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OB - Spring 2016 > Postpartum - Unit 3 > Flashcards

Postpartum - Unit 3 Flashcards

1
Q

What is involution?

A

When the uterus shrinks back up!

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2
Q

What is catabolism (in regards to involution?)

A

When the cells shrink back after birth.

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3
Q

by the time a woman leaves the hospital, the uterus is 1-2 fingers below the umbilicus. T/F?

A

True

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4
Q

The uterus should shrink about __ cm per day.

A

1cm

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5
Q

The weight of the uterus at delivery is about ____ kg
1 week after = ___ g.
4 weeks = ____ g.

A

1kg (1000g)
500 g
100 g

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6
Q

Less afterpains with each pregnancy. T/F?

A

FALSE - you’ll have more afterpains.

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7
Q

Lochia - what is it? How do we measure it?

A

Fancy term for the bleeding you have after pregnancy. You measure it by how much of the pad is saturated.

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8
Q

If the pad is saturated, what do we do?

A

Ask the mom about it, see how long she’s had it in, etc. Educate educate educate!

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9
Q

If the pad is saturated within an hour, that’s too much or too little?

A

TOO much.

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10
Q

Saturated pad = whole bad. T/F?

A

True

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11
Q

15 minutes = excessive bleeding. T/F?

A

TRUE

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12
Q

Scant bleeding - how much in an hour?
Small/light - how much in an hour?
Moderate - how much in an hour?
HOLY FUCKING SHIT/EXCESSIVE - how much in an hour?

A

Scant = 2.5 cm in an hour.
Small/light = 10 cm in an hour.
Moderate = 10-15cm in an hour.
HOLY FUCKING SHIT/EXCESSIVE = >15cm.

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13
Q

The cervix will go back to almost closed. T/F?

A

TRUE

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14
Q

By one week, the mom is dilated to __ cm with edema present for up to ____ to ____ Months.

A

1cm.

3-4months.

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15
Q

It takes __ to ___ weeks for the epithelial cells of the vagina to be repaired.

It will regain tone but won’t go back to normal. T/F?

A

6-10 weeks.

True!

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16
Q

You can have a baby immediately after birth - T/F?

A

FALSE - wait at least 6 weeks!

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17
Q

Cardiac - ___ ml of blood is shifted back into circulation after birth.

A

500ml

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18
Q

Due to the excess fluid/blood/etc. in the body during pregnancy, how does the body get rid of it?

A

SWEAT and pottying a ton!

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19
Q

It’s normal to have a slightly elevated WBC after the end of the pregnancy. T/F?

A

TRUE

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20
Q

Hct takes 4-6 weeks to return to normal, unless there’s excessive blood loss. T/F?

A

TRUE

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21
Q

Increased coagulation takes about 4-6 months to return to normal. T/F?

A

FALSE - 4-6 weeks.

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22
Q

Progesterone will make your bowel sludgy for a few days after, so what are women at a risk for?

Normal BM’s return in __ to ___ days.

A

Constipation - 8-14 `days.

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23
Q

Takes about 4 weeks for the urinary system to return to normal. T/F? Until then, they might lack sensation, etc.

A

TRUE

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24
Q

Acetone is sometimes normal in the urine. T/F?

A

TRUE

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25
Q

stress continence disappears at about __ weeks.

A

8

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26
Q

Sometimes, women can have aches and pains that come out of nowhere a few days after pregnancy, right?

A

YES

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27
Q

Stretch marks disappear, but skin marks like linea nigra never fade. T/F?

A

FALSE - linea nigra and such will disappear BUT stretch marks do not disappear (they just get lighter/silvery)

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28
Q

Hair loss - bald spots can happen, but not often. You’ll look normal at about ___ months.

A

5

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29
Q

Breastfeeding can hold menstruating out, but it’s not contraception. T/F?

A

TRUE

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30
Q

Quarter sized clots - ok or bad?
Golf ball sized clots - ok or bad?
Grapefruit size - ok or bad?

A

Quarter sized clots - ok
Golf ball sized clots - ok, as long as they aren’t often.
Grapefruit size - BAD

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31
Q

Prolactin increase milk production __ to ___ days after delivery.

A

2-3 days

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32
Q

If the mom starts pumping too early, the body will think “okay, great, I’ll make even ____ (more or less?)”

A

MORE, so don’t encourage a non-breastfeeding mom to pump.

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33
Q

Oxytocin is needed for let-down. T/F?

A

TRUE

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34
Q

10-13 pounds are lost during birth itself, then 5-8 pounds for diruesis, 2-3 for lochia, and 2-3 for inversion. T/F? She’ll be within 1kg of her pre-pregnancy weight within how long?

A

TRUE

one year.

35
Q

Fundal check - push on uterus and then push…do we support the ligaments?

A

YES

36
Q

Uterus - shouldn’t be hard. T/F?

A

FALSE - it should be. If it isn’t, massage that fucker.

37
Q

If the fundus isn’t midline, then maybe she needs to ___?

A

PEE

38
Q

IV - should be left in for how long after birth?

A

6 hours.

39
Q

Pneumonia vac - over the age of 19 and you have to have a risk factor, like asthma. T/F?

A

TRUE

40
Q

What is BUBBLE-HE?

A

For focused assessment -

Breasts
Uterus
Bladder
Bowels
Lochia
Episiotomies
Homan's Sign
Emotional state
41
Q

What are some parts of the chart review?

A

Gravida/para, time of delivery, type of delivery, episiotomy or lacerations, anesthesia/meds given, surgery?, history, meds in general, food/drug allergies, condition of infant, lab data, need for rhogam, immunizations, risk factors for bleeding

42
Q

What are some parts of the initial assessment?

A

Vital signs, skin color, fundus, lochia, perineum, pain, IV, urinary output, level of feeding and ability to stand.

43
Q

What are some comfort measure we can give?

A

Ice packs, sitz bath, perineal care, topical medications, pain medications, promoting bladder elimination and providing fluids and food.

44
Q

Ice pack for the first __ hours, then warm water.

A

24 hours.

45
Q

Episiotomy - patients need to pat dry with toilet paper, and they should not WIPE dry. T/F?

A

TRUE

46
Q

For episiotomy patients, what are some sprays they should use?

A

Demaplast (Benzacaine) spray - it’s cold and numbing. Use it every other time they go to the bathroom.
The opposite time is hydrocortizone.
Witch hazel pads every time.

47
Q

What are some post-partum pain meds?

A

Ibuprofen and naproxen - but might have norco, tylenol #3 for 3rd or 4th degree episiotomy repair.

48
Q

C-section - after, they might get what med for pain? (Hint, starts with P!)

A

Percocet

49
Q

What are some assessments after a c-section?

A

Pain relief, respirations, abdomen, I/O

50
Q

C-Section - I/O until catheter comes out. T/F?

A

True

51
Q

24 hours after c-section - resume normal activities. T/F?

A

True

52
Q

Encourage use of straws after c-section - T/F?

A

FALSE - it increases gas pain.

53
Q

What do we do for the first 24 hours after c section?

24 hours after?

A

First 24 = providing pain relief, overcoming immobility, providing comfort.

After 24 hours - resuming normal activities, assisting with feeding, preventing abdominal distention, teaching for discharge

54
Q

Handwashing - is it important?

A

YES

55
Q

Are cabbage leaves good for breast engorgement?

A

YES

56
Q

Babies can something eat every 30 minutes..or two hours. T/F?

A

True - so it can disrupt rest for a mom.

57
Q

How long until women should resume sex?

A

AT LEAST 6 weeks.

58
Q

What are some signs and symptoms that should be reported?

A

Fever, localized area of redness/swelling/or pain in either breast, persistent abdominal tenderness, feelings of pelvic fullness or pressure, persistent perineal pain, frequency/urgency/burning on urination, abnormal changes in lochia, localized tenderness/redness/warmth in the legs, redness/separation/ or edema of abdominal incision or foul drainage from incision

59
Q

Localized area of redness in breast = what?

A

Probably mastitis

60
Q

Pelvic fullness might be a what?

A

Retained placenta

61
Q

Persistent perineal pain might be a what?

A

Hematoma

62
Q

Lochia normally goes to yellow at the end. What should we do if it turns to red?

A

Report it!

63
Q

Bonding - two ways. T/F?

A

FALSE - it is one way. Parent to child.

64
Q

Attachment - one way?

A

FALSE - it is two ways. Parent to child and back.

65
Q

What are the three puerperal phases?

A

Taking in, taking hold & letting-go

66
Q

What is the taking-in phase?

A

You’re just focused on your own needs as the mother. Usually lasts less than a day.

67
Q

What is the taking hold phase?

A

Lasts several days, attention shifts towards baby. They are taking care of the baby but forgetting more about themselves, like “oh, I forgot to wash my hair today!”

68
Q

What is the letting-go phase?

A

Letting go of their old life, or maybe the pregnancy didn’t end well? Maybe the kid went to NICU? All that.

69
Q

What’s engrossment for the fathers?

A

They realize it’s real and become all excited and involved with the bambino!

70
Q

Kids - might regress once the baby comes. T/F?

A

TRUE

71
Q

What are some factors that affect family adaptation?

A

Discomfort and fatigue, knowledge of infants needs, previous experience, expectations about the newborn, maternal age, maternal temperament, temperament of the infant, support system, birth experience.

72
Q

Hispanic, Middle Eastern, and Asian women - hate privacy. T/F?

A

FALSE - they want more privacy.

73
Q

Muslims - value modesty. T/F?

A

TRUE

74
Q

Hispanic/Native American women - they might have increased direct communication. T/F?

A

FALSE - they will probably have decreased direct communication.

75
Q

Asian/Hispanic women - follow traditions. T/F?

A

True

76
Q

Indian women - return home for 16 weeks. T/F?

A

TRUE

77
Q

Phillipines - mom comes to take care. T/F?

A

TRUE

78
Q

Mother in law in Korea - she stays away. T/F?

A

FALSE - she comes to care for baby and mom.

79
Q

Restriction - 40 days after for Russian moms. T/F?

A

True

80
Q

Laotian women - one month after - near a fire- T/F?

A

TRUE

81
Q

Native American women - 20 days of rest or until cord falls off. T/F?

A

True

82
Q

Asian/Hispanic women - they have to stay cold after birth. T/F?

A

FALSE - they stay warm.

83
Q

Mexican women after birth - they tay warm, eat no spicy foods, and do nothing for 40 days. T/F?

A

True

OB - Spring 2016 (18 decks)

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