpartum period?
10 - 12 pounds
36
Describe expected HR during the postpartum period
Bradycardia for first 10 days
37
Describe expected RR during the postpartum period
16 - 24
38
Describe expected temperature during the postpartum period
Elevated temperature for first 24 hours
39
Describe expected BP during the postpartum period
Orthostatic hypotension for first 24 hours
40
Describe expected laboratory findings during the first 1 - 3 days postpartum (3)
- Decreased H&H - Elevated WBCs (20,000) - Increased urine output
41
What are the manifestations of postpartum infection? (3)
- Temp > 100.4 °F AFTER 24 hours - Chills / malaise / headache - Purulent lochia
42
With proper treatment, postpartum infections should improve within ______
48 - 72 hours
43
When is the "taking in" phase?
1 - 2 days postpartum
44
Describe the "taking in" phase (3)
- Dependence on others - Open to advice - More concern with own needs rather than infant
45
When is the "taking hold" phase?
3 - 7 days postpartum
46
Describe the "taking hold" phase (3)
- Self care - Bonding with infant - Strong interest in infant care
47
Describe nursing assessment during the "taking hold" phase
Assess is mother responds hesitantly to infant cries - could indicate problem with bonding
48
When is the "letting go" phase?
> 7 days postpartum
49
Describe the "letting go" phase (2)
- New parent role - Assumes responsibility for care
50
Describe postpartum blues (2)
- Emotional lability / crying - Does not affect ability to care for baby
51
When do postpartum blues occur?
Day 5 (peak) - subsides by day 10
52
Describe postpartum depression (3)
- Profound / intense depression - Interferes with daily activities - Inability to care for self or baby
53
When does postpartum depression occur?
4 weeks postpartum - lasts for a few months
54
Describe postpartum psychosis (2)
- Agitation / irrational thoughts - Emergency - risk of suicide / infanticide
55
When does postpartum psychosis occur?
3 months postpartum
56
Mothers with a rubella titer of ______ should receive the MMR vaccine in the postpartum period
< 1:10
57
Describe the education associated with the MMR vaccine (3)
- Safe for breastfeeding mothers - Cannot receive while pregnant or if egg allergy (live virus) - Avoid pregnancy for 3 months following vaccination
58
When is IM RhoGAM injection given? (2)
- 28 weeks during pregnancy - 72 hours after delivery

NURS 320 - Final (19 decks)

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