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parent/child: ch 18
| Question | Answer |
|---|---|
| Postpartum period | The interval between birth & the return of the reproductive organs to their normal nonpregnant state |
| Involution | The return of the uterus to a nonpregnant state after birth; process begins immediately after the expulsion of the placenta with contraction of the uterine muscle |
| Autolysis | The self-destruction of excess hypertrophied tissue |
| Subinvolution | The failure of the uterus to return to a nonpregnant state due to ineffective uterine contractions; the most common causes are retained placental fragments & infection |
| Where should the uterus be approximately 12 hours after giving birth? | The fundus can rise to approximately 1 cm above the umbilicus |
| How do we assess for involution after birth? | Firm palpation |
| Hemostasis & oxytocin | Hemostasis is primarily achieved by contractions; oxytocin strengthens & coordinates these contractions = reducing the risk for postpartum hemorrhage |
| Afterpains | Periodic relaxation & vigorous contractions are more common in subsequent pregnancies & can cause uncomfortable cramping; in primiparous women, the uterine tone is usually still good |
| Lochia | Postbirth discharge; the characteristics correlate with involution & changes in the endometrium; the amount of lochia after a c-section is usually less because the surgeon suctions the blood & fluids from the uterus or wipes the lining before closing |
| Characteristics of lochia | Rubra: bright red; 1-3 days; from placental site Serosa: pinkish-brown; 4-10 days; wound exudate & RBCs Alba: whitish-yellow; 10-14, but can last 3-6 weeks; WBCs |
| Lochial vs. Nonlochial bleeding | Lochial: trickles; flow is greater as the uterus contracts; a gush can appear as the uterus is massaged or as mom stands; dark red Nonlochial: spurts from vagina & the uterus is firmly contracted, there can be tears; bright red |
| Cervix | Never regains prepregnancy appearance; it no longer has a circular shape, but instead appears as a jagged slit often described as a “fish mouth” |
| Ovaries | Because of the uncertainty about the return of ovulation & menstruation, discussion of contraceptive options early in the postpartum period is necessary |
| Vagina & perineum | Localized dryness & coital discomfort can persist until ovarian function returns & menstruation resumes -> use of water-soluble lubricant is recommended at this time; hemorrhoids are common |
| Kegel exercises | Help strengthen perineal muscles & encourage healing |
| Colostrum | Early milk, a clear yellow fluid |
| Lactogenesis II | Colostrum transitions to mature milk by about 72 - 96 hours after birth; often referred to as the “milk coming in” |
| Engorgement | Caused by an increase in blood & lymphatic fluid as milk production increases; hard & uncomfortable & mild temperature elevation can occur; the fullness of the nipple can make it difficult to breastfeed |
| Breastfeeding teaching | - Latching - Positioning - Fluids - Foods - Feeding - Signs of infection |
| Non-breastfeeding teaching | How to reduce pain: cold compresses, ice, & cabbage leaves |
| Blood volume | Avg blood loss for vaginal birth: 300 - 500 mL Avg blood loss for c-section: 500 - 1000 mL |
| Postpartal diuresis | Caused by decreased estrogen levels, removal of increased venous pressure in the lower extremities, & loss of remaining pregnancy-induced increase in blood volume aids the body in ridding itself of excess fluid |
Created by:
tatianalopez03
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