Term
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Definition
| Also known as post partum period, 6 weeks following childbirth |
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Term
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Definition
| Changes that the reproductive organs undergo particularly the uterus after birth to return to its prep regnant state |
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Term
| When does the uterus return to its Pre pregnancy state |
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Definition
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Term
| Where does the most dramatic change occur in a woman after birth? |
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Definition
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Term
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Definition
| changes that the reproductive organs, particularly the uterus, undergo after birth to return them to their pre pregnancy state |
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Term
| When does the uterus return to the pre pregnant state? |
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Definition
| 5 to 6 weeks after delivery |
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Term
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Definition
| Failure of the uterus to return to the prepregnant state |
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Term
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Definition
| uterine lining when not pregnant |
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Term
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Definition
| uterine lining during pregnancy, sheds when the placenta detaches |
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Term
| when does the placental site heal? |
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Definition
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Term
| How much does the uterine fundus descend? |
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Definition
| after birth at umbilicus, after 24 hours 1 cm a day |
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Term
| When should the funds be no longer palpable? |
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Definition
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Term
| What would you do if the mother's uterus is soft? |
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Definition
| Massage it support the lower segment to expel clots so it will remain contracted |
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Term
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Definition
| intermittent uterine contractions; occurs more often in multiparas or in women who uterus was overly distended |
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Term
| Why would breastfeeding mothers have more afterpains? |
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Definition
| infant suckling causes their posterior pituitary to release oxytocin, a hormone that contracts the uterus. Use analgesics |
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Term
| Why wouldn't aspirin be used postpartum? |
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Definition
| it interferes with clotting |
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Term
| What is lochia composed of? |
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Definition
| endometrial tissue, blood and lymph |
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Term
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Definition
| red because it is composed mostly of blood; lasts for about 3 days after birth |
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Term
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Definition
| pinking because of its blood mucus content; lasts from about the 3rd through the 10th day after birth |
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Term
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Definition
| mostly mucus and is clear and colorless or white; lasts from the 10th through the 21st day after birth |
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Term
| What are the characteristics of Lochia? |
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Definition
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Term
| When would lochia increase? |
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Definition
| when a mother goes to sit up, when the mother breastfeeds, exercise, |
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Term
| What would the absence of lochia mean? |
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Definition
| it is not normal and may be associated with blood clots retained within the uterus or with infection |
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Term
| How would you assess the fundus? |
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Definition
| firmness, location and position related to the midline; report if the fundus is not descending |
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Term
| When should the women or nurse report about lochia? |
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Definition
foul smelling lochia, with or without a fever
lochia rubra persists beyond the 3rd day
unusually heavy flow
when gone to lochia serosa or alba to lochia rubra |
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Term
| What medications are given to stimulate uterine contraction? |
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Definition
Oxytocin or Pitocin, usually given IV after birth.
Methergine, given IM or orally |
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Term
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Definition
| regains its muscle tone after birth but never closes as tightly before birth, edema a few weeks after labor. |
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Term
| If fundus is firm and there is blood trickling, this can mean that? |
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Definition
| there is a laceration of the cervix or vagina |
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Term
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Definition
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Term
| What happens to rugae during childbirth? |
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Definition
| undergoes a great deal of stretching |
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Term
| When does the rugae appear again? |
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Definition
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Term
| A woman's vagina never returns to its original size before pregnancy |
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Definition
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Term
| When is it safe to begin intercourse again after childbirth? |
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Definition
| When the bleeding has stopped and the episiotomy has healed |
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Term
| What teaching should be done about intercourse after childbirth? |
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Definition
| The vagina is not well lubricated in the first 6 weeks after childbirth and is longer in the breastfeeding mother. Use a water soluble gel like KY or a contraceptive gel |
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Term
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Definition
| incision to enlarge the vaginal opening; can be done intentionally or a perineal laceration may have occurred |
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Term
| When is the acronym REEDA used to assess? |
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Definition
| the perineum and a cesarean incision for healing |
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Term
| What does REEDA stand for? |
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Definition
| Redness, Edema, Ecchymosis, Discharge, Approximation |
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Term
| Nursing care for an episiotomy? |
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Definition
| ice for the first 12 to 24 hours to reduce edema and bruising and numb the perineal area |
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Term
| Nursing care for an episiotomy after 24 hours? |
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Definition
| sitz bath may be warm or cool, sitting in 4 to 5 inches of water in a bathtub, perineal care after voiding or a bm |
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Term
| How do you use a peribottle? |
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Definition
| fill it up with warm water, squirt water from front to back then pat dry and apply perineal pad. Pads should be removed the same way, front to back to prevent fecal contamination of the perineum and vagina |
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Term
| When is it safe to begin intercourse again after childbirth? |
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Definition
| When the bleeding has stopped and the episiotomy has healed |
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Term
| What teaching should be done about intercourse after childbirth? |
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Definition
| The vagina is not well lubricated in the first 6 weeks after childbirth and is longer in the breastfeeding mother. Use a water soluble gel like KY or a contraceptive gel |
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Term
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Definition
| incision to enlarge the vaginal opening; can be done intentionally or a perineal laceration may have occurred |
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Term
| When is the acronym REEDA used to assess? |
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Definition
| the perineum and a cesarean incision for healing |
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Term
| What does REEDA stand for? |
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Definition
| Redness, Edema, Ecchymosis, Discharge, Approximation |
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Term
| Nursing care for an episiotomy? |
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Definition
| ice for the first 12 to 24 hours to reduce edema and bruising and numb the perineal area |
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Term
| Nursing care for an episiotomy after 24 hours? |
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Definition
| sitz bath may be warm or cool, sitting in 4 to 5 inches of water in a bathtub, perineal care after voiding or a bm |
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Term
| How do you use a peribottle? |
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Definition
| fill it up with warm water, squirt water from front to back then pat dry and apply perineal pad. Pads should be removed the same way, front to back to prevent fecal contamination of the perineum and vagina |
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Term
| What medications are commonly prescribed to relieve perineal pain? |
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Definition
Hydrocortisone and pramoxine (Epifoam)
Benzocaine (Americaine or Dermoplast) |
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Term
| What is used to relieve hemmorrhoids? |
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Definition
| Witch hazel pads (Tucks) and sitz baths |
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Term
| What should you teach mother's to do to reduce pain when sitting? |
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Definition
| When sitting, tell mother to squeeze her buttocks together as she lowers herself to a sitting position and then relax her buttocks |
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Term
| When does the production of placental estrogen and progesterone stop? |
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Definition
| when the placenta is delivered, causing a rise in the production of follicle stimulating hormone and the return of ovulation and menstruation |
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Term
| When does menstruation return? |
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Definition
| about 6 to 8 weeks if the woman is not breastfeeding |
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Term
| When does ovulation return? |
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Definition
| in a breastfeeding mother it may be delayed but ovulation may occur at any time after birth, with or without menstrual bleeding, and pregnancy is possible |
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Term
| What can be used as birth control during early breast feeding? |
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Definition
| regular oral contraceptives cannot be used but a minipill can be used effectively |
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Term
| What are changes in the breast postpartum? |
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Definition
| for the first 2-3 days, the breasts are full but soft. By the 3rd day, the breasts become firm and lumpy as blood flow increases and milk production begins |
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Term
| What is engorgement of the breasts? |
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Definition
| Can occur in both nursing or non nursing moms, it is hard, erect, and very uncomfortable. baby might not easily grasp it |
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Term
| When does the breast of nonnursing mother's return to their normal size? |
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Definition
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Term
| What do you assess for when assessing the breasts? |
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Definition
| consistency, size, shape and symmetry. Inspect for redness or cracking (pain or risk for infection), flat or inverted nipples make it more difficult for the infant to latch on |
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Term
| Why is it important for non nursing mother's to wear a bra? |
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Definition
| avoid stimulating nipples, stand facing away from the water spray in the shower |
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Term
| Care for breasts post partum |
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Definition
| wear bra for support or a binding, for non nursing mothers do not make it too tight that it affects circulation, when showering use just water no soap because of the drying effect that can lead to cracking, and less stimulation as possible |
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Term
| Why can women tolerate normal blood loss at delivery? |
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Definition
| 50% increase in blood during pregnancy |
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Term
| how much blood is loss at birth? |
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Definition
| 500ml in vaginal birth and 1000 mL in cesarean birth |
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Term
| Why are women bradycardic after birth? (low pulse) |
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Definition
| increase in blood volume and cardiac output because blood that was directed to the uterus and placenta return to the main circulation as well as from the tissues. The heart pumps more blood with each contraction (increased stroke volume) |
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Term
| What is a woman's pulse after initial postbirth excitement? |
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Definition
| 50-60 BPM for about 48 hours |
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Term
| How does the body rid itself of excess fluid to reestablish fluid balance? |
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Definition
1. Diuresis (increased excretion of urine, may reach 3000 mL a day
2. Diaphoresis( profuse sweating) |
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Term
| Women's blood clotting factors are higher during pregnancy and post partum |
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Definition
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Term
| Who is more likely to have a clot formation? |
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Definition
| women who have varicose veins, has had a cesarean birth or must delay ambulation |
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Term
| What are hallmark signs of a pulmonary embolus? |
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Definition
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Term
| What does the fluid shift do to the woman's hemoglobin and hematocrit values? |
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Definition
| it shifts into the bloodstreaming, diluting the blood cells which lowers the hematocrit |
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Term
| Why does the level of white blood cells rise? |
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Definition
| Increase response to pain, inflammation, and stress and protects the mother from infection as her tissues heal |
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Term
| When does the WBC count return to normal? |
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Definition
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Term
| Why do women experience chills and what is the nursing intervention for that? |
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Definition
| sudden release of pressure on the pelvic nerves and a vasomotor response involving adrenaline during the birth process |
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Term
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Definition
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Term
| what would chills accompanied by fever suggest? |
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Definition
| after the first 24 hours, it suggest an infection |
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Term
| What does a high pulse rate indicate post partum? |
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Definition
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Term
| What does edema above the waist indicate? |
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Definition
| pregnancy induced hypertension, which can continue during the early postpartum period |
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Term
| What kind of assessment determines thrombosis in the legs? |
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Definition
| reddened, tender area or edema, pain and sometimes pallor |
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Term
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Definition
| calf pain when the foot is passively dorsiflexed |
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Term
| When does kidney functions return to normal?? |
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Definition
| within a month after birth |
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Term
| What can lead to post partum hemorrhage? |
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Definition
| when the bladder displaces the uterus or from urine sitting in the bladder |
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Term
| Nursing tip for assessing for residual urine in post partum women |
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Definition
| women who voids frequent small amounts may have increased residual urine |
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Term
| When should urine be measured? |
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Definition
| the first 2 to 3 voids after birth |
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Term
| Why does constipation occur during the post partum period? |
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Definition
| medications may slow peristalsis, abdominal muscles are stretched making it hard to bear down (sections make it harder), soreness and swelling of the perineum or hemorrhoids make her fear moving her bowels, slight dehydration and little food intake during labor make the feces harder |
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Term
| Nursing care for constipation |
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Definition
| drink lots of water, add fiber to diet, and ambulate. |
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Term
| What are some stool softeners used for postpartum constipation? |
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Definition
| docusate calcium (Surfak), docusate sodium (Colace), a laxative like bisacodyl (Dulcolax) |
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Term
| When can light exercise begin? |
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Definition
| one day after vaginal birth and longer for cesarean birth |
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Term
| What do Rh mothers receive within 72 hrs after giving birth to an Rh-positive infant? |
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Definition
| Rh(D) immune globulin (RhoGAM), prevents sensitization to the Rh-positive erythrocytes that may have entered her bloodstream when the infant was born |
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Term
| Failed induction or failure to progress |
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Definition
| imply woman herself was not competent in some way |
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Term
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Definition
| as soon as she can ambulate reliably...use a shower chair to reduce the risk for fainting. incision can be covered with a plastic wrap and the edges secured with tape. change dressing after shower |
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Term
| What kind of teaching should be done to observe for signs of UTI? |
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Definition
| fever, burning pain on urination, and urgency of urination |
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Term
| Who is at more risk for thrombophlebitis? |
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Definition
| A woman who has undergone cesarean birth |
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Term
| Phase 1 of rubins psychological changes |
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Definition
| Phase 1: Taking In (mother is passive and willing to let others do for her. Primary focus is on recovery from birth and her need for food, fluids and deep restorative sleep. |
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Term
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Definition
| Conflicting feelings joy and emotional let down the first few weeks after birth; normal and temporary |
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Term
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Definition
| A persistent mood of unhappiness; persistent depression is not expected and should be reported |
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Term
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Definition
| Discuss home environment and available support before discharge and plan for periods of rest |
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Term
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Definition
| Intense interest in the new child by the father |
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Term
| 4 phases of adjustment to fatherhood |
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Definition
1. Having expectations and personal intentions
2. Confronting reality and overcoming frustrations
3. Creating ones own personal father role
4. Reaping rewards of fatherhood |
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Term
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Definition
| Taking hold. - mother begins to initiate action and becomes interested in caring for her child. Increase concern about her body's function and assumes responsibility |
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Term
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Definition
| Letting go- mothers and fathers work together and give up their previous lifestyle to incorporate the new infant. They give up the fantasy child and accept the real child |
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Term
| Phase 2: care of the newborn |
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Definition
| Occurs after transport to the postpartum unit |
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Term
| Intensive care concept phase 1: |
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Definition
| 0-30 mins ( period of reactivity) tachycardia gradually lowers to normal rate, irregular restorations, rales, infant is alert frequent moro ( startle reaction), reflex, tremors, crying, increase motor activity, absent bowel sounds |
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Term
| Phase 2: 30 mins - 2 hours |
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Definition
| Decreased responsiveness, decreased motor activity, rapid respirations, normal heart rate, audible bowel sounds |
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Term
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Definition
| Abrupt brief changes in color and muscle tone, presence of oral mucus, responsiveness to external stimuli, infant stabilizes begins suck swallow |
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Term
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Definition
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