Hormones - ________ - ________ - ________ These all DROP and if stay low if they are _________! - low ________ leads to increased _______ levels which stimulate breast milk production - low ______ levels lead to increased ______! Autoimmune: women are at increased risk of developing ________ later in life Non-immune: doesn't usually lead to this

- Progestin - Estrogen - Estradiol breastfeeding! - progesterone; prolactin (breastfeeding, nipple stimulation keeps these levels high) STOP breastfeeding - prolactin; FSH (can get pregnant again!) - hypothyroid

Week 7 (Postpartum) Flashcards by Priscilla Gallardo

The Postpartum Period
- also known as the ____ _______
- beings immediately after the birth of the _________
- last about ___ weeks
- ends with the return of the reproductive system to pre-pregnant state

4th trimester
placenta
6

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The Placenta
- detaches within ___-____ minuets
- delivery imminent
- lengthening of cord
- _____ of ______
- Assessment!
- ______
- health
- pathology (test if there are clots, tissue calcifications)
- great source of ________ and _______

15-30
GUSH; blood
INTACT
progesterone; iron (that is why mom may want to keep it to make pills)

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The Postpartum Exam
B
U
B
B
L
E
E
E

Breasts
Uterus
Bladder
Bowel
Lochia
Episiotomy
Extremities
Emotional Status

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Immediate PP Period
Comfort measures
- clean peri pad & under pad
- ____ pack
- pain meds for ______ which are PP uterine _________
- warm blanket for ______
- restart ________
- encourage ________ right away
- offering emotional support
- PP recovery assessment

ice
afterpains; contractions
tremors
nutrition
breastfeeding

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PP Recovery Assessment
- Vital Signs
- Fundus: ______ and ______
- Lochia: _____ and _____
- Perineum: _______ and pericare/comfort
- Breastfeeding :_____ and _____ of time
- Epidural: _____ ___ of catheter intact
- Activity level: checks extremities for sensation and gait (assistance if needed)
- Voids

height; location
amount; color
REEDA (Redness, Edema (swelling), Ecchymosis (bruising), Discharge, and Approximation)
side; length
blue tip

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Vital Sign Changes
Blood Pressure
- _______ ________
- check for pregnancy-induced _______

Pulse
- ________ x 24 hours
- rapid pulse associated with _________ _____

Respirations
- NO _______ because they have more room for lung expansion

Temperature
- slightly ________ x 24 hours
- should not exceed ______

Pain (0-10)
- incision
- perineum
- HA (r/o PP _________ and ______ HA)

orthostatic hypotension
HTN
decreases
hypovolemic shock
change!!
elevated
100.4
Preeclampsia; Spinal

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Hormones
- ________
- ________
- ________
These all DROP and if stay low if they are _________!

low ________ leads to increased _______ levels which stimulate breast milk production
low ______ levels lead to increased ______!

Autoimmune: women are at increased risk of developing ________ later in life
Non-immune: doesn’t usually lead to this

Progestin
Estrogen
Estradiol
breastfeeding!
progesterone; prolactin (breastfeeding, nipple stimulation keeps these levels high)
STOP breastfeeding
prolactin; FSH (can get pregnant again!)
hypothyroid

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Endocrine Function
Diabetes
- insulin antagonists (_____, ______ & ______) _______ in the PP period
- insulin requirements therefore ________

Gestational Diabetes usually goes away after pregnancy

hPL; estrogen; cortisol
decrease
decrease

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Return of Ovulation & Menstruation
- ______ rises after 12 days

Breastfeeding mom
- ovaries not responsive to _____ with increased _______ levels
- _________ _________

Non-breastfeeding Mom
- _____ levels rise around __ weeks
- 1/3 of women will ovulate prior to first ________

FSH
FSH; prolactin
lactational amenorrhea
FSH; 6
menses

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Recall…
What is the role of Estrogen in the breasts?
- grows ______ and _______ _____

What is the role of progesterone in the breasts?
- maintains ______ and ______ milk producing cells of the breast

ducts; connective tissue
pregnancy; develops

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Recall…
What is the role of Prolactin in PP women?
- stimulates ________ to produce _____

How are Prolactin levels maintained?
- levels are maintained by _______ of the ______ and _____

What hormone is suppressed with high prolactin levels? _______

What is the result of suppressed FSH?
- __________ __________

lactocytes; milk
stimulation; nipple; areola
FSH
lactational amenorrhea

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What is the role of Oxytocin in PP women?
- stimulates myoepithelial cells that surround the alveoli in the breast
- responsible for the _____ ____ _____
- causes smooth muscle _______
- causes uterine _________

Milk Ejection Reflex
contractions
contractions

these are afterpains after pregnancy (give NSAIDs to target muscles directly!)

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Immediately following the delivery of the baby and placenta ________ and ________ rapidly decline allowing _______ to increase

estrogen; progesterone; prolactin

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What is the role of the Montgomery glands?
- sebaceous glands surrounding the nipple
- secrete _____ substance (natural _____?)
- provide ______ and _____ to entice baby

oily; lubricant
taste; smell

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What’s in it for MOM?
- reduces the risk of ______ ______
- reduces the risk of ______ and ______ cancer
- decreases risk of ________ (4x greater risk if you DON’T Breastfeed)
- Child ______ (delays _____)
- Promotes emotional health
- decreased risk of _____ and PP _______
- promotes uterine ______ and PP weight ____! :)
- decreased cost
- promotes _______
- CONVIENENT

breast cancer
uterine; ovarian
osteoporosis
spacing (ovulation)
PPD; anxiety
involution; loss
bonding

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Benefits of Breastfeeding for BABY
- Maturation of the ____ system= less _______
- _______ (____): less RSV & pneumonia
- Decreased incidence of asthma, eczema, T1DM, certain childhood cancers, obesity, food allergies

Enhances cognitive and _____ developmental

GI; diarrhea
immunity (IgA)
jaw

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Women who should NOT breastfeed
- _____ positive
- certain __________

HIV
medications (marijuana)

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Breastfeeding: Where, When, How?
- should being in _______ room 1st period of reactivity

_________= 1st milk
- production begins in the 4th month of pregnancy
- small amount of ______/____ like substance
- promotes _____ closure inhibiting ______
promotes coordination of _____/______/______
- _____ to deep ______ yellow= ______ ______
- Excellent source of nutrition and immunity
- laxative effect to clear ________
- high in Na, K, Cl, Protein, and Fat Sol Vitamins, Imunoglobulins (IgA)
- helps establish _____ _______

delivery

Colostrum
- thick/gel
- gut; pathogens
- suck/swallow/breathe
- pale; golden; liquid gold
- meconium
- bifidus flora (immune system)

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Transition of Breast milk
_________= 1st milk
VERY IMPORTANT (first couple of days)

________ milk —-> ______ milk (usually in by day 14)

milk composition changes during a feeding: _______= lower in fat and ________= higher in fat

Colostrum

Transitional; Mature

foremilk; hindmilk

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Positions for Successful Breastfeeding
- baby should have ____, ______, and ______ aligned!

ears; shoulders; hips

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Breastfeeding on DEMAND
- no supplements
- NO _______!
- their stomachs can only hold so much so they need to only have _______-dense fluids
- should eat ___-___ times in ___ hours

water!!
nutrient
8-12; 24 (every 2-3 hours!)

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Breastfeeding: The Basics
Storage:
- room temperature for ___ hours
- refrigerator x ___-___ days
- freezer x ____-___ months
- deep freeze x ____-____ moths

Never put in _______ make sure to ____!!

8 (ONLY!)
3-5
3-6 (NOT ON DOOR)
6-12

microwave; THAW

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Assessing Adequate Nutrition
- infant ______
- suck strong, coordinated
- audible swallow
- weight
- loss no greater than ___% day 3
- regain birth weight by day ____

Hydration Status
- fontanels _____ and ____
- ___-__ wet diapers daily
- ____-___ BMs daily

satisfied
7
10
soft; flat
6-8
2-3

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Anticipatory Guidance: Breastfeeding
Nutrition
- mom increases ______ additional calories
- increased _____ intake!!

How long to Breastfeed
- _____ months no supplements
- ______ _______ reflex gone @____ months
- no _____ milk x 12 months

Weaning
- gradual process
- decreases _______
- remove _____ feeding per week

500
fluid
6
tongue extrusion; 6
cow’s
engorgement
one

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Nipple Problems Assessment - subjective: C/O of pain - objective: document side/s, ______, ______, _______ Cause - improper ______ Treatment and Teaching - correct ______ - comfort measures: ________, _______, nipple shield/shells

- redness; cracking; bleeding - latch - latch - colostrum; lanolin (chapstick for nipples)

Engorgement Assessment: - Subjective: _____, taut/tenderness; ______/fullness, _______ (relieved after ______), warm - objective: breast is firm, warmth, generalized _______ (NORMAL if on BOTH breasts!!) Cause: - ______ - ________ of milk!! (educate mom that this will happen) Treatment: - prevention - ______ _______ - Comfort measures - express ______ (manually/pump) - ______ compress - ________ (stimulates the nipple too!!) - ________ leaves - _____ pack

- warmth; heavy; pain; feeding - redness - edema (fluid retention) - fullness - frequent feedings - milk - warm - shower - cabbage - ice

Plugged Milk Ducts Causes: - ________ emptying - _______ feedings - tight or underwire _____ Symptoms: - ____, _____ area - small ______ (softens and decreases after feeding) - ______ ______ at nipple - NO _______ Treatment: - ________ - avoid ______ - change ______ for breastfeeding each feeding - more ______ feeding

- inadequate - missed - bra - red; tender - lump - white pearl - fever - massage - bra - positions - frequent (use affected side first!)

Mastitis= _________!! Assessment - subjective: ______ (UNRELIEVED) - ____-like symptoms - objective: ________ (______- localized area) - rock ______ breast - _______!! Causes - _______ _______ - blocked ____ Treatment - ________ - ______ compress - change ______ w/ feed - call _____!! - _________ Teaching - continue ________ - infection/antibiotics do ______ harm baby - safe to ______ off infected side

INFECTION - pian - flu - redness (unilateral) - hard - FEBRILE - bacterial infection - blocked duct - massage - warm - position - MD - antibiotics - breastfeeding - NOT - feed

Mastitis- RRUFF Pain R R U F F P

Red Rock hard Unilateral Fever Flu-like symptoms Painful

Return to Prepregnant State: - _______ pains (more in _______ women) Placental site - vascular constriction - __________ - day 16 vs 6 weeks Cervix - firm 2-3 days - ectocervix - cervical Os - 2 weeks for changes to go through Vagina - ________ deprivation

- afterbirth (multipara) - thromboses - Estrogen vaginal dryness irritation

Uterine Assessment Nursing Assessment of the Fundus - lay patient ______ with knees _____ (GO SLOW because their muscles are sore) - stabilize the uterus at the _______ _____ - palpate the ______ - massage until ______ - have patient raise _______ - look under pad for ________ - note _____!! (number and size)

- flat; flexed - symphysis pubis - fundus - firm (if already firm and midline, then don't need to massage!) - buttocks - bleeding - clots! (they will come out if you are massaging the fundus)

Uterine Assessment uterine _______= uterus returning to pre-pregnant state Assess Fundus - _____ - location (______/____/_____) - height in relation to ________

involution - tone - midline/L/R (if shifted to left or right, first intervention would be to have mom void bc it could be d/t a full bladder!) - umbilicus (1/U=1 cm above, U= umbilicus, U/1= 1 cm under) 1 finger breathe down per day!!

____________= uterus is NOT returning to pre pregnancy size may occur up to 6 weeks PP Assessment: - Subjective: C/O pain, ______, feels increased "_______" or bleeding, changes in LOC - Objective: observe increased/excessive vaginal _______; palpate uterus off to _____ or _____, _______ uterus. change in VS (increased ____!) Cause: - diminished _____ - resinated ______ - uterine/cervical _______ - _______/clotting disorders Treatment: - find the source and FIX!

Subinvolution - cramping; leaking - bleeding; left; right; boggy; HR= hemorrhage - Tone - Tissue - Trauma - Thrombin

Common Causes of Subinvolution: 1. 2. - _______ placenta - placenta ______ - placenta _______ - placenta _______ 3. - uterine ______ - uterine ______ - cervical _______ - vaginal ________ 4. 5.

1. Tone (Atony) diminished 2. Tissue - retained - accreta - increta - percreta 3. Trauma - rupture - laceration - hematoma 4. Thrombin - coagulopathy 5. Traction (uterine inversion)

#1 Diminished TONE (ATONY) - uterine muscle unable to ______ and ______ bleeding Cause: - bladder __________ - overextended/tired: _________, _________, macrosomia, ___________, prolonged ______, infection, oxytocin, general anesthesia (doesn't wake up), placenta _______/______ Objective S/S - HR __________ - BP __________ - _______ vaginal bleeding with _____ - fundus will not remain ______ - bladder palpated above _______ _______ Treatment - fundal ________ - bladder _______ - pain management - D & C for removal of placental _______

- contract; control - distension - multigravida; multiparity (twins), polyhydramnios; labor; previa/abruption - increased!! - decreased - heavy; clots - firm - symphysis pubis - massage - emptying - fragments

#1 Diminished TONE (ATONY) Medications: - ________= 1st line - _________ ________: do NOT use with _____ - _____, ________: caution with _______ - ________- suppository: watch for ______ - _________: caution with ____ or _______ issues - _________ ____ - antibiotics r/t infxn

- oxytocin - methylergonovine maleate; HTN - PGE, carboprost; asthma - Dinoprostone; hypotension - Misoprostol; CV; respiratory - Tranexamic acid (TXA)

Endometritis Risk Factors - ROM >24 hours - Retained _______ ________ - ________ or ________ - pre-existing _______ - prolonged and difficult ______ - _____ FHR monitoring - uterine exploration after birth - C-section Signs of Infection - CBC/SED rate - vaginal culture - pelvic u/s - uterus= _____/_____; _____ upon palpation - may lead to ___________ Assessment - ____/_____ uterus - excessive vaginal ______= _______ color, ______ odor - ______ or _____ pain - _____/_____ Treatment: - _____ bladder - med's - IV site/O2

- placental fragments - episiotomy; lacerations - anemia - labor - internal - boggy/enlarged; tender - peritonitis - soft/boggy - bleeding; BROWN; FOUL - back; pelvic - fever/chills - empty

#2 Tissue retained= retained placenta ________ Placenta _______= deep in wall NOT ______ Placenta _______= penetrates into ______ wall Placenta ________= penetrates into _____ wall and attaches to other ______ (______) Cause: UNKNOWN Predisposing factors - placenta _______ - previous _____ Treatment - manual removal of ______ - surgical removal of ________

- fragments Accreta; muscle Increta; muscle Percreta; uterine; organs (bladder) - previa - C/S - fragments - uterus

#3 Trauma 1. Uterine _________ - Cause: ______, muscle ______ - Tx: _________ - _________? - blood _________ 2. Cervical _________ - Cause: birth trauma - objective: ______ of blood despite ______ uterine tone - Tx: call ______/______ - _______ - _______ - REMOVE within ____ hours!

1. Rupture - medication; weakness - surgery - hysterectomy? - transfusion 2. Laceration - SPURTS' firm - physician/midwife - suture - packing - 48

#3 Trauma Perineal Hematomas - Cause: injury to perineal blood vessels - Objective: perineal pain, ______, firm _____, enlarges in size - Tx: - _______ and _______ - heal by tertiary intention - packing removed ___-___ hours - administer analgesics

bruised; mass - incisions; drainage - 24-48

#4 Thrombin Clotting/Thromboembolic Disorders - PP are at a higher __________ state in order to fix bleeding - but it could either be not enough or too much - To much clotting= 1. 2. 3.

- hypercoagulable 1. Superficial Venous Thrombosis 2. Deep Vein Thrombosis 3. Pulmonary Embolus

#5 Traction= uterine __________ - uterus pulled ______ out - Cause: pulling of placenta r/t ______ ______ - Outcome: _______ - Tx: put ______ or ______

Inversion - inside - cord traction (method used to pull out placenta) - Shock - back; surgery

Other Sources of Bleeding - Perineum: REEDA; _______ - Cervix: ________ - Incision: REEDA Key to Remember: - Cervical vs Vaginal Location - cervix hurts= _______ - uterus - typical= _______

- hematoma - laceration - spurts - trickles

Fluid Balance Diaphoresis - it happens because ______ levels drop suddenly and... - the body no longer needs the extra ______ volume - improvement of _____ _______ - may have elevated temp for 24 hours, call if temp >______ Diuresis - it happens because there is a decrease in ________ and the body stops retaining ______ and _______ - lasts ___-___ days PP - can be up to _______ mL/day - _______ can delay duress

- estrogen - plasma - carpal tunnel - 104 - aldosterone; sodium; water - 2-5 - 3000 - oxytocin

Diaphoresis & Tremors Patient Teaching - _____ _____ are typical - improvement of ______ _______ syndrome d/t decrease in swelling - increased ______/ encourage ______ - _______ incontinence (transient or persistent)

- night sweats - carpal tunnel - urination/fluids - stress Nursing diagnosis - disturbance in sleep patterns r/t night sweats, pain, infant feeding

Bladder Problems Difficulty Voiding - weakened abdominal & pelvic muscles - perineal trauma and swelling- long labor - fear of _____ - decreased sensitivity of filling - ________ if unable to void - urinary _________ Bladder Distention leads to: - __________ - uterine _______ - __________ Methods to encourage voiding - run ______ in sink - spray _____ over perineal - ______ ______ in hat - _____ pack Measure first ____ voids!

- pain - catheterize - incontinence - subinvolution - atony - bleeding - water - water - peppermint oil - ice 3!

Getting Mom to the Bathroom - typically done ___-___ hours PP - Prior to getting patient up --> ASSESS - up with assist _______!!

- 1-2 - assess VS, mobility, pain, dizziness - ALWAYS!

Bowels General Diet - usually ______ and _____ after birth! Motility - ______ muscle tone for several days - more delay with ______ and ______ Bowel evacuation - ___-___ days - fear of pain!

- hungry; thirsty - decreased - analgesia; anesthesia - 2-3

Hemorrhoids= varicose vein in rectal/anal area Assess - Subjective: pain, itching, swelling, burning - Objective: patient in ____ position, presence and size Cause: - ______ stage Patient Education: - avoid _______!! - FFA!!! Treatment: - _____ bath - _____ ______ - _____ pads - _____ cream/suppository

- Sims - pushing - constipation - Fluids, Fiber, Ambulation - SITZ - stool softeners - Tucks - Anusol

Lochia 1. Amount - _____ (1in) - ______ (4in) - ________ (6in) - _______ (1pad/15 min) 2. Color - ______ (dark or bright red; day 1-3) - ______ (pinkish brown; day 3-10) - ______ (yellowish/white; day 11-??) 3. Odor - _____/____ - ______

- scant - light - moderate - heavy - Rubra - Serosa - Alba - Musty/fleshy - Foul

Determining Amount of Vaginal Blood loss - Typical blood loss from a vaginal delivery= ______ mL - 1st determine when pt. last changed their pad - Assess patient _____ pad as well as ___ pad - saturated perineal pad= ____-___ mL - When in doubt, weight pads/linens - _____g=____mL blood loss

- 500 - chucks; peri - 25-50 - 1; 1

Hypovolemic Shock S/S Subjective - c/o feeling _____ - change in _____ Objective - persistent ____ ______ - skin ______ & _______ - blood pressure - pulse is ________ Nursing Actions: - _____ with patient - SUMMON HELP - notify physician - fundal ________ - catheter - legs _______ - monitor VS - O2 - IV (mainline, oxytocin, blood)

- weak - LOC - heavy bleeding - cool & clammy - increased - stay - massage - elevated

Medications to Control Hemorrhage: Treatment: - goal: promote _______-_______ - _________= 1st line treatment - _______ ______- dont use with HTN - _____,_______ - caution with asthma/CV disease - ___________- suppository: watch for _________ - ___________- caution with CV or respiratory issues: NOT FDA approved - _______ ______: administer no longer than ___ hours after birth

- contractions-uterotonic - Oxytocin - Methylergonovine Maleate - PGE, Carboprost - Dinoprostone; hypotension - Misoprostol - Tranexamic acid; 3

Discharge Teaching: Loch - soaking ___pad/hour - passing clots size of an _____ or _____ - rest- call if bleeding counties - failure of transition from ________ to ______ - PP hemorrhage can occur up to ___ weeks - Pelvic rest for ___ weeks or return of _________

- 1 - egg; larger - serosa; alba - 6 - 6; menstruation

Classification of Perineal Lacerations Classification: 1st degree= vaginal _____ _____ and skin of _______ 2nd degree= ______ tissue of the perineal body 3rd degree= involves _____ of the external _____ _______ 4th degree= through ______ _____ the _____ of the _______

mucous membrane; perineum subcutaneous fibers; rectal sphincter rectal sphincter; lumen; rectum

Episiotomy NO day at the BEACH Assessment B E A C H Hemorrhoids - tucks - proctofoam - NO _____ _______ or ______ Comfort Measure s - _____ - ______ - ______ bath - ________ exercises - _____ care! - medications (sprays!)

Brusing Edema Approximation Comfort Hematoma - rectal suppositories; enemas - ice - heat - Sitz - legal - peri

Perineal Hygiene - clean pad with each void - _____-_____ - proper wiping - ice packs X _____ ______ - ____ baths ______ - _______/________/_______ - _______ exercises - avoidance of ______, _______, and ____ baths

- peri-bottle - 24 hours - Sitz; TID - tucks; dermaplast; epifoam - kegel - tampons ; intercourse; tub

Extremities Blood loss - vaginal birth <____ mL - c-section _______ mL Plasma Volume - ________ - _________ Coagulation - assess for ______ - ______, _____, ______ with ambulation Blood Values - return to normal ___-___ days - increased _____ - decreased ____ - decreased _____

- 500 - 1000 - diuresis - diaphoresis - DVT - redness; heat; pain - 3-7 - WBC - Hgb - Hit

Preventing Thrombophlebitis - can lead to ___________ - ______ ______ --> support _____ - early _________ - decrease time in ________ position - do not _____ ______ - DVT most common in _______ ____ ________ - _____ can occur!

- thromboembolism - varicose veins; support hose - ambulation - lithotomy - cross legs - lower left extremity - PE

Emotional Status: Postpartum Blues - 50-80% of new mothers experience - ______ onset (day 1-10 post birth) - _____ _____ duration - ______, _____ ______, _______ - related to ________ & _________ - feelings of ___________ - feelings of ___________ - _____ of baby - type of _______

- early - two weeks (if it continues, you need to teach family because they will notice if they do not get better) - weeping; mood swings; anxiety - estrogen; progesterone - abandonment - disappointment - sex - delivery

PP Depression - may occur up to ___ _____ postpartum - affects 10-15% of women - overwhelming ______ or exhaustion - sadness, ________, hopelessness - appetite and sleep disturbances - __________ ________ with infant - over concern of lack of _______ in infant - __________ from family and friends - excessive crying, ________, or anger - avoidance behavior - extreme _______ or fear - panic attacks - _______ _______ of harming infant - difficulty _______ _______

- 1 year - fatigue - depression - difficulty bonding - interest - withdrawing - irritability - anxiety - repetitive thoughts - thinking clearly

Prevent Postpartum Psychosis - more _________! - ________; __________ - more ________ thinking - _________ of ____ _____ or _____ _____ Surfaces within ___ months of birth

- serious! - delusions; hallucinations - disorganized - thoughts; self harm; infant harm 3

Maternal/Paternal Attachment _________= holding, staring at infant, 1st hour after birth perfect opportunity _________= occurs when infant responds back, grasping, gazing, rooting __________= father's developing bond with infant

bonding attachment engrossment

Developmental Tasks: Reva Rubin 1. ______-_____: mother focused on self/birth experience, physical self (dependent) 2. _______ _____: (holding baby) responsible for own care, interested in learning about self/newborn care 3. ______ ______: let go of old roles and preconceived ideas of baby

1. taking-in 2. taking hold 3. letting go

Cesarean Section Patient: Assessment of Abdominal Incision Asess Smelly REEDA R E E D - assess and mark drainage (bandage) A - sutures, derma bond, staples?

Redness Edema Ecchymosis Discharge Approximation

Cesarean Section Patient: Discharge Teaching Incision Care: - staples/sutures/dermabond - S/S of ________ - keep _____ and _____ - bathing: no ____ baths or ____ Pain Management Activity level - _______ restrictions - ________ restrictions - _______ when baby ______

- infection - clean; dry - tub; soap - lifting - driving - sleep; sleeps

Rest & Exercise Rest - fatigue is normal - ______ when baby ______ Exercise - abdominal exercises (modified ___-____) - leg _____ - ______ if bleeding is more= you are over doing it

- sleep; sleeps - sit-ups - lifts - legals

Rubella Vaccine Indications - assess immune status - administer if not immune Educate Patient - ____ pregnancy for ____ month following injection - may give if __________ - not contraindicated in patients with ____ allergy - administer _________

- NO; 1 - breastfeeding - egg - subcutaneous

RhoGAM mom= _________ baby= ________ we have a negative attitude and needs more information - so you look at the antibody screen AKA __________ - ______ _____ looks for antibodies that act against RBCs - _______: baby (made by mom & sent through placenta) - ________: mom (finds antibodies in mom's blood but not attached to RBCs)

negative positive - Coombs - Coombs test - Direct - Indirect

RhoGAM - Coombs Maternal (Indirect Coombs) - if indirect Coombs is _____ mom has NOT been exposed and _______ is given to protect next baby - if indirect Coombs is _____ then exposure has already _______ and Rhogam is _____ given

- NEG; Rhogam - POS; occurred; NOT

Call your HCP if: Breast: - ________ - ________ problems Uterus: - ____/_____ odor - _________ Bladder: - signs of _____ Bowel: - __________ - _________ Lochia: - soaking ____ pad/hour, clots _____ _____ size or larger, regression blood to bright _______ Legs: - signs of _______, _______, _____ pain - temp of _____ or greater Sad: - signs of ______ Incision (REEDA): - signs of infection, oozing, bleeding, odor, pain, perineal, or abdominal pain

- mastitis - breastfeeding - pain/foul - endometritis - UTI - hemorrhoids - consitpation - 1; golf ball; red - warmth; redness; calf - 100.4 - PPD

Typical Follow-UP PP Period Vaginal Birth - hospitalization ____ hours after deviltry - return to office in ___ weeks - return to office ___ weeks Cesarean Birth - hospitalization ___-___ days - ______/______ removal--> 5-7 days - return to office ___ weeks

- 48 - 2 - 6 - 3-4 - suture/staple - 6

Week 7 (Postpartum) Flashcards

(72 cards)