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N3 Provider EXAM 2 > Well Postpartum > Flashcards

Well Postpartum Flashcards

(49 cards)

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1
Q

*BUBBLE HE

A 
Breast
Uterus
Bladder
Bowel
Lochia
Episiotomy

Homan’s sign
Emotional

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2
Q

*What is being asses breast wise?

A

Size, symmetry, trauma/bruising, aerolar, nipple, dimpling

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3
Q

*What do dimpling and/or thickening of the breast indicate?

A

Tumor

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4
Q

*Trauma of the breast may look like and indicate what?

A

look: blisters, redness, bruising
indicate: the baby is not positioned correctly while being fed

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5
Q

*What is abnormal for breast tenderness and what ma it indicate?

A

Tenderness—

Lumpy– milk ma not be evenly distributed

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6
Q

*Potential issue for a flat or inverted nipple?

A

Issues with attachment and breast feeding.

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7
Q

*What may be caused by oxytocin release other than milk production?

A

Stimulation of the uterus to contract

  • helps return it to normal size
  • may cause the mother discomfort
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8
Q

*What are we assessing regarding the uterus?

A

Is it shrinking back to normal

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9
Q

*What three things help/lead to the uterus shrinking?

A
  • Contraction of the muscle fibers
  • Converting of cells into simple compounds
  • Epithelial regeneration
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10
Q

*By what day at the latest should the uterus no longer be palpable?

A

14

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11
Q

*What is the size/weight of the uterus right after birth?

A

large grapefruit

about 2.2lbs

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12
Q

*What is a soft (boggy) uterus at an increased risk for?

A

Bleeding

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13
Q

*What can be done to firm up a boggy uterus

A
  • Massage until it firms up
  • Take oxytocin
  • DNC (not first option)
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14
Q

*What are we concerned about regarding the bowels postpardum?

A

Constipation

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15
Q

*Why may constipation occur postpartum

A
  • epidural
  • reduced muscle and bowel tone from pregnancy
  • decreased fluid and food intake during labor
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16
Q

*When should mom have her first stool after giving birth/

A

2-3 days post birth

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17
Q

*What leads to increased potential for urinary retention post birth?

A
  • increased bladder capacity due to no more pressure from baby
  • decrease in the sensitivity to fluid pressure
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18
Q

*What can be caused by a distended bladder?

A
  • Displacement of the uterus. Which can cause an increase in bleeding.
  • infection/UTI
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19
Q

*Signs of a distended bladder

A

-Fundus is displaces off mid-line and baseline
-Excessive lochia
-Bladder discomfort
Void <150ml

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20
Q

*What is asses in regards to lochia (3)?

Study These Flashcards
A

Amount
Type
Odor

21
Q

*What does a foul odor of the lochia indicate?

Study These Flashcards
A

Suggest an endometrial infection

22
Q
  • Lochia rubra
  • appearance
  • when is it seen
Study These Flashcards
A

Red/Brown color

1-3 days post birth

23
Q
  • Lochia serosa
  • appearance
  • when is it seen
Study These Flashcards
A

Pink, possibly with a brown tinge

4-10 days post birth

24
Q
  • Lochia alba
  • appearance
  • when is it seen
Study These Flashcards
A

Light cream/yellow color

day 11

25
*What makes us worried about the amount of lochia/
When the pad is heavily saturated in 15min or, according to simulation, the mom is changing her pad every hour
26
Risk factors for postpardum hemorrage
- grand multiparity (uterus is like a baloon) - Big baby/overdistention of uterus - Retained placenta - Too fat or too slow of labor - Placenta previa - Placenta abrupto - Medications (tocolytics, oxytocin) - C-section - Coagulation defects
27
Placenta previa
Part of the placenta is over the cervix
28
Placenta abrupto
Placenta breaks from the uterine wall before the baby is born
29
*What is an episiotomy?
When a cut is made to increase the vaginal opening.
30
*Why is an episiotomy done?
Baby is coming too fast and before the mom has been completely dilated
31
*Is a medio-lateral or mid-line episiotomy preferred? Why?
Medio-lateral | -less risk to cut tearing to the anus, which would increase the risk for infection
32
How long does it take the vagina to return to its normal size and contour?
6-10 weeks
33
What does REEDA stand for and what is it assesing
``` Assessing episiotomy healing Redness Edema Ecchymosis Discharge, drainage Approximation ```
34
*What is the purpose of homan's sign
To asses for DVT
35
*When should homan's sign not be done?
When signs of a DVT are present - redness - swelling - warm to touch
36
*How to preform homan's sign and what indicates a DVT
supine, leg bent at 90 (like trying to make the side and top of a box), flex the foot If there is a pain in the back of the leg that indicate a DVT
37
Risk associated with the separation of the rectus muscles postpardum
- hernia - Muscle aches - Muscle fatigue (constipation)
38
What position should a women maintain postpartum and why?
Semi-fowlers | -to promote lochia drainage
39
Considerations regarding menstruation/ovulation postpardum
- ovulation may occur before first period postpartum | - breastfeeding may delay ovulation and menstruation
40
Why may breastfeeding mothers experiance vaginal dryness?
Decreased estrogen
41
Risk factors for postpartum infection
- Operative birth procedures - multiple cervical examinations - prolonged labor - manual extraction of the placenta - diabetes - catheterization
42
Symptoms of postpartum depression
- change in sleep pattern - anger/rage - weeping/sadness - difficulty concentration - changes in appetite - anxiety
43
What is bonding?
initial attraction felt by parents towards the infants. Unidirectional from parent to child
44
What is attachment?
Process by which an enduring bond between a parent and child is developed. Starts in pregnancy and extends many months after birth
45
Name some reciprocal attachment behaviors. (6)
- Eye contact - Attempts of infant to "track" parents face or voice - Grasping/holding parents's finger - Successful breastfeeding - Being comforted by parent's voice - Movements in response to parents voice
46
what are the 3 puerperal phases
Taking-in Taking-hold Letting-go
47
What does the taking-in phase entail and when does it occur?
birth-1/1.5 days postpartum - mom is focused on herself and her needs - has to process and deal with not being prgnante anymore.~~ seen throug talking about the birth details - Is happy to let others take care of her child
48
What does the taking-hold phase entail and when does it occur?
Lasts a few days after the taking-in phase - shift of focus to baby and its behaviors - most teachable time - time of anxiety for new moms - mom may compare herself and her skill to the nurse - mom is independent in care - there is concern about what is happening in her own body
49
What does the letting-go phase entail and when does it occur?
not told when - relinquishing life without baby - can't do things you used to - new things you have to do

N3 Provider EXAM 2 (7 decks)

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