Postpartum - Unit 3

Question 1

What is involution?

Answer 1

When the uterus shrinks back up!

Question 2

What is catabolism (in regards to involution?)

Answer 2

When the cells shrink back after birth.

Question 3

by the time a woman leaves the hospital, the uterus is 1-2 fingers below the umbilicus. T/F?

Answer 3

True

Question 4

The uterus should shrink about __ cm per day.

Answer 4

1cm

Question 5

The weight of the uterus at delivery is about ____ kg
1 week after = ___ g.
4 weeks = ____ g.

Answer 5

1kg (1000g)
500 g
100 g

Question 6

Less afterpains with each pregnancy. T/F?

Answer 6

FALSE - you’ll have more afterpains.

Question 7

Lochia - what is it? How do we measure it?

Answer 7

Fancy term for the bleeding you have after pregnancy. You measure it by how much of the pad is saturated.

Question 8

If the pad is saturated, what do we do?

Answer 8

Ask the mom about it, see how long she’s had it in, etc. Educate educate educate!

Question 9

If the pad is saturated within an hour, that’s too much or too little?

Answer 9

TOO much.

Question 10

Saturated pad = whole bad. T/F?

Answer 10

True

Question 11

15 minutes = excessive bleeding. T/F?

Answer 11

TRUE

Question 12

Scant bleeding - how much in an hour?
Small/light - how much in an hour?
Moderate - how much in an hour?
HOLY FUCKING SHIT/EXCESSIVE - how much in an hour?

Answer 12

Scant = 2.5 cm in an hour.
Small/light = 10 cm in an hour.
Moderate = 10-15cm in an hour.
HOLY FUCKING SHIT/EXCESSIVE = >15cm.

Question 13

The cervix will go back to almost closed. T/F?

Answer 13

TRUE

Question 14

By one week, the mom is dilated to __ cm with edema present for up to ____ to ____ Months.

Answer 14

1cm.

3-4months.

Question 15

It takes __ to ___ weeks for the epithelial cells of the vagina to be repaired.

It will regain tone but won’t go back to normal. T/F?

Answer 15

6-10 weeks.

True!

Question 16

You can have a baby immediately after birth - T/F?

Answer 16

FALSE - wait at least 6 weeks!

Question 17

Cardiac - ___ ml of blood is shifted back into circulation after birth.

Answer 17

500ml

Question 18

Due to the excess fluid/blood/etc. in the body during pregnancy, how does the body get rid of it?

Answer 18

SWEAT and pottying a ton!

Question 19

It’s normal to have a slightly elevated WBC after the end of the pregnancy. T/F?

Answer 19

TRUE

Question 20

Hct takes 4-6 weeks to return to normal, unless there’s excessive blood loss. T/F?

Answer 20

TRUE

Question 21

Increased coagulation takes about 4-6 months to return to normal. T/F?

Answer 21

FALSE - 4-6 weeks.

Question 22

Progesterone will make your bowel sludgy for a few days after, so what are women at a risk for?

Normal BM’s return in __ to ___ days.

Answer 22

Constipation - 8-14 `days.

Question 23

Takes about 4 weeks for the urinary system to return to normal. T/F? Until then, they might lack sensation, etc.

Answer 23

TRUE

Question 24

Acetone is sometimes normal in the urine. T/F?

Answer 24

TRUE

Question 25

stress continence disappears at about __ weeks.

Answer 25

8

Question 26

Sometimes, women can have aches and pains that come out of nowhere a few days after pregnancy, right?

Answer 26

YES

Question 27

Stretch marks disappear, but skin marks like linea nigra never fade. T/F?

Answer 27

FALSE - linea nigra and such will disappear BUT stretch marks do not disappear (they just get lighter/silvery)

Question 28

Hair loss - bald spots can happen, but not often. You'll look normal at about ___ months.

Answer 28

5

Question 29

Breastfeeding can hold menstruating out, but it's not contraception. T/F?

Answer 29

TRUE

Question 30

Quarter sized clots - ok or bad? Golf ball sized clots - ok or bad? Grapefruit size - ok or bad?

Answer 30

Quarter sized clots - ok Golf ball sized clots - ok, as long as they aren't often. Grapefruit size - BAD

Question 31

Prolactin increase milk production __ to ___ days after delivery.

Answer 31

2-3 days

Question 32

If the mom starts pumping too early, the body will think "okay, great, I'll make even ____ (more or less?)"

Answer 32

MORE, so don't encourage a non-breastfeeding mom to pump.

Question 33

Oxytocin is needed for let-down. T/F?

Answer 33

TRUE

Question 34

10-13 pounds are lost during birth itself, then 5-8 pounds for diruesis, 2-3 for lochia, and 2-3 for inversion. T/F? She'll be within 1kg of her pre-pregnancy weight within how long?

Answer 34

TRUE one year.

Question 35

Fundal check - push on uterus and then push...do we support the ligaments?

Answer 35

YES

Question 36

Uterus - shouldn't be hard. T/F?

Answer 36

FALSE - it should be. If it isn't, massage that fucker.

Question 37

If the fundus isn't midline, then maybe she needs to ___?

Answer 37

PEE

Question 38

IV - should be left in for how long after birth?

Answer 38

6 hours.

Question 39

Pneumonia vac - over the age of 19 and you have to have a risk factor, like asthma. T/F?

Answer 39

TRUE

Question 40

What is BUBBLE-HE?

Answer 40

For focused assessment - ``` Breasts Uterus Bladder Bowels Lochia Episiotomies Homan's Sign Emotional state ```

Question 41

What are some parts of the chart review?

Answer 41

Gravida/para, time of delivery, type of delivery, episiotomy or lacerations, anesthesia/meds given, surgery?, history, meds in general, food/drug allergies, condition of infant, lab data, need for rhogam, immunizations, risk factors for bleeding

Question 42

What are some parts of the initial assessment?

Answer 42

Vital signs, skin color, fundus, lochia, perineum, pain, IV, urinary output, level of feeding and ability to stand.

Question 43

What are some comfort measure we can give?

Answer 43

Ice packs, sitz bath, perineal care, topical medications, pain medications, promoting bladder elimination and providing fluids and food.

Question 44

Ice pack for the first __ hours, then warm water.

Answer 44

24 hours.

Question 45

Episiotomy - patients need to pat dry with toilet paper, and they should not WIPE dry. T/F?

Answer 45

TRUE

Question 46

For episiotomy patients, what are some sprays they should use?

Answer 46

Demaplast (Benzacaine) spray - it's cold and numbing. Use it every other time they go to the bathroom. The opposite time is hydrocortizone. Witch hazel pads every time.

Question 47

What are some post-partum pain meds?

Answer 47

Ibuprofen and naproxen - but might have norco, tylenol #3 for 3rd or 4th degree episiotomy repair.

Question 48

C-section - after, they might get what med for pain? (Hint, starts with P!)

Answer 48

Percocet

Question 49

What are some assessments after a c-section?

Answer 49

Pain relief, respirations, abdomen, I/O

Question 50

C-Section - I/O until catheter comes out. T/F?

Answer 50

True

Question 51

24 hours after c-section - resume normal activities. T/F?

Answer 51

True

Question 52

Encourage use of straws after c-section - T/F?

Answer 52

FALSE - it increases gas pain.

Question 53

What do we do for the first 24 hours after c section? 24 hours after?

Answer 53

First 24 = providing pain relief, overcoming immobility, providing comfort. After 24 hours - resuming normal activities, assisting with feeding, preventing abdominal distention, teaching for discharge

Question 54

Handwashing - is it important?

Answer 54

YES

Question 55

Are cabbage leaves good for breast engorgement?

Answer 55

YES

Question 56

Babies can something eat every 30 minutes..or two hours. T/F?

Answer 56

True - so it can disrupt rest for a mom.

Question 57

How long until women should resume sex?

Answer 57

AT LEAST 6 weeks.

Question 58

What are some signs and symptoms that should be reported?

Answer 58

Fever, localized area of redness/swelling/or pain in either breast, persistent abdominal tenderness, feelings of pelvic fullness or pressure, persistent perineal pain, frequency/urgency/burning on urination, abnormal changes in lochia, localized tenderness/redness/warmth in the legs, redness/separation/ or edema of abdominal incision or foul drainage from incision

Question 59

Localized area of redness in breast = what?

Answer 59

Probably mastitis

Question 60

Pelvic fullness might be a what?

Answer 60

Retained placenta

Question 61

Persistent perineal pain might be a what?

Answer 61

Hematoma

Question 62

Lochia normally goes to yellow at the end. What should we do if it turns to red?

Answer 62

Report it!

Question 63

Bonding - two ways. T/F?

Answer 63

FALSE - it is one way. Parent to child.

Question 64

Attachment - one way?

Answer 64

FALSE - it is two ways. Parent to child and back.

Question 65

What are the three puerperal phases?

Answer 65

Taking in, taking hold & letting-go

Question 66

What is the taking-in phase?

Answer 66

You're just focused on your own needs as the mother. Usually lasts less than a day.

Question 67

What is the taking hold phase?

Answer 67

Lasts several days, attention shifts towards baby. They are taking care of the baby but forgetting more about themselves, like "oh, I forgot to wash my hair today!"

Question 68

What is the letting-go phase?

Answer 68

Letting go of their old life, or maybe the pregnancy didn't end well? Maybe the kid went to NICU? All that.

Question 69

What's engrossment for the fathers?

Answer 69

They realize it's real and become all excited and involved with the bambino!

Question 70

Kids - might regress once the baby comes. T/F?

Answer 70

TRUE

Question 71

What are some factors that affect family adaptation?

Answer 71

Discomfort and fatigue, knowledge of infants needs, previous experience, expectations about the newborn, maternal age, maternal temperament, temperament of the infant, support system, birth experience.

Question 72

Hispanic, Middle Eastern, and Asian women - hate privacy. T/F?

Answer 72

FALSE - they want more privacy.

Question 73

Muslims - value modesty. T/F?

Answer 73

TRUE

Question 74

Hispanic/Native American women - they might have increased direct communication. T/F?

Answer 74

FALSE - they will probably have decreased direct communication.

Question 75

Asian/Hispanic women - follow traditions. T/F?

Answer 75

True

Question 76

Indian women - return home for 16 weeks. T/F?

Answer 76

TRUE

Question 77

Phillipines - mom comes to take care. T/F?

Answer 77

TRUE

Question 78

Mother in law in Korea - she stays away. T/F?

Answer 78

FALSE - she comes to care for baby and mom.

Question 79

Restriction - 40 days after for Russian moms. T/F?

Answer 79

True

Question 80

Laotian women - one month after - near a fire- T/F?

Answer 80

TRUE

Question 81

Native American women - 20 days of rest or until cord falls off. T/F?

Answer 81

True

Question 82

Asian/Hispanic women - they have to stay cold after birth. T/F?

Answer 82

FALSE - they stay warm.

Question 83

Mexican women after birth - they tay warm, eat no spicy foods, and do nothing for 40 days. T/F?

Answer 83

True