Postpartum Flashcards
(50 cards)
1
Q
what changes postpartum physical adpatations
A
- vital signs
- cardiovascular
- reproductive
- urinary
- gastrointestinal
- musculoskeletal
- interhumentary
- neurologic
- immune
2
Q
VS: postpartum temperature
A
97-100.4
may be elevated for 24 hr after brith and elevated again after milk comes in
3
Q
VS: postpartum BP
A
usually 120/80
- assess for orthostatic hypotension
- assess for hypertension/ reclampsia
4
Q
VS: postpartum HR
A
60-100 normal
-slight bradycardia not uncommon (50-90)
5
Q
Postpartum changes in cardiovascular/ lab values and EBL
A
- increase blood volume 40-50%
- normal pp blood loss (EBL): 200-500mL vaginal and 700-1000mL cesarean
- cardiac output: preload increased and returns to normal with 1hr
6
Q
postpartum changes reproductive system
A
everything: uterus lochia cervix vagina breast
7
Q
changes in uterus postpartum
A
- spongy layer of decide is sloughed off
- placental site heals by exfoliation
- uterin cells will atrophy : involution
8
Q
changes in lochia postparturm
A
-uterine debris in the uterus is discharged though loch
9
Q
changes in cervix/ vagina postpartum
A
- cervix: spongy, flabby, and may appear bruised
- extrnal os may have lacerations is irregular and closes slowly: shape of the external os changes to a lateral slit
- vagina may be edematous , bruises with small superficial lacerations
10
Q
postpartum changes in breast/lacation
A
- estrogen/progesterone decrease
- breast are ready for lactation
11
Q
relationship between postpartum ovulation and menstruation
A
- nonbreastfeeding: menstruation occurs 7-12 weeks, first ovulation can occur 5 week
- breastfeeding, takes 3 or more months for mensuration/ovulation: exclusive bf reduce risk of pregnancy
12
Q
postpartum urinary changes
A
- postpartum diuresis causes loss fo 5 lbs
- increased bladder capacity
- urinary stasis
13
Q
causes of urinary stasis
A
- swelling and bruising of tissues around the urethra
- decrease in sensitivity to fluid pressure
- decrease in sensation of bladder filling
14
Q
postpartum changes in gastrointestinal
A
- hungry 1-2hr after brith
- bowel patterns slow and risk for constipation
15
Q
causes of risk of constipation
A
-episiotomy, lacerations or hemorrhoids may delay elimination
16
Q
postpartum changes musculoskeletal
A
- loose and flabby but will respond to exercise
- diastasis recti abdominis
17
Q
diastasis recti abdonminis
A
abdominal muscle divides into 2, may cause hernia
18
Q
postpartum changes integumentary
A
- perineum may be: edematous, bruised
- lacerations or episiotomy may be present
- striae
19
Q
postpartum changes neurologic
A
-headaches and carpal tunnel
20
Q
postpartum changes immune
A
- rubella: can cause brith defects
- Rh + results in incompatibility
- HIV
21
Q
postpartum assessment mnemonic
A
Breast Uterus Bowel Bladder Lochia Episiotomy/Lacerations H- Hemorrhoids/Homan's Emotions
22
Q
how to initiate an assessment
A
- identify yourself
- identify your patient
- ppe
23
Q
what to look for in breast assessment
A
- skin integrity: abnormalities, redness, blisters, nipple: cracks, tissues, soreness, inversion
- consistency: presence of breast fullness due to milk presence and engorgement
- lactation status
24
Q
what to look for in a uterus/abdominal assessment?
A
- tone
- position of funds to midline
- heigh of fundus related to umbilicus
- assess incision for bleeding, approximation and signs of infections
25
Fundal message
- bimanual
- to make fundus firm
- may hurt
26
what to look for in a bowel and bladder assessment
- intestinal elimination: maternal concerns regarding bowel movements
- adequacy of urinary elimination
- bladder distention and pain during urination
27
Assessment of loch and perineum
- assess loch for: amount, color, order, presence of clots
- wound assessed for REEDA
- presence of hemorrhoids
- level of comfort/discomfort
- efficacy of any comfort measures
28
What does REEDA stand for and when is it used
- assessing any wound
- Redness
- Edema
- Ecemycin: bruising
- Discharge
- Approximation
29
Postpartum loch flow
- scant: 1inch stain
- light:1-4inch stain
- moderate 1-6 inch stain
- heavy: saturated within an hour
30
Episiotomy what is it and what to do for it
incision for in perineum
| -sitz bath recommended
31
Hemorrhoids
distended viens
32
assessment for extremities
- asses calf for redness and warmth
- varicosities (viens)
- edema
33
Nursing process
- Assessment
- nursing diagnosis
- planning
- implementation/interventions
- evaluation
34
nursing diagnoses for postpartum patient
- knowledge deficient
- fluid volume deficient
- urinary retention
- constipation
- infection, risk for..
- pain, acute
- sleep pattern, disturbed/fatigue
35
interventions: comfort measures: relieve of afterpains
- positioning
- ambulation
- analgesics
36
interventions: comfort measures: perineal care
- ice packs
- sitz baths
- analgesics
37
interventions: suppressing lactation
- well bitting bra
- cold compresses or cabbage leaves
- anti- inflammatory meds
38
care of C-section mother
- minimize complications: deep breathing and incentive spirometry, ambulation, pain management
- rest
- minimize gas pains
- consider grief response
39
care of postpartum adolescent: discussion
- postpartum hygiene: demonstrate self care
- contraceptive consoling
- newborn care: physical exam at bedside
40
care of postpartum adolescent: nurse-patient relationship
- positive feedback
- sensitive, nonjudgemental
- still trying to meet educational goals
- relies on others
41
care of postpartum adolescent: opportunities
- include family
- role model
- ensure knowledge and skills/ teach back
- information about options in community
42
cultural influence in postum period
- determine customs and practices
- ask about fluids and temperature
- breastfeeding practices: assistance or alone
- role of grandmother
43
maternal psychological adjustment: taking in period
they need a moment to care for themselves, not ready to learn or assume full care of baby (day 1)
44
maternal psychological adjustment: taking hold
ready to learn and take care of baby (2-3 days)
45
attachment
interactive process between the parent and infant which develops their relationship
46
signs of attachment
- en face position
- fingertip explorations-- palmar contact--enfolding
- engrossment: father's characteristics
47
postpartum blues
adjustment reaction with depressed mood
| -related to rapid changes in estrogen, progesterone, prolactin
48
how many people experience postpartum blues
85%
49
how long does postpartum blues last
2-4day to 14 days
50
Contributing factors to postpartum blues
- anxiety of new moms
- physical discomfort of early postpartum
- difficulty sleeping
- feeling let down
