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24 Cards in this Set
- Front
- Back
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atony
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absence or lack of usual muscle tone
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Afterpains
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cramping pains after childbirth, caused by alternating relaxation and contraction of uterine muscles.
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catabolism
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process that converts living cells into simpler cmpds. Involved in involution of the uterus after childbirth.
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decidua
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The endometrium during pregnancy. All except the deepest layer is shed after childbirth.
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dyspareunia
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difficult or painful coitus in women.
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engorgement
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swelling of breasts, resulting from increased blood flow, edema, and presence of milk.
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episiotomy
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surgical incision of perineum to enlarge the vaginal opening.
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fundus
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top of the uterus - the part that is farthest from the cervix
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involution
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retrogressive changes that return the reproductive organs, particularly the uterus, to their nonpregnant size and condition.
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Lochia
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lochia rubra - mostly blood (first 3 days) to lochia serosa - serous exudate, leukocytes and cervical mucus (>3days) to lochia alba - leukocytes, decidual, epithelial cells, fat, mucus, bacteria (~11th day to ~21days)
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milk-ejection reflex
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release of milk from alveoli in to ducts, also called letdown reflex.
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3 processes of uterine involution
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1. contraction of m. fibers 2. catabolism reduces individual cell size 3. regeneration of uterine epithelium
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descent of the fundus
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approximately 1cm/day
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Amounts of lochia
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Scant: <1" Light: 1-4" Moderate: 4-6" Heavy: saturated pad in 1hr Excessive: saturated pad in 15min
Also lochia is less in CB b/c some of endometrial lining is removed in surgery |
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Cervical changes after childbirth
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shape of external os is permanently changed (remains slitlike rather than round - as in nulliparous)
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CV System changes in:
1) CO 2) Plasma Vol 3) Blood Values 4) Coagulation |
1) CO increases due to increase in flow of blood back to heart when blood from uteroplacental unit returns to central circulation - this increase is stroke volume causes bradycardia (50-60bpm during early postpartum)
2) Returning plasma vol thru diuresis (increased excretion of urine) and diaphoresis (profuse perspiration). 3) blood values: WBC return to norms by day 6 after birth. 4) elevations in clotting factors continue for several days or longer leading to continued risk of thrombus formation. |
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Urinary System
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during birth the urinary system can become traumatized and edematous due to the decent of fetal head, resulting in decreased sensation of full bladder.
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Urinary retention and overdistention can cause:
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1) UTI due to urinary stasis
2) postpartum hemorrhage because a full bladder displaces and prevents the contraction of the uterus |
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Milk production
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begins 2-3 days after childbirth due to the release of prolactin
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How long do women stay in a birth facility after childbirth:
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1) vaginal: 48 hours
2) CB: 96 hours |
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Initial pp assessment should include:
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vitals, skin color, fundus (location, firmness, lochia (amnt, color), perineum (edema, episiotomy), pain, IV infusion type, urinary output, status of abdominal incision and dressing, level of sensation if regional anesthesia was used
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Chart review includes:
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G/P, time and type of delivery, degree of episiotomy, anesthesia or meds used during labor, med & surgical Hx
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Perinium is assessed using the acroynym:
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(R)edness
(E)dema (E)cchymosis (bruising) (D)ischarge (A)pproximation |
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Homan's Sign
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discomfort in the calf with sharp dorsiflexion is a (+) sign, indicating DVT...along with redness, tenderness or warmth of leg
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