Postpartum- EXAM 1

Question 1

Puerperium

Answer 1

The postpartum period
Begins immediately after birth
Continuous for approximately 6 weeks

Question 2

Fourth stage of labor

Answer 2

After birth is done; 3 stages done
Includes identifying and preventing hemorrhage
Evaluating pain
Observing bladder function, recover from anesthesia and providing initial care for the newborn

Question 3

What do you look for when observing for hemorrhage

Answer 3

Vital signs, skin color, location and firmness of uterine fundus, lochia and pain

Question 4

Care for the newborn phases and their time

Answer 4

Phase 1: from birth to 1 hour (usually in delivery room)
Phase 2: From 1-3 hours (usually in transition nursery or postpartum unit)
Phase 3: From 2-12 hours (usually in postpartum unit if rooming in with the mother)

Question 5

Care for the newborn phase 1

Answer 5

From birth to 1 hour
Usually in delivery room
Care includes:
Maintaining thermoregulation, cardiorespiratory function
Observing for urination and passage of the meconium
Identifying mother, father and newborn
Performing brief assessment and encouraging bonding and breastfeeding

Question 6

Apgar scoring includes:

Answer 6

Heart rate
Respiratory effort
Muscle tone
Reflex response
Skin color

Question 7

What is involution

Answer 7

The rapid reduction in size as the uterus returns to non pregnant state
Bleeding is controlled by compression of muscle fibers
Top of the funds will descend into pelvis by 10th day
Uterus will approach prepregnant location by 5-6 weeks

Question 8

When does the placental site heal

Answer 8

Over 6 weeks

Question 9

What are afterpains

Answer 9

cramp like pains after birth caused by intermittent contraction of uterus after childbirth
Is more severe in multiparas

Question 10

Lochia

Answer 10

discharge from the uterus of debris remaining after childbirth
Loch patterns vary
Has musty, stale odor, foul smell may mean infection and needs to be assessed
Total volume of 225 ml

Question 11

Lochia rubra

Answer 11

First discharge
dark red, first few days and may contain small clots

Question 12

Loch serosa

Answer 12

pinkish, days 3-10

Question 13

Loch alba

Answer 13

creamy or yellowish, persists for 1-2 more weeks

Question 14

Cervical changes after birth

Answer 14

Cervix is flabby and formless
Admits 2 fingertips for a few days after birth, the only 1 by end of first week
First childbearing permanently changes shape of external os

Question 15

Vaginal changes

Answer 15

Appears edematous, bruised following birth
Size decreases, rug returns in 2-3 weeks
Appears normal by 6 weeks
Tone, contractility improves with perineal tightening exercises

Question 16

Perineal changes

Answer 16

Soft tissue edemotaous bruised
Episiotomy or laceration should have initial healing within 2-3 weeks after birth
Complete healing may take up to 4-6 months

Question 17

Ovulation and menstruation

Answer 17

Menstration returns 7-12 weeks after birth
As late as 3 years in 70% of breastfeeding mothers
All associated with the length of time the women breastfeeds

Question 18

Abdomen after birth

Answer 18

Stretched abdominal wall, responds well to exercise within 2-3 months
May remain flabby
Diastasis recti abdomens may be present= separation of abdominal muscles
Stretch marks may be present

Question 19

GI system

Answer 19

Bowels tend to be sluggish due to pregesterone and decreased abdominal muscle tone
Discomfortt from flatulence can be relieved from early ambition to use of antiflabulence meds, chamomile tea or peppermint tea
stool softeners may be helpful, especially if hemorrhage or laceracions

Question 20

Urinary system

Answer 20

Increased bladder capacity
swelling and bruising of tissue around the urethra
Urinary output increases

Question 21

Where is the fundus immediately after delivery

Answer 21

symphysis pubis and umbilicus

Question 22

Vital signs after birth

Answer 22

Women should be febrile
Temp may increase and mother may shiver

Question 23

Cardiac changes

Answer 23

Stabilizes and returns within 1 hour after birth
Diuresis in first 2-4 days helps decrease extracellular fluid, this results in weight loss
This is done to prevent pulmonary edema and cardiac problems

Question 24

Neurological changes

Answer 24

Headaches are the most common symptom in postpartum, migraines may be persistent during and after pregnancy; especially if mother had sezuires

Question 25

Psychological changes

Answer 25

Mother will experience various responses to now having a baby and may seem concerned about how to care for it

Question 26

4 stages of maternal role attainment

Answer 26

Anticipatory, Formal, Informal and personal

Question 27

Anticipatory stage

Answer 27

Occurs during pregnancy

Question 28

Formal stage

Answer 28

Begins when the child is born

Question 29

Informal stage

Answer 29

Begins when women starts making her own choices about being a mother

Question 30

Personal stage

Answer 30

When women is comfortable with the idea of herself as a mother

Question 31

Postpartum weight and nutrition

Answer 31

Initial weight loss of 10-12 lb, as a result of birth and expulsion of placenta and amniotic fluid
Within 6-8 weeks most women will return to post pregnancy weight

Question 32

Postpartum nutritional staus

Answer 32

Constipation is common, encourage women to maintain high fluid intake and sources of fiber

Question 33

Interventions to relieve perneal discomfort

Answer 33

Ice or gel packs to episiotomy
Sits bath or topical ointments or even witch hazel

Question 34

What would you implement if a mother chooses not to breastfeed

Answer 34

Wear a supportive bra within 6 hours of birth to help suppress lactation
Apply ice packs under armpits for 20 min, 4 times a day
Avoid stimulation to breasts, can cause milk to come out