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Nursing 240 > test 2 > Flashcards

test 2 Flashcards

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1
Q

What are the main goals of postpartum care?

A

Monitor for hemorrhage, infection, promote bonding.

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2
Q

stages of labor?

A

Stage 1- distant contractions and cervix readying
stage 2- pushing delivery of the baby.
stage 3- delivery of the placenta
stage 4- stabilization, bonding

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3
Q

when is the largest risk of hemmoraging during labor?

A

Detachment of the placenta is the greatest risk.

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4
Q

Is it a good sign to be having cramping after giving birth?

A

Yes this is a sign of uterine involution, contraction back.

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5
Q

What drug helps with contractions?

A

Oxytocin
Natural hormone created in the pituitary posterior.

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6
Q

How can you help stimulate oxytocin release?

A

Breastfeeding, breast stimulation.

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7
Q

Are the contractions post delivery painful?

A

Yes

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8
Q

How long does the ovulation take lactating post partum?

A

6 months

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9
Q

What is the hormone that helps hinder the ovulation in breastfeeding?

A

Prolactin
Stays high when breastfeeding
not a good birth control method.

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10
Q

If you don’t breastfeed how soon after birth does prolactin return to normal?

A

3 weeks

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11
Q

What is the first milk called and what is the purpose of it?

A

Colostrum
Highly nutrient dense milk

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12
Q

When should you start to breastfeed?

A

1-2 hours post delivery?

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13
Q

How long does it take for colostrum to turn into full milk?

A

3-5 days

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14
Q

What is the immune systems response after birth?

A

Leukocytosis increased to prevent infection.
Increasing the production of WBC.

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15
Q

fluid loss after birth?

A

loss of blood and diaphoresis loosing 19 pounds in the first 5 days.

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16
Q

Common GI complications after birth?

A

Constipation, hemorrhoids

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17
Q

GU changes after birth?

A

Elasticity or sensation loss from birth leading to retention.

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18
Q

How long should mothers wait to get pregnant again after the rubella vaccine?

A

This is a live vaccine and should wait at least 30 days before getting pregnant again.

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19
Q

When do you give Rho globin?

A

If mother is negative and baby is positive give within 72 hours of labor

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20
Q

Quick assessment tool for postpartum?

A

BUBBLE
B: enlargement of breasts encourage breastfeeding within 2 hours post delivery, Helps with oxytocin for uterine contractions.

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21
Q

Quick assessment tool for postpartum?

A

BUBBLE
B: enlargement of breasts encourage breastfeeding within 2 hours post delivery, Helps with oxytocin for uterine contractions.
U: Uterus, position and consistency, you want firm midline. Encourage voiding.
B: Bowel softeners are recommended to lessen the strain to the sore premium.
B: bladder ensure voiding
L: Lochia, Making sure that it is lessening what the color is and how much?
E: Episiotomy, tear, what is the stage 1-4 hows it healing?

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22
Q

Which is more concerning for infection?
Unilateral breast pain,
bilateral breast pain?

A

Unilateral pain.
Bilateral is common with engorgement needs to be emptied.
Unilateral is mastitis

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23
Q

How often should you check the new mothers BP/P after delivery?

Study These Flashcards
A

every 15 mins for the first 2 hours looking for hypovolemia from bleeding.

24
Q

How often is the temp taken?

Study These Flashcards
A

Q4h for first 8

25
What is the progression of bleeding discharge after delivery?
Rubra- dark red with clots 1-3 days Serosa- serosang more clear small clots, 4-10 days Alba- yellowish white creamy 10 days- 8 weeks
26
When do you check for the bleeding?
Q15min -1 hour Q1h -4 hours Q4-8hrs
27
Excessive bleeding
1 saturated pad in 15 mins
28
scant, light, moderate bleeding?
<2.5cm 2.5-10cm >10cm
29
Heavy bleeding is?
Saturating one peri pad in 2 hours
30
uterus contractions after birth?
Should be within the pelvis unable to be palpated within 2 weeks. The uterus should be at the umbilicus within an hour PP.
31
How far does the uterus move each day PP?
1-2cm each day one or two fingers.
32
After delivery, dry baby wrap in warm blanket and place on mother. what can wait.
This is the golden hour for bonding wait for eye ointment and do vitals while on skin.
33
Should you wipe off the vernix when drying the baby?
No this is a special (antibiotic lotion should be left on)
34
Which is the good form of breast engorgement primary or secondary?
Primary since it is temporary when milk is coming in.
35
Secondary engorgement?
When the milk production doesn't match up with the extraction. Feed every 2 hours warm compress cool cabbage wraps milk while at work
36
What are risk factors for having bleeding and hemorrhaging
Fast(precipitous labor prolonged labor oxytocin augmentation high parity ( previous deliveries
37
What are some things to do with a patient that has a boggy uterus before calling the HCP?
Massage fundus have patient void or straight cath have patient breastfeed
38
How can you promote the newborn baby thermoregulation after birth?
Keeping on skin, under a warmer, hat and socks dry right away. no baths for water for first day.
39
How can you prevent nipple confusion?
Nipple breastfeeding for the first 3 weeks bottles before 3 weeks can lead to nipple confusion.
40
When the placenta is delivered what do you need to look for?
All lobes are connected with no tears.
41
retained placenta over 30 mins
uterus can not contract back down can lead to inversion of the uterus or hemorrhaging.
42
PP hemorrhage
greater than 500 vaginally greater than 1000 C/S
43
Primary bleeding
Within the first 24 hours
44
Secondary bleeding
after 24 hours up until 3 months after
45
What is considered a persipitus labor?
fast delivery less than 3 hours.
46
What is the o2 you should set a woman on PPH?
10L nonrebreather
47
What are the meds that are given for PPH?
Oxytocin (IM,IV) methylergonovine (methergine) IM misoprostol (Cytotec) PV PR Carboprost tromethamine (hemabate) IM
48
What is the last attempt to try and stop the bleeding?
hysterectomy and surgery
49
What are some areas for pain after delivery?
C/S tenderness general soreness hemorrhoids perineal trauma uterine contractions
50
What are common infections PP?
UTI wound infection (c-section, episiotomy) Mastiitis (milk stasis) endometritis- 3-4 days post Delivery
51
Mastitis
Usually from a blocked duct unilateral breast have baby still feed during this condition. Staph auerus headache, fever, different from a blocked duct because of the systemic signs such as fever and WBC
52
Endometritis
infection starting at the site of the placenta. pelvic pain, fever, chills, odorous lochia.
53
Are postpartum blues normal PP
Yes this is normal watch for anything lasting anything after 2 weeks.
54
postpartum psychosis
Higher risk if bipolar paranoia, sadness, disorientation, confusion, hallucinations.
55
diet should be changed to what?
450 to 500 over a normal intake for breastfeeding.
56
what should you watch for when discharging?
Watch for signs of infection, changes in the bleeding size amount and color, mood changes and suicidal thoughts,

Nursing 240 (2 decks)

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