Postpartum Physiologic Changes

Question 1

Postpartum period

Answer 1

Birth and the return of the reproductive organs back to their nonpregnant state
6 weeks

Question 2

Discharge instructions

Answer 2

Car seat
Ways to feed the baby
Lactation consultation
WIC
Formula (how to mix and do not)

Question 3

Uterus PP

Answer 3

Uterine involution is the return of the uterus to a nonpregnant state (under the pubic bone)

Question 4

When does the uterus start to return?

Answer 4

After the delivery of the placenta and contraction of smooth muscle of the uterus occurs

Question 5

Where is the uterus located at 3rd stage of labor

Answer 5

Midline and 2 cm below the umbilicus

Question 6

Within the 1st 12 hrs, the fundus can rise ____ above the umbilicus

Answer 6

1 cm

Question 7

After 2 weeks, the fundus _____

Answer 7

should not be able to palpate

Question 8

The uterus return to the nonpregnant location by

Answer 8

6 weeks

Question 9

Day 1-3 what type of lochia

Answer 9

lochia rubra

Question 10

Days 1-3 Normal Discharge

Answer 10

Bloody, small clots; fleshy earthy odor; red or red-brown

Question 11

Abnormal discharge Days 1-3 Lochia

Answer 11

Large clots; saturated perineal pads; foul odors

Question 12

Days 4-10 what kind of lochia

Answer 12

Lochia serosa

Question 13

Normal discharge Days 4-10

Answer 13

v amount ; serosanguineous; pink or brown tinged

Question 14

Abnormal Discharge Days 4-10

Answer 14

Excessive amount; foul smell, continued or recurrent reddish color

Question 15

Day 11-21 what kind of discharge

Answer 15

Lochia alba

Question 16

Normal discharge lochia alba

Answer 16

white, cream, or light yellow color; decreasing amount

Question 17

Abnormal discharge lochia alba

Answer 17

persistent lochia serosa; return to lochia rubra; foul odor; discharge continuing

Question 18

Cervix PP

Answer 18

Gradually closes

Question 19

Placental Hormones (PP)

Answer 19

v estrogen
v progesterone
v HCG
Autolysis

Question 20

Autolysis

Answer 20

Placenta pulls away the wall; rough edge

Question 21

Metabolic Changes (PP)

Answer 21

v HCS
v Estrogen
v Cortisol
v Insulinase
v T3 and T4

Question 22

Pituitary and Hormones and Ovarian Function (PP)

Answer 22

v or ^ prolactin

Question 23

How to decrease prolactation

Answer 23

No stimulation of the breasts

Question 24

Would BUN ^ or v PP

Answer 24

Increase; 50% kidneys work hard to excrete the volume (urine out or sweat out)

Question 25

Check for Bowel Sounds due to

Answer 25

Constipation

Question 26

Colostrum

Answer 26

the first milk; 3days; the liquid gold

Question 27

What does colostrum contains?

Answer 27

Antibodies

Question 28

Mature Milk

Answer 28

4th days

Question 29

Engorgement

Answer 29

Breast fills up; continue breastfeeding the baby

Question 30

Mastitis

Answer 30

opening of the breast that can cause infection; continue to breastfeed

Question 31

Non-breastfeeding

Answer 31

do not simulate the breasts (no touching; water) Tightfitting bras Uterus will take longer to reutn to normal Educate both products and make them an education decision Learn how to clean the bottle

Question 32

Blood Volume PP

Answer 32

Plasma volume v the first few days

Question 33

Cardiovascular CO

Answer 33

decrease back to the prepregnant state

Question 34

Temperature the first 24th hour

Answer 34

Possible Increase (body trying to reregulating)

Question 35

Pulse PP

Answer 35

Increase (1hr) Next 24 hr -> decrease must know her normal pulse

Question 36

Blood components

Answer 36

Hgb and Hct v 3-4 days back to prepregnant 8wk

Question 37

WBC

Answer 37

^ body undergo stress

Question 38

Coagulation factors

Answer 38

^ clotting factors and fibringen

Question 39

Varicosities

Answer 39

varices empty rapidly with complete or near emptying during the postparum period

Question 40

What is the most common varicosities location?

Answer 40

Back of the legs, front of the legs, labia

Question 41

Respiratory system PP

Answer 41

Breathing must better intraabdominal pressure v chest wall compliance ^

Question 42

Neurologic System

Answer 42

Neuro discomforts of pregnancy go away HA are common (stress and preëclampsia), warrant careful assessment

Question 43

Musculoskeletal System

Answer 43

Abdominal wall back to prebody state Time for muscle tone return varies Diastasis recti abdominis (picture) Back pain resolves

Question 44

Integumentary System

Answer 44

Melasma (cholsama) go away Hyperpigmentation of areolae and linea nigra Striae gravidarum = lighter

Question 45

BUBBLE-HE

Answer 45

B-Breast (symmetrical) U-Uterus B-Bowel B-Bladder at least 30 ml L-Lochia (color, odor, clot, amount) E-Episiotomy/Laceration H-Heaviness and Hemorrhoids (DVT, hematomas, Witchhazel and ice pack) E-Emotions (Baby blue, PPD, Psychosis)