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Postpartum
| Question | Answer |
|---|---|
| puerperium | - also called postpartum- 1st 6 weeks after birth- per. from end of childbirth until end of involution |
| REEDA | - used to assess wound healing- Redness- Ecchymosis- Edema- Discharge- Approximation |
| lochia | - vaginal discharge during puerperium- consists of blood, tissue, & mucous |
| Which three processes are involved in involution of the uterus? | 1. contraction of muscle fibers; 2. catabolism; 3. regeneration of uteirne epithelium |
| How is the fundus expected to descend after childbirth? | descend 1 cm (1 fingerbreadth) per dayafterbirth - b/t symphysis pubis & umbilicusday 10 - should be in the pelvic cavity; no longer palpable |
| Which mothers are most likely to experience afterpains?How are they treated? | 1. multipara - repeated stretching, loss of muscle tone; 2. breastfeeding - oxytocin causes milk-ejection reflex; 3. analgesics - won't reach milk for 30 min/more; - lying in prone position w/pillow or blanket under abd |
| What are the differences among lochia in appearance and expected duration? | rubra - dark red (1st 3 days) 1. serosa - pink/brown (4-10 days); 3. alba - white/cream/light yellow (11-21 days/3-6 wks); |
| What are some teaching of perineal discomfort self-care measures? | 1.sitz bath; 2.topical anesthetics; 3.cooling astringent pads; 4.analgesics; p.397 |
| Why is a postpartum woman at risk for urinary retention?Which complications may result? | 1.decreased sensitivity to full bladder; 2.trauma of childbirth; 3.anesthesia;1.UTI - urinary stasis allows bacteria to multiply; 2.postpartum hemorrhage - full bladder; 3.displaces uterus causing uterine muscles to relax; |
| Why does hyperpigmentation decrease after childbirth? | decreases in:1.estrogen;2.progesterone;3.melanocyte-stimulating hormone; |
| How does breastfeeding affect the resumption of ovulation & menstruation? | delays the return of ovulation & menstruation |
| Should the nurse be concerned if a woman who delivered a baby yesterday has a WBC count of 16,000? Why or why not? | WBC count is normally elevated to an avg of 14,000 to 16,000 mm3 after childbirth.alert of s/s of infection if: fever, rising WBC count |
| When should a woman who is formula feeding her infant expect her menses to resume?The woman who is breastfeeding? | formula feeding - 7 to 9 wks breastfeeding - 12 to 18 months |
| How much weight will the woman lose during childbirth?How much can she expect to lose by 6 weeks after childbirth? | approx. 10-12 lbs during childbirth; 5-8 lbs during involution |
| What are the two most common complications during puerperium? | hemorrhage & infection |
| What additional assessments are necessary when tachycardia is noted? Why? | 1. temp; 2.BP; 3.loc & firmness of uterus; 4.amt of lochia; 5.est blood loss at delivery; 6.Hgb/Hct; - excitement, fatigue, dehydration, infection, pain, or hypovolemia |
| What causes orthostatic hypotension? What are the typical onset & s/s? | drop in BP from supine to sitting/standing quickly (engorement of visceral blood vessels from decreased intraabdominal pressure after delivery.;- s/s: 15-20mmHg drop in BP, dizziness, lightheadedness, or fatigue |
| When is uterine massage necessary? How is the uterus supported during massage? | - when uterus is not firmly contracted; - nondominant hand above symphysis pubis to anchor and support the uterus during massage |
| What does excessive bleeding suggest when the uterus is firmly contracted? | a cervical/vaginal laceration |
| What add'l assessments are necessary for the postcesarean mother? | 1.freq resp assess; 2.ausculatation of breath sounds & bowel sounds; 3.inspection of surgical dressing & wound |
Created by:
boxer246