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Exam 2 NUR113
Postpartum Care
| Question | Answer |
|---|---|
| What changes occur in the reproductive system after birth? | -Involution (uterus goes back to normal, takes 5-6wks) -Lochia: uterine discharge -Cervix shape changes permanently -Vaginal/perineal changes: swollen/bruised -ovulation/period returns in 6-10wk if not breastfeeding |
| What are the types of Lochia? What do they look like? | Rubra - dark red, seen in hospital Serosa - pinkish Alba - whiteish |
| Does lochia have an odor? | yes, musty/stale odor that is not offensive |
| True or false: breastfeeding can be used as birth control. | False, ovulation return after about 3 months |
| What abdominal changes occur after birth? | Striae (stretch marks), separation of abdominal muscles is abnormal |
| What milk/lactation changes occur during pregnancy? | -Lactogenesis triggered by decreased progesterone levels -milk has 3 stages: Colostrum, transitional, mature -engorgement is normal d/t milk -Mastitis is a clogged duct complication |
| What GI changes occur after birth? | bowels sluggish, no restricted intake after C-section; mother may be hungry/thirsty |
| What urinary system changes occur after birth? | Increased bladder capacity, swelling, bruising -prolonged bladder distention can cause atony (doesnt contract and cannot pee) |
| Why would the fundus be palpated to the right instead of midline? | The bladder is full; patient needs to void because it is preventing the fundus from contracting |
| What temperature range is acceptable following birth? | 98-100.4; fever may precede milk coming in |
| What will lab values look like after birth? | Leukocytosis, Hgb down, Hct down, platelets down |
| What cardiovascular changes occur after birth? | Cardiac output stabilizes Diuresis first 2-5 days (no diuresis = pulmonary edema) |
| What neurological changes occur after birth? | HA, Seizures may occur in 24hr post delivery |
| What psychological adaptations occur after birth? | Readjustment and adaptations for mom and family; mom must adjust to changes in body and family life |
| How does nutrition change following birth? | Initial weight loss of 10-12 lbs; nutritional needs change and depend on if breastfeeding Also depends on weight gained and ideal weight |
| What information is important for breastfeeding mothers? | -Necessary intake is increased as inadequate can reduce milk supply -Keep taking prenatal vitamin -Stay hydrated -Monitor baby reaction to milk/foods you eat |
| What conditions cause alteration in postpartum care? | -Preeclampsia: need more bed rest=high DVT risk -Diabetes: need insulin regulation and have decreased healing -Cardiac disease: maternal exhaustion -Csection: increased healing needs, pain, risk of infection -Overdistention of uterus = hemorrhage DVT |
| What are signs of positive maternal attatchment? | Inclined to nurture infant by feeding Acting consistently Sensitive to newborn's needs States she is pleased with baby's appearance, gender Cultural factors |
| What are 2 normal alterations in the physical assessment? | Hypotension d/t blood loss Paresthesia d/t epidural/spinal |
| Where should the fundus be and how should it feel? | Midline and firm May be tender when palpated but constant tenderness may indicate infection |
| What do large amounts of lochia and clots indicate? | Hemorrhage |
| What does foul smelling lochia indicate? | Infection |
| True or false: CVA tenderness is an expected finding in a postpartum patient. | False, this indicates kidney infection/UTI |
| What does pain in the calf indicate? | DVT |
| After birth, how soon should the mom urinate? | Within 4-6hrs |
| After birth, how soon should the mom have a bowel movement? | by day 2 or 3 |
| What behaviors indicate an issue with infant attachment? | Continued expressions of disappointment Refusal to care for infant Derogatory comments Lack of bonding behaviors |
| How can the nurse promote patient teaching? | Assess learning needs Teaching during postpartum continuous Consider physical, psychosocial needs Consider partner's schedule Use variety of instructional methods Teach pertinent content Make referrals as necessary |
| How can the nurse promote well-being and comfort? | Monitor uterine status, vital signs, elimination Ask woman about preferences Interventions include -Ice to episiotomy -Sitz bath -Topical anesthetics -Encourage fluid intake -Common postpartum medications |
| How can the nurse help enhance attachment? | Darken birthing room, encourage parents to do what is comfortable, ensure contact during first hour |
| How can nurses promote well-being for a post C-section patient? | Ambulate day after surgery Monitor: chance of pulmonary infection increased Encourage cough, deep breathing Leg exercises every 2 hours Most complications due to prolonged bed rest Monitor and manage pain Assess bowel sounds Monitor surgical site |
| How can the nurse provide postpartum care to an adolescent? | Contraception counseling Opportunities for teaching Positive feedback Education about newborn, maternal responses Group classes to include infant care skills |
Created by:
failingstudent88
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