postpartum Flashcards

Question

how to care for painful nipples

Answer 1

- nipples- Express some breastmilk on nipples before feeding, Start on less sore nipple, make sure you have a good latch; may need to change position of infant- Parent should be encouraged to do most of the feeding with support from nursing

Answer 2

infected boob

Answer 3

frozen helps after feeding

Answer 4

- fist in mouth - looking for a breats - lip smacking - crying calm them own first

Answer 5

put finger in mouth to break the suction

Answer 6

taking in phase taking hold phase letting go phase

Answer 7

- First 24-36 hours after birth - Focus on self: rely on others to meet their needs - Very dependent - may need to be reminded to eat, shower, sleep etc. - Desire to review birth experience - very excited

Answer 8

- Starts 2nd day and lasts approximately 10 days - Alternates between need for extensive nurturing and a desire to take charge - Responds enthusiastically to opportunities to learn and practice baby care - Emotional change – possible experiences with the “blues” - more into learning - labile moods, crying for no reason - 1-2w after delivery - still bond and take care of body

Answer 9

- Focus: forward movement of family as unit with interacting members - Reassertion of relationship with partner - Resolution of individual roles - after couple of weeks

Answer 10

- Fever more than 100.4°F (38°C) - Foul-smelling lochia or an unexpected change in color or amount - Large blood clots, or bleeding that saturates a peripad in an hour: bigger than gold ball size, saturate pad within an hour, 1000ml - Severe headaches or blurred vision - Visual changes, such as blurred vision or spots, or headaches - Calf with localized pain, tenderness, redness, and swelling - Swelling, redness, or discharge at the episiotomy, epidural, or abdominal sites - Dysuria, burning, or incomplete emptying of the bladder - Shortness of breath or difficulty breathing without exertion - Depression or extreme mood swings

Answer 11

hyper reflextive

Answer 12

``` breast uterus bladder bowls lochia episiotomy extremities emotional status ```

Answer 13

inspect & Palpate for size, contour, engorgement, nipple condition, milk production - only touch if they ask - soft tender right after delivery

Answer 14

assess fundus consistency, location, r/o tenderness | - firm at midline, and umbilicus

Answer 15

Assess for distention, tenderness, adequate emptying | - Note the location and condition of the fundus; a full bladder tends to displace the uterus up and to the right.

Answer 16

Has mother moves bowels, listen X4 for BS, assess for abdominal distention - flatus, bowl sounds x4, no n/v, stool softener

Answer 17

Assess type, amount, color, odor, does change of activity change amount of lochial flow? - Typically, the amount of lochia is described as follows: - Scant: a 1- to 2-in lochia stain on the perineal pad or approximately a 10-mL loss - Light or small: an approximately 4-in stain or a 10- to 25-mL loss - Moderate: a 4- to 6-in stain with an estimated loss of 25 to 50 mL = Large or heavy: a pad is saturated within 1 hour after changing it

Answer 18

asess episiotomy &/or lacerations q. 8 hrs.; assess for approximation, swelling, ecchymosis, D/C, pain

Answer 19

assess for maternal risk, edema, varicosities, | - calf pain, swelling, redness

Answer 20

assess for maternal mood, bonding with infant, energy/exhaustion levels, desire for independence or lack thereof, touch - if separated, asking about baby - The length of time necessary for bonding depends on the health of the infant and mother, as well as the circumstances surrounding the labor and birth

Answer 21

``` : Pulmonary emboli typically result from dislodged deep vein thrombi in the lower extremities. Risk factors associated with thromboembolic conditions include: Anemia Diabetes mellitus Cigarette smoking Obesity Preeclampsia Hypertension Severe varicose veins Pregnancy Multiple pregnancies Cardiovascular disease Sickle cell disease Postpartum hemorrhage Oral contraceptive use Cesarean birth Severe infection Previous thromboembolic disease Multiparity Bed rest or immobility for 4 days or more Advanced maternal age > 35 years (Kline & Kabrhel, 2015). ```

Answer 22

Cold and heat applications Ice pack (1st 24 hours), peribottle, Sitz bath (after 24 hours) Topical preparations Analgesics: dermaplastt

Answer 23

``` Promoting voiding Promoting bowel elimination - patting dry, babywash and warm water in a bottle - front to back - fresh pad everytime - clean hands - tucks pads: with hazel ```

Answer 24

Coagulation Issues Postpartum Hemorrhage Postpartum Infections Postpartum Emotional Disorders

Answer 25

Deep Venous Thrombus (DVT) | Lower extremities, various veins from foot to iliofemoral region  

Answer 26

- most common during pregnancy) - Unilateral leg pain, calf tenderness, swelling - Tenderness, warmth, or asymptomatic, Homan’s sign +/-

Answer 27

``` Pulmonary Embolus (PE) - Complication DVT, clot travels to pulmonary artery, occludes blood flow to lungs ```

Answer 28

Dyspnea, tachypnea, tachycardia, apprehension, pleuritic chest pain, cough, hemoptysis (coughing up blood), elevated temperature, syncope, cardiac arrest

Answer 29

Analgesics (NSAIDs) | Rest, elevation, compression stockings, heat locally

Answer 30

Anticoagulant Initially IV heparin, bed rest, elevate affected leg, analgesia later oral anticoagulant warfarin (coumadin), compression stockings, ambulation

Answer 31

Emergent treatment IV: Anticoagulant IV heparin, later SQ or oral anticoagulants - prevention: compression stockings, moving around

Answer 32

Medications containing aspirin are not given to women on anticoagulant therapy because aspirin inhibits synthesis of clotting factors and can lead to prolonged clotting time and increased risk for bleeding

Answer 33

Postpartum hemorrhage is a potentially life-threatening complication of both vaginal and cesarean births. It is the leading cause of maternal mortality in the United States.

Answer 34

Uterine atony

Answer 35

``` Prolonged labor Manual extraction of placenta Pitocin augmentation History of postpartum hemorrhage Large baby Grand multiparity ```

Answer 36

>500 mL following a vaginal birth >1,000 mL following a cesarean birth Any amount of bleeding that places the mother in hemodynamic jeopardy

Answer 37

within 24 hours

Answer 38

24hr to 12 weeks after birth

Answer 39

Risk factors | Uterine tone; vaginal bleeding

Answer 40

``` Focus on underlying cause Uterine massage Fundal massage Removal of retained placental fragments Antibiotics for infection Repair of lacerations ```

Answer 41

``` (priority) Fundal massage; QBL Administration of uterotonic Drug Guide 22.1 p. 847 Fluid administration Monitoring for signs and symptoms of shock Emergency measures if DIC occurs ```

Answer 42

- Complication: Disseminated Intravascular Coagulation (DIC) - Clotting and anticlotting mechanisms occur at the same time Not a primary condition; secondary to pregnancy complications (placental abruption, infection, preeclampsia/eclampsia, hemorrhage, etc.) - Manifestations include unusual spontaneous bleeding from gums and nose; oozing , trickling or flow of blood from incision/laceration; petechiae, hematuria - Institute emergency measures to control bleeding and impending shock; prepare to transfer to ICU - Identification of underlying condition and elimination of causative factors are essential

Answer 43

Labs: CBC, blood type/cross, clotting factors Nursing Care Administration of fluid volume replacement (can include blood/blood products) Administer pharmacological interventions (antibiotics, vasoactive mediations, uterotonic agents) Administer supplemental oxygen Protect from injury

Answer 44

- Oxytocin (Pitocin) - Methylergonovine (Methergine ) - Hemabate (Carboprost, Prostin 15m) - Misoprostol (Cytotec)

Answer 45

Action: stimulates uterine smooth muscle. Has vasopressor and antidiuretic effects. Usually given wide open for PPH; however drug resources say for PPH only administer via pump at 10 to 40 milliunits per minute, can go up to 80 milliunits for short period.

Answer 46

Hypertension, pre-eclampsia, | Cardiac diseas

Answer 47

- Ergot alkaloid - Dose: 0.2 mg IM; most likely will start 0.2 mg PO q 6 hours x 4 after stable - Action: stimulates uterine and vascular smooth muscle. - use filter needle, open with gauze, open away

Answer 48

- Dose: 250 mcg IM q 15 minutes x 3 - Contraindication: Asthma - Lomotil- anti-diarrheal given to help with the side effect of Hemabate - causes vomiting, explosive diarrhea take lomotal and zofran with it

Answer 49

800-1000 rectally

Answer 50

Increased temp, redness swelling, uterine tenderness, chills, fever, localized pain

Answer 51

blood culture, CBC, urine cultures, uterine culture

Answer 52

To include good handwashing, aseptic technique, teaching perineal hygiene, teaching signs and symptoms of an infection

Answer 53

go away in a few says or 1 week | • Sad, anxious, or overwhelmed feelings, Crying spells, Loss of appetite, Difficulty sleeping

Answer 54

(can begin any time in the first year): • Same signs as baby blues, but they last longer and are more severe, Thoughts of harming yourself or your baby, Not having any interest in the baby

Answer 55

Seeing or hearing things that are not there • Feelings of confusion • Rapid mood swings • Trying to hurt yourself or your baby

Answer 56

Panic attacks | Obsessive thoughts/behaviors

Answer 57

- The baby blues continue for more than 2 weeks • Symptoms of depression get worse • Difficulty performing tasks at home or at work • Inability to care for yourself or your baby • Thoughts of harming yourself or your baby

postpartum Flashcards

(84 cards)