Test 3 Blueprint (2) Flashcards
(51 cards)
What should the nurse expect when palpating the breasts of a PP client?
PP day 1 or 2: soft, colostrum
PP day 3 or 4: firm from milk coming in
When is engorgement expected?
3-5 days when milk comes in
What is colostrum?
Clear, yellowish fluid available for the first 2-3 days PP
What is the nutritive value of colostrum?
High in antibodies & protein
Low in fat & carbs
Colostrum: High protein facilitates binding of _____.
bilirubin
Colostrum: Laxative action encourages passage of _____.
meconium
Colostrum: Establishes normal _____ _____ flora in infant’s gut.
Lactobacillus bifidus
Colostrum: Contains ____ ____ that provides passive immunity.
IgA immunoglobulin
Interventions to treat breast engorgement:
- Apply COOL compresses BETWEEN feedings
- Apply WARM compresses/take WARM shower BEFORE feeding
Nutritive sucking is associated with increased production of ____.
milk
the more nutritive sucking, the more milk production
Hormone for milk PRODUCTION
Hormone for milk LET DOWN
(Remember the Ps & Os)
PROduction = PROlactin
Let down = Oxytocin (Oxytocin lets milk OUT)
What are the parameters of elevated temp indicative of infection in the PP client?
- After 24, PP temp of 100.4 or higher
- Lasts for 2 consecutive days during first 10 days PP
Interventions for perineal edema in the first 24 hrs:
- Ice pack (reduces edema, provides analgesia)
- Meds (acetaminophen, NSAID, opioid)
- Topical anesthetics (Americaine spray, Dermoplast, Tuck’s Pads…witch hazel) for hemorrhoids
What’s the difference between a laceration & an episiotomy?
Laceration = tear Episiotomy = cut made by physician
Classify the degrees of lacerations/episiotomies:
1st Degree: superficial vaginal mucosa or skin of perineum
2nd Degree: deeper tissues including muscles of perineum
3rd Degree: same as 2nd but extends to the anal sphincter
4th Degree: extends through anal sphincter into the rectal mucosa
Periurethral: laceration in the area of the urinary urethra (never intentionally cut)
Interventions for perineal healing & comfort AFTER first 24 hrs:
- Sitz bath at 100-104 or cooler at least 2x day
- Ice pack
- Analgesia (acetaminophen, NSAID, opioid)
- Topica Anesthetics
How many calories should the LACTATING PP client consume over the recommended pregnancy calories?
2700 kcal/day
This is 450-500 kcal more than the non-lactating moms
Education to help prevent mastitis:
- wash hands before breast feeding
- keep breasts clean, change breast pads often
- let nipples air dry
- teach proper infant positioning/latching on techniques; release suction before removing baby from breast
- completely empty breasts at each feeding to prevent milk stasis = medium for bacterial growth
What are major indicators of UTI in a prenatal or PP client?
frequency with overflow
incomplete emptying
dysuria
urgency…esp urgency but with incomplete emptying
What causes frequent urination/diaphoresis PP?
Fluid shift as uteroplacental circulation is eliminated –> increasing circulating volume (ABOUT 3RD DAY)
Mobilization of fluid…eliminated by diuresis & diaphoresis
Output may > 3000 mL/day
When would rubella vaccination be administered to non-immune PP client?
after birth & then 1 month later
What is isoimmunity?
Mom’s Rh (-) blood builds antibodies to baby’s Rh(+) blood. Next baby, if Rh (+) can be negatively effected
Behaviors of the “TAKING IN” phase:
- 1st 1-2 days PP
- Introspective and preoccupied with own needs rather than new baby
- Passive/dependent behavior
- Excited & talkative
- Touches & explores infant
- Needs to verbalize L&D experience
Behaviors of the “TAKING HOLD” phase:
- 2nd-3rd day PP, lasts 10 days to several weeks
- Moves toward more independent behavior
- Desires to take charge
- More receptive to teaching –> learning readiness
