313 Exam 2

Front 1

Involution

Back 1

Return of the uterus to a non-pregnant state after birth

Front 2

size of uterus at 24 hours post-partum

Back 2

same size as at 20 weeks

Front 3

weight of uterus at 6 weeks postpartum

Back 3

50-60g

Front 4

what stimulates massive growth of uterus?

Back 4

estrogen and progesterone

Front 5

autolysis

Back 5

self destruction of excess hypertrophied tissue

Front 6

subinvolution

Back 6

failure of uterus to return to nonpregnant state

Front 7

most common causes of subunvolution

Back 7

retained placental fragments and infection

Front 8

how is postpartum hemostasis achieved?

Back 8

compression of intramyometrial blood vessels

Front 9

what makes uterus contract

Back 9

oxytocin (Pitocin)

Front 10

two ways to get oxytocin postpartum

Back 10

injection & breastfeeding

Front 11

afterbirth pains

Back 11

uncomfortable cramping early puerpenium; more noticeable with large baby

Front 12

endometrial regeneration is complete by postpartum day...

Back 12

day 16

Front 13

regeneratio of the placental site usually complete at week...

Back 13

week 6

Front 14

Lochia

Back 14

post-childbirth uterine discharge: bright red (lochia rubra) with small blood clots.

Front 15

Lochia lasts how long

Back 15

about 2 hours

Front 16

Lochia serosa

Back 16

Old blood (brown), serum, leukocytes & tissue debris

Front 17

Lochia serosa, how long?

Back 17

22-27 days

Front 18

Lochia alba

Back 18

yellow to white: leukocytes, decidua, epithelial cells, mucus serum, and bacteria. scant if having recieved oxytocin

Front 19

Lochia alba lasts...

Back 19

10-14 days

Front 20

Lochia general:

Back 20

pools in vagina when lying in bed; upon standing, gush of flow. most women stop at 3-4 weeks but some at 6

Front 21

Nonlochial bleeding

Back 21

discharge spurts from vagina: may be tears in vagina if bloodk continues to be bright and excessive.

Front 22

Cervix shortens, becomes firm and regains form in (how long?)

Back 22

2-3 days

Front 23

Cervix closed by...(how long)

Back 23

2 weeks

Front 24

Vagina returns to normal size in...(how long)

Back 24

6 weeks

Front 25

dyspareunia

Back 25

coital discomfort

Front 26

How long to regain tone of pelvic floor muscles?

Back 26

6 months

Front 27

What to do to regain tone of pelvic floor muscles?

Back 27

Kegel exercises

Front 28

Pelvic relaxation

Back 28

lengthening and weakening of the fascial supports of pelvic structures

Front 29

What are the pelvic structures?

Back 29

uterus, upper posterior vaginal wall, urethra, bladder rectum

Front 30

Decrease in placental hormones

Back 30

human chorionic somatomammotropin, estrogen, cortisol, insulinase, estrogen, progesterone

Front 31

puerperium

Back 31

The time immediately after the delivery of a baby

Front 32

Menstrual flow

Back 32

usually heavier for 3-4 cycles

Front 33

diastasis recti abdominis

Back 33

seperation of abdominal wall muscles usually caused by overdistention of the abdoman because of large or multiple fetuses

Front 34

Urinary & kidney function returns in...

Back 34

approximately 2-8 weeks

Front 35

Postpartal diuresis

Back 35

usually at nighttime for 2-3 days

Front 36

Bladder tone usually restored in

Back 36

5-7 days

Front 37

Appetite

Back 37

strong after giving birth

Front 38

bowel evacuation

Back 38

may not occur for 2-3 days

Front 39

Colostrum

Back 39

clear, yellow fulid expressed from the breast before it becomes milk (72-96 hours after birth)

Front 40

Noduels

Back 40

associated with milk production

Front 41

measures to relieve breast engorgment discomfort

Back 41

suppoort bra, ice packs, fresh cabbage leaves, analgesics, avoid nipple stimulation

Front 42

blood loss as a result of birth

Back 42

500ml via vaginal birth or 2X that for cesarian

Front 43

3 protection factors that increase circulatory blood volume

Back 43

1. elimination of uteroplacental circulation: reduces size of the vascular bed.
2. loss of placental endocrine funtion: removes stimulus for vasodilation.
3. Mobilization of extravasculare water.

Front 44

Cardiac output returns to normal in....

Back 44

6 weeks

Front 45

Temperature

Back 45

may rise for 24 hours (dehydration) and then return to normal

Front 46

Pulse

Back 46

returns to normal within a few days

Front 47

respirations

Back 47

decrease to return to normal within 6-8 weeks.

Front 48

Blood pressure

Back 48

orthostatic hypotension can develop in the first 48 hours

Front 49

Pueperal sepis

Back 49

suggested if a rise in temp lasts for more than 2 days

Front 50

rapid pulse rate could mean

Back 50

hypovolemia due to hemorrhage

Front 51

hypoventilation

Back 51

may follow after epidural, cesarean or spinal block

Front 52

High blood pressure may reslut from

Back 52

excessive us of vasopressor or oxytocin

Front 53

Neurologic changes

Back 53

nubmness and tingling of fingers disappear

Front 54

headaches could be caused from

Back 54

postpartum-onset preeclampsia, stress, CSF leakage,

Front 55

Integumentary changes

Back 55

dholasma disapears; hyperpigmentation of areolae and linea nigra may not regress completely; stretch marks may not disapear; spider nevi may persist, hair growth slos, hair loss, fingernails return to normal, profuse diaphoresis occurs immmediately postpartum.