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OB Exam 1 > Week 1 (Postpartum) > Flashcards

Week 1 (Postpartum) Flashcards

(61 cards)

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1
Q

Gravida

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A

Total number of confirmed pregnancies

  • regardless of whether these pregnancies have resulted in birth, miscarraige, abortion, or ectopic pregnancy
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2
Q

Para

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A

Number of pregnancies in which the fetus or fetuses have reached 20 weeks gestation

  • Para is divided into 4 categories: term (T), preterm (P), abortion (A), living (L)

  • not the number of individual fetuses
  • twins are counted as 1 pregnancy
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3
Q

Term (T or F)

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A

Number of pregnancies that resulted in full term birth

  • 37 + weeks gestation
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4
Q

Preterm Births (P)

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A

Number of pregnancies that resulted in preterm birth

  • 20 - 36 weeks gestation
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5
Q

Abortion (A)

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A

Number of pregnancies that ended BEFORE 20 weeks gestation

  • either due tomiscarraige or elective abortion
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6
Q

Living (L)

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A

Number of currently living children the woman has

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7
Q

EDC

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A

Estimated Date of Confinement

  • DUE DATE
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8
Q

Naegele’s Rule

A

Subtracts 3 months from last menstration & add 7 days to calculate the estimated due date (EDD)

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9
Q

Primigravida

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A

First pregnancy

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10
Q

Multigravida

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A

2 or more pregnancies

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11
Q

Precipitous

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A

Quick birth

  • Onset to birth is LESS THAN 3 HOURS (from time water breaks to birth of baby)
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12
Q

SVD

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A

Spontaneous vaginal delivery

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13
Q

LDPR

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A

Labor, delivery, postpartum, recovery

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14
Q

C/S

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A

cesarean section

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15
Q

What is the postpartum period?

A

From delivery to the placenta to the return of the reproductive system to the non-pregnant state

  • usually 6-8 weeks
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16
Q

Involution

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A

When the uterus returns to pre-birth state

  • within 12 hours palpate the fundus 1 cm above the umbilicus; make sure the bladder is empty
  • by 2 weeks, the fundus should not be palpable
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17
Q

Subinvolution

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A

Uterus fails to return to normal size

  • caused by retained placenta fragments & infection
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18
Q

Afterpains

A

Painful, intermittent contractions of the uterus after delivery

  • most often occur in multiparas from loss of uterine tone & large babies, and are more painful during breastfeeding because it stimulates oxytocin; will relieve in 5-7 days
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19
Q

Placental Site

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A

Separates from the uterus within 15-30 minutes
* or manual removal (painful)

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20
Q

What can leaving the placenta is left inside & not removing it lead to?

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A

Risk of Hemorrhage

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21
Q

Lochia

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A

Combination of blood, mucus, & tissue discharged from the uterine lining

  • types: rubra, serosa, alba
  • evaluate for clots for possible piece of placenta!
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22
Q

Lochia rubra

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A

Reddish or red-brown vaginal discharge that occurs IMMEDIATELY after childbirth

  • mostly composed of blood with clots (grape size clots)

  • Rubra = Ruby Red
  • 1 - 3 days
  • May have small clots
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23
Q

Lochia serosa

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A

Pink, serous, & blood-tinged vaginal discharge that lasts 3-4 days after delivery

  • Pinkish / brown
  • little to no clotting
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24
Q

Lochia alba

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A

White, cream-colored, or yellow vaginal discharge that occurs 10 days to 6+ weeks after delivery; contains WBCs

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25
**Excessive blood loss**
Saturation of pad in 15 minutes
26
**QBL** | **KNOW THIS!!!!**
**Quantitative Blood Loss** * 1 g = 1 mL **NORMAL:** * vaginal < 500 mL * C-section = 1,000 mL
27
**What might presence of free-flowing bright red blood indicate?** | **KNOW THIS!!!!**
**cervical laceration**
28
**A vagina should return to normal size within how many weeks of delivery?** | **KNOW THIS!!!!**
**6 - 8 weeks**
29
**A nurse is assessing the lochia discharge on a 1 day postpartum woman. THe nurse notes that the lochia is red & has a fleshy odor. The nurse determines that this assessment finding indicates what?** **a.)** A normal finding **b.)** The presenc eof infection **c.)** The need for increasing oral fluids **d.)** The need for increasing ambulation
**a.) A normal finding**
30
**Hematoma**
Accumulation of blood in the pelvic tissue **S/S:** * **unrelenting pain** * **pressure in rectum** * **↑ HR** * **↑ RR** * **↓ BP**
31
**Episiotomy**
**Incision into the body of the perineum during 2nd stage of labor** (incision made into the vulva) * Have to **assess while woman is lying on her side** * heals in 2-3 weeks after delivvery * kegels
32
**1st Degree Laceration**
Laceration through the skin to the superficial muscles
33
**2nd Degree Laceration**
Laceration extends through muscles of the perineal body
34
**3rd Degree Laceration**
Laceration through the anal sphincter
35
**4th Degree Laceration**
Laceration involves the anterior rectal wall
36
**Urethral laceration**
laceration upward from the vagina towards the urethra
37
**Postpartum voiding**
**Normal = 3,000 mL/day** * Q2 from aldosterone diuresis * painful * delayed BM from low intake * decreased muscle tone, pain, analgesia * UTIs are comon
38
**Colostrum** | **KNOW THIS!!!!**
**Milk that delivers essential nutrients & antibodies;** produced in the first **2-3 days PP**
39
**Lactogenesis**
**Production of milk**
40
**Postpartum Complications**
* anemia * gestational diabetes * clotting * orthostatic hypotension * hypertension * swelling / edema
41
**What type of state is pregnancy?** | **KNOW THIS!!!!**
**Hypercoaguable** state
42
**Pregnancy is a ------ state.** | **KNOW THIS!!!!**
**hypercoaguable**
43
**----- is a common complaint in postpartum** because of hormonal shifts. Can also be from pathological etiology like spinal or PP **onset of preeclampsia (have they delivered in the past year?** * Increased risk of stroke / seizures * **TX: magnesium sulfate** | **KNOW THIS!!!!**
**headache**
44
**Preeclampsia** | **KNOW THIS!!!!**
A complication of pregnancy characterized by **hypertension, edema, & proteinuria**
45
**Uterine atony** | **KNOW THIS!!!!**
**Lack of normal muscle tone in the uterus** * tx: hemabate, methergine ## Footnote * *most frequent cause of excessive bleeding PP (from placental fragments*
46
**What is the most frequent cause of excessive postpartum bleeding?** | **KNOW THIS!!!!**
**Uterine Atony** (lack of normal muscle tone in the uterus)
47
**Edinburgh Postnatal Depression Screening**
* Screening tool * Self-report assessment * 10 statements
48
**BUBBLE-HE** | **KNOW THIS!!!!**
* **B**reasts * **U**terus * **B**owels * **B**ladder * **L**ochia * **E**pisiotomy * **H**emorrhoids * **E**motional status
49
**Breast (in BUBBLE-HE)**
* condition * color * pain * redness * nipple condition (normal, inverted, intact, bruised, cracked) * soft, firm, full, engorged * observe latch if breast feeding
50
**Uterus (in BUBBLE-HE)** | **KNOW THE BOLD**
* 2 handed fundal check * **Normal: firm fundus, midline, should be at or below the umbilicus** * *Interventions:* teach to monitor uterus for firmness; advise frequent urinating; ibuprofen for afterbirth pains * **boggy = bad** * **void Q2H**
51
**Bowel (in BUBBLE-HE)**
**Normal:** soft & non-distended, normal bowel sounds in all quadrants, passing flatus, bowel movmeents with no difficulties * check for hemorrhoids, episiotomies, lacerations, lochia
52
**Emotions (in BUBBLE-HE)**
Assess emotions, mood, attachment to infant; cultural aspects ## Footnote * cambodian women = no showers after birth * japanese = avoid washing hair * chinese = use ginger
53
**REEDA** | **KNOW THIS!!!!**
* **R**edness * **E**dema * **E**cchymosis * **D**rainage * **A**pproximation | * wound evaluations
54
**Peri Care**
* peri bottles * ice packs / frozen pads * analgesics
55
**Maternal adaptation**
**1.)** Taking in or dependent phase **2.)** Taking hold **3.)** Letting go or independent phase
56
**Maternal Adaptation: Dependent Phase**
* first 24 hours * vulnerable & needy * divert energy to the infant to extent that her **basic needs** are met * reliving birth **details** * may need assistance with self-care * inwardly focused/concerned about physical needs
57
**Taking Hold Phase (maternal adaptation)**
* Day 2/3 to several weeks * independent & dependent * preoccupied with care of the baby
58
**Independent Phase (maternal adaptation)**
* Letting go phase * focus on family as a unit * resumption of role (intimate partner, individual, etc.)
59
**Postpartum Blues**
* Right after delivery - labile & cry for no reason; mild depression * resolve in 2 weeks (day 10) * 40-80% prevalence **Teaching:** * rest * relaxation * self-care / time * plan a day out of the house * talk to partner * community resources
60
**Postpartum discharge**
**begins on admission** * look for complications - infection * no sexual activity for 6 weeks * medications * follow-up in 2/3 days for infant & 2 weeks for mom
61
**POST BIRTH warning signs**
**POST** * **P**ain in chest * **O**bstructed breathing or SOB * **S**eizures * **T**houghts of hurting yourself or the baby * **BIRTH** * **B**leeding**:** soaking through a pad in an hour or > golf ball clots * **R**ed or swollen leg that is painful or warm to touch * **T**emperature of 100.4 or greater * **H**eadache that does not get better

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