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68WM6 Postpartum
Postpartum Nursing and Meds
| Question | Answer |
|---|---|
| what are the 3 processes of involution | muscle contraction, catabolism, epithelial regeneration |
| how much should the fundus descend per day postpartum | 1 cm |
| fundus should be back in the pelvic cavity by what day postpartum? | day 10 |
| theses mothers are more likely to experience intense afterpains | multiparas who breastfeed |
| red discharge postpartum | lochia rubra |
| pink/brown discharge postpartum | lochia serosa |
| white/cream/yellow discharge postpartum | lochia alba |
| why is urinary retention commonly a problem in postpartum women | decreased urge to void and pain from birth trauma |
| breastfeeding can delay the onset of these two natural processes postpartum | ovulation and menstration |
| normal WBC level in a postpartum woman | 14000-16000 |
| how long does it take for menses to resume in nonbreastfeeding women? | 7-9 weeks |
| how long does it take for menses to resume in breastfeeding women? | 12-18 months |
| how much weight does a woman usually lose during childbirth? | 10-12 lbs |
| how much weight does a woman usually lose during involution of the uterus | 5-8 lbs |
| are tachy or bradydysrhythmias common pospartum? | bradydysrhythmias due to increased intravascular volume |
| this technique can be used to stimulate uterine contractions | fundal massage |
| priority assessments following C section | Respiratory, GI, and wound assessments |
| to prevent pneumonia following a C section what should be done | turning coughing, deep breathing and early ambulation |
| to prevent lactation in a woman who does not intend to breastfeed what interventions are approbriate | snug bra, avoid nipple stimulation |
| these nursing interventions can be used to prevent abdominal distension | pelvic lifts, no carbonated beverages, avoiding use of straws, and ambulation |
| initial attraction between parents and child | bonding |
| development of enduring and loving relationship between parents and child | attachment |
| normal progression of maternall touch | fingertipping->enfolding->consoling |
| this phase focuses on the mother's own needs, the mother is passive and dependent on others for instruction in care of child and recounts birth experience | taking in phase |
| in this phase the mother becomes focused on the needs of the infant and becomes independent and is ready to learn | taking hold |
| in this phase the parents relinquish their previous lifestyle to embrace new role as parents | letting go |
| in this stage parents prepare for birth | anticipitory |
| this stage begins at birth and is when parents get acquaited with child | formal |
| in this stage parents respond to cues from infant rather than nursing staff regarding care | informal |
| in this stage parents feel comfortable with their new role as parents | personal |
| some potential family impacts of childbirth | postpartum blues, father feeling left out, jealousy of siblings |
| predisposing factors for postpartum hemorrhage | precipitous labor, oxytocin use, vaccum/forceps use, large baby, uterine overdistension |
| how is uterine atony treated | massage, voiding, oxytocin |
| signs and symptoms of subinvolution | prolonged lochial discharge, excessive or irregular bleeding, pelvic/back pain, fatigue, malaise |
| drug of choice for DVT during pregnancy | heparin |
| things to monitor for in a patient on anticoagulant therapy | bruising, petechiae, bleeding |
| why is vaginal infection risk higher postpartum | altered vaginal pH, lochia, necrosis of endometrium |
| to prevent postpartum UTI, these interventions are appropriate | increased oral fluid intake, void every 2-3 hours, good hygeine |
| the different types of postpartum psychological conditions | blues, depression, psychosis |
| these factors stimulate the infants respiratory center during birth and result in the first breath | hypoxia, decreased pH, increased CO2, cool air |
| reduces the surface tension in the alveoli and allows them to stay partially open | surfactant |
| what happens to fetal lung fluid during and after birth | pushed into the interstitial spaces and absorbed into circulation |
| decresed tension in pulmonary vessels and increased tension of perhipeheral vessels results in functional closure of these two shunts shortla after birth | ductus arteriosus and foramen ovale |
| this shunt becomes inactive when the umbilical cord is clamped | ductus venosus |
| how do newborns generate heat? | increased activity, brown fat (nonshivering thermogenesis) |
| greenish black first stools | meconium |
| seedy mustard colored stools | milk stools |
| yellow brown stools less frequent than milk stools | formula stools |
| what causes pathologic jaundice? | excessive hemolysis following birth |
| this jaundice may result from enzymes in breast milk | breast milk jaundice |
| this immune globulin crosses the placenta easily | IgG |
| this immune globulin is present in breastmilk | IgA |
| this immune globulin is produced by the infant | IgM |
| deep sleep, little response to stimuli | quiet sleep |
| sleep in which the infant is moving and respirations become more irregular | active sleep |
| stage between infant sleeping and waking | drowsy |
| in this stage the infant is awake and interested in stimuli | quiet alert |
| in this stage the infant becomes fussy but is not actively crying | active alert |
| this stage is initiated when needs expressed during the active alert phase are not met and the infant becomes difficult to console | crying |
| initial assessments on newborns focus on what? | cardiorespiratory status, thermoregulation, physical anomalies |
| what does a CV assessment include on an infant | airway, color, heart sounds, pulses, and blood pressure |
| what temperature location is preferred for infants? | axillary |
| localized swelling of the head that crosses the suture lines | caput succedaneum |
| bleeding between periosteum and bone that does NOT cross the suture lines | cephalohematoma |
| normal change of head shape occuring during birth | molding |
| s/s of infant hypoglycemia | jitteriness, poor muscle tone, respiratory distress, high pitched cry, diaphoresis, decreased temperature, weak suck, lethargy, irritability seizures, coma, DEATH |
| how soon after birth should an infant pass the first stool? | 12-48 hours |
| how soon after birth should an infant void? | 12-24 hours |
| after first two days, how many wet diapers per day indicated adequate hydration and good kidney function | 6 |
| all newborns get these two medications prophylactically | vitamin K and erythromycin opthalmic |
| rich in protein, vitamins and minerals and immune globulins, precedes milk | colostrum |
| less protein and immunoglobins than colostrum and preceds mathur milk. rich in lactose, fat, and calories | transitional milk |
| less rich milk that appears after transitional milk | mature milk |
| why is breast milk superior to formula | easier to digest, helps to establish immunity and intestinal flora |
| triggers letdown reflex and the release of oxytocin and prolactin | suckling |
| how often and how much breastfeeding is appropriate for an infant | every 2-3 hours for 10-15 minutes per breast |
| how do preterm infants differ from term infants in their physical appearance? | frail, weak, thin, limp extremeties, poor muscle tone, and red skin |
| what is the cause of respiratory distress in preterm infants? | lack of surfactant, undeveloped cough reflex, small air passages, weak muscles |
| why are preterm infants more prone to water loss? | thin skin, immature kidneys |
| how to postterm infants differ from term in their physical appearance | skin folds, peeling, minimal vernix and lanugo, meconium staining, worried expression |
| what are postmature infants at risk for? | polycythemia, meconium aspiration, hypoglycemia, poor temperature regulation |
| in this growth restriction, the whole body is small | symmetric |
| in this growth restriction, the body is small and frail making the head appear disproportionately large | assymmetric |
| what are Large for gestational age infants at increased risk for? | fractures, nerve damage, cephalohematoma, hypoglycemia, polycythemia |
| narrowing near ductus arteriosus | coarction of aorta |
| narrowing of aortic valve | aortic stenosis |
| narrowing of pulmonic valve | pulmonic stenosis |
| ventricular septal defect, pulmonic stenosis, overriding aorta, and right ventricular hypertrophy | tetralogy of fallot |
| tricuspid valve fails to develop resulting in no communication betwee the right atrium and ventricle | tricuspid atresia |
| no communication between systemic and pulmonary circulation unless the foramen ovale remains patent or if there is a cooexisting atrial or ventricular septal defect | transposition of great vessels |
| pulmonary and systemic circulation mixed into one commen vessel that is connected to both ventricles, usually occurs along with a ventricular septal defect | truncus arteriosus |
| underdevelopment of the left side of heart with right ventricle doing work of both ventricles, usually occurs with atrial septal defect or a patent foramen ovale | hypoplastic left heart syndrome |
| imbalance of production and absorption of CSF caused by either impaired absorption or ventricular obstruction | hydrocephalus |
| developmental dysplasia characterized by shallow, oblique acetabular roof without displacement of proximal femur | acetabular dysplsia |
| developmental dysplasia in which the hip is incompletely dislocated with flattening of the socket | subluxation |
| developmental dysplasia in which the hip is dislocated wtih an elongated and taut ligamentum tres | dislocation |
| used to maintain hip in safe position witht he proximal femur centered in the acetabulum | pavlik harness |
| congenital clubfoot; inversion | talipes varus |
| congenital clubfoot, eversion | talipes valgus |
| congenital clubfoot, plantar flexion | talipes equinus |
| congenital clubfoot, dorsiflexion | talipes calcaneus |
| most common form of congenital clubfoot | talipes equanovarus (inverted and plantar flexion combined) |
| term for malformation of spinal canal and/or cord | myelodysplasia |
| incomplete closing of the spinal column | spina bifida |
| spina bifida that is not visible externally | spina bifida occulta |
| spina bifida with an external saclike protrusion | spina bifida cystica |
| spina bifida cystica that contains only meninges and CSF | meningocele |
| spina bifida cystic that contains nerves in addition to meninges and CSF | myelomeningocele |
| spina bifida greatly increases the risk of having an allergy to this substance | latex |
| skull defect through which tissues protrude | cranioischesis |
| brain totally exposed or extruded | exencephally |
| brain degenerates to spingiform mass due to exencephaly | anencephaly |
| herniation of brain and meninges | encephalocele |
| extra copy of one chromosome | trisomy |
| single chromosome missing | monosomy |
| body canno process phenylalanine consumed in food | phenylketonuria |
| treatment for phenylketonuria | diet restriction |
| what does IDM stand for | infant of diabetic mother |
| postpartum medication for rH negative mothers | Rhogam |
| after receiving this vaccination one should avoid pregnancy for a minimum of 28 days | Rubella |
| medications given to promote cervical ripening | prostaglandins, misoprostol (cytotec), and magnesium sulfate |
| medication given to stimulate uterine contraction | oxytocin |
| for cheldren of Hepatitis B positive mothers | Hep B vaccine, Hep B Immunoglobulin |
| trisomy 21 | down's syndrome |
| monosomy x | turner's syndrome |
Created by:
ewoff85
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