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80 Cards in this Set
- Front
- Back
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Three divisions of the uterus are
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corpus (fundus)
isthmus cervix ( internal os, cervical canal, eternal os) |
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The post partum period lasts
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6 weeks or 42 days
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puerperium is
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the return of the reproductive organs to their non-pregnant state
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organs never return to
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pre-preganant state
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retrogressive changes
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are changes that result in an organ etc, going back to its non-pregnant state
ex. uterus, cervix |
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progressive
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changes that keep moving forward after delivery
ex. breasts |
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reproductive postpartum changes
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uterus
cervix vagina perineum breasts endocrine |
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non-reproductive postpartum changes
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abdomen
urinary gastrointestinal musculoskeletal integumentary vascular |
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uterine involution
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the rapid return of the uterus to the non-pregnant state
happens immediately pp |
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pregnancy is a
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vasodilation state
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What causes uterine contractions after placenta detaches
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oxytocin
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Where is the fundus immediately after birth
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half way between the pubic synthesis and umbilicus
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Over the first 12 hours after birth the fundus will rise to
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one finger breadth above the umbilicus
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Between 12-24 hours the fundus
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goes down a predictable rate, 1-2 finger breaths
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at 24 hours the funds should be
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at the umbiliuc or 1 finger breadth below
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The first hour after birth
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is the most dangerous
highest risk of hemorrhage |
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uterine atony is
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a uterus without tone
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uterine atony can be cause by
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lack of oxytocin
retained placenta infection |
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subinvolution
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failure or delay of the uterus to return to the non-pregnant state
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pitocin is administered to all women
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post partum
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For multiparas women contractions postpartum are
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stronger
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Reproductive changes post partum include
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sloughing of off uterine lining
reduction in pregnancy hormones progesterone production stops till first ovulation endometril regeneration muscle tone recovery build up breast tissue for lactation |
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Endometril regeneration occurs within
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6 weeks of delivery
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Lochia is
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uterine discharge of blood and waste
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Three types of Lochia
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Lochia Rubra
Lochia Serosa Lochia Alba |
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Lochia Rubra is seen
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first 1-3 days pp
red |
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Lochia Serosa is seen
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3-10 days pp
brownish, lighter decreased amount |
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Lochia Alba is seen
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10 days - 3 wks pp
can last up to six weeks pp |
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Heavy
Saturated Soaked are descriptions that are |
ABNORMAL
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What hormones decreases after birth
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human placental lactogen
human chorionic gondadotropin estrogen progesterone cortisol |
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What hormones are increased/ produced right after birth
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oxytocin
prolactin |
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oxytocin is responsible for the _____ of milk
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let down of milk
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prolactin is responsible for the _______ of milk
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production
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Humna Placental Lactogen
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promotes normal nutriton and growth of the fetus
promotes maternal breast development for lactation |
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HUman Chorionic gondadotrpoin
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helps to maint the corpus luteum to persist for the first 6-8 weeks and helps to secrete progesterone and estrogen
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What hormones are increased/ produced right after birth
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oxytocin
prolactin |
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estrogen
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causes enlargement of the breast
growth of the ductal system of the breast enlargement of the extrnal genitalia |
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oxytocin is responsible for the _____ of milk
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let down of milk
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progesterone
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promotes normal continuation of the pregnancy
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prolactin is responsible for the _______ of milk
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production
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cortisol
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increase during pregnany and helps with metabolism of glucose, proteins and fat
anti-inflammatory, helps prevent rejection |
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Humna Placental Lactogen
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promotes normal nutriton and growth of the fetus
promotes maternal breast development for lactation |
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Cervis is back to its pre-pregnant size by day
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7
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HUman Chorionic gondadotrpoin
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helps to maint the corpus luteum to persist for the first 6-8 weeks and helps to secrete progesterone and estrogen
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With every 250ml of blood lost
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there is a 4 point decrease in hematocrit and 1 g decrease in hemoglobin
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estrogen
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causes enlargement of the breast
growth of the ductal system of the breast enlargement of the extrnal genitalia |
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progesterone
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promotes normal continuation of the pregnancy
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cortisol
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increase during pregnany and helps with metabolism of glucose, proteins and fat
anti-inflammatory, helps prevent rejection |
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Cervis is back to its pre-pregnant size by day
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7
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With every 250ml of blood lost
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there is a 4 point decrease in hematocrit and 1 g decrease in hemoglobin
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Normal blood loss in vaginal delivery
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up to 500cc
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Normal blood loss with C-section
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up to 1000cc
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Above how many cc's with vaginal delivery is considered hemorrhage
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800cc
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Increased cardiac output postpartum results from
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uteroplacental blood returns to maternal central circulation
decreased pressure on blood vessels mobilization of excess fluid |
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Postpartum body gets rid of extra fluid by
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diuresis -- 3,000cc's per day
diaphoresis- especially at night |
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Elevated cardiac output remains for at least ___________ and returns to pre-pregnancy levels within ____________
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48 hours
2 weeks PP |
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During postpartum period women experience
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increased appetite
delayed bowel exacuation urinary retention hemoconcentration elvated WBC stabilization of joints reverse of hyperpigmentation hair "loss |
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hemoconcentration results fromd
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during pregnancy volume increases faster then production of RBC, leading to hemodilution hence after birth you have hemoconcentration
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Normal WBC
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3.5-9
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WBC can go as high as
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15 during pregnancy
also typical immediately postpartum |
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Relaxint
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relaxes the joint during pregnancy giving leeway for delivery
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temperature within the 1st 24 hours post partum is
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normal
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uterus not being midlines is usually because
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mother has a full bladder
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If a mother is bleeding postpartum first thing you do is
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ASSESS
then massage the fundus |
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Holmans Sign
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check for a DVT
flex foot and feel for pain in the calf |
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During Fundal assessment woman should be
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lying flat
f |
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Normal fundal assessment should include
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unding should be midline
fundus should be firm not boggy fundus 1-2 FB below umbilicus |
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1st degree laceration
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involves the superficial vaaginal mucosa or perineal skin
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2nd degree lacerations
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involves the vaginal mucosa, perineal skin, and deeper tissues, which may include muscles of the perineum
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3rd degree lacerations
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same as second but involves the anal sphincter (goes to the edge but not through the anal sphincter)
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4th degree lacerations
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extends through the anal sphincter into the rectal mucosa
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periurethral area
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laceration in the area of the urethra may cause a woman to have difficulty urinating after birth
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if a uterus is contracting normally and there is still a lot of bleeding
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there may be a cervical tear
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tears are communally seen
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at 2 and 10 for cervical lacerations
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Nothing in the Vagina for
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6-8 weeks
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How much pitosin is given postpartum
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20 units ( 1000CC) @ 100/125 cc times 2
40 units total |
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Phases of maternal PP Adjustment
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Phase 1- dependent
phase 2 - dependent - independent phase 3 - interdependent |
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Paternal adjustment
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stage 1: expectations
stage 2: reality stage 3: transition to mastery |
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postpartum blues occur in
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50-80% of mothers
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baby blues peak within the
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first week and usually resolve by 2nd week
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