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117 Cards in this Set
- Front
- Back
postpartum
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after delivery |
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How many stages are in Labor?
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four stages
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_is a series of events during which a woman's uterus contracts and expels a fetus and completes the birthing process. |
Labor |
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What happens during stage I of Labor?
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Dilation: uterine contractions cause the cervix os of the cervix to open and move the fetus downward into the birth canal. |
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How many phases do Stage I of labor have?
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three: latent, active, and transitional |
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What happens during stage II of labor?
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Expulsion: uterine contractions continue and increase in intensity until the baby is delivered through the vaginal opening |
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What happens during stage III of labor? |
Placental: uterine contractions expel the placenta after the delivery of the newborn |
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What happens during stage IV of labor? |
Recovery: uterine contractions continue and close off open blood vessels to prevent excessive blood loss. |
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How long does postpartum last?
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last until the end of the sixth week after the birth |
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CNM |
certified nurse midwife |
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NP |
nurse practitioner |
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PA
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physician assistant |
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What is a birthing room? |
a room where both the labor and the delivery take place |
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LDRP
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labor/delivery/recovery/postpartum rooms |
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_is a written document in which the expectant mother expresses her desires for labor and birth. |
birth plan |
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What are some items that may be included in the birth plan? |
-The woman's feelings about having an intravenous (IV), electronic fetal monitoring, or an episiotomy -The type of pain-relief measures the woman desires |
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What is the nurse's role when helping the mother with the birthing plan?
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to inform the woman or couple preparing a birth plan of the policies of the birth setting and birth attendant, and of the need for flexibility if complications develop.
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_is a term used to compare the position of the fetal spinal cord (the "long part") to that of the woman. |
Lie |
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What is the normal lie of the fetus? |
longitudinal (up and down), which means the fetal spine is parallel to the woman's |
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_the fetus is lying crosswise in the uterus and cannot be delivered until the lie is altered.
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transverse lie |
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_refers to the body part of the fetus that lies closet to the pelvis and will enter the birth canal first. |
presentation |
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What is the usual presenting part? |
the head: aka the cephalic presentation |
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What are the types of cephalic presentations?
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vertex, face, and brow |
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_is when the buttocks, foot, or knee is the presenting part.
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breech presentation |
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_is the term used when the fetal head has moved downward in the birth canal until it can no longer be pushed up and out of the pelvis. |
Engagement |
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another name for "first time delivery" |
nulliparous |
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In nulliparous women, engagement often happens when?
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before the onset of labor |
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Another name for having a history of more than one birth |
parous |
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In parous women, engagement usually occurs when? |
during labor |
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_refers to the relationship between standardized points on the presenting part of the fetus to a designated point on one of four quadrants of the woman's pelvis. |
Position
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refers to a woman who has never been pregnant
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nulligravida |
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refers to a woman who has never delivered a live child; also seen as "para 0" |
nullipara |
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relates to the woman who is pregnant for the first time |
primigravida |
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is the term for a woman who has had more than one pregnancy |
multigravida |
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is the term for a woman who has given birth to one child
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primipara |
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is a woman who has given birth to more than one viable infant |
multipara |
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What are the three breech positions? |
complete breech, Frank breech, kneeling |
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the fetus has both legs drawn up, bent at both the hip and the knee |
complete breech |
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Either one or both legs are extended at the hip, flexed at the knee |
Frank breech |
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breech type Either one or both legs are extended both at the hip and knee |
Footling breech |
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In all types of ____, the sacrum is the assigned point. |
breech presentations |
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the umbilical cord could prolapse bc there is so much empty space with the uterus. |
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What are the common variables of labor, know as the 4 P's?
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passage, passenger, powers, psyche |
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The passage includes
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the diameter of the body pelvis and its soft tissues |
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The passenger includes
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the fetus, umbilical cord, and placenta |
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The powers include
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the uterine contractions |
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the psyche include
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the process of birthing, the attitude and behaviors of the parents, and the evaluation process of the stages of labor |
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_is the settling of the fetus into the pelvis |
lightening |
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_is usually painless, short, and irregular. They are also known as false labor. |
Braxton-Hicks contraction |
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A mucous plug seals the cervix during pregnancy, Just before labor, the cervix opens slightly and this plug dislodges. At the same time, some capillaries of the cervix rupture, staining the sticky mucus a pinkish color. The process is called__ |
the show or bloody show |
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What does "the show or bloody show" indicate |
labor is about to begin |
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contractions |
True- Regular, rhythmic |
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True vs False duration, frequency, and intensity |
True-increases and becomes closer and stronger over time |
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True vs False Effect of position or activity change |
False-contractions lessen True- Becomes stronger with ambulation or activity |
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true vs false Location where felt |
True- starts in back, radiate to abdomen |
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Cervical change and presence of "show" |
True- progressive effacement and dilation, show is usually present |
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Contractions help create _a_ and _B_ of the softened cervix. |
b- dilation (opening) |
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What is the most important difference between true and false labor is
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whether or not the cervix changes |
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_of the uterine muscles bring about the birth of the fetus.
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contractions |
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When the contraction ends and the uterus is at rest, the muscles remain slightly shorter that when it started. This is called_
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retraction of the muscles. |
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Three stages of labor contractions
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2. Acme 3. Decrement |
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Increment phase |
This phase, during which the contraction builds from the resting phase to full strength, is longer than the other two combined |
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Acme phase |
This is the time during which the contraction is at full intensity. This phase becomes longer as labor progresses
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Decrement phase |
during this phase, the uterine contraction eases, until the resting state is achieved. |
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The time between contractions is called_ and is equally as important as the contractions themselves. |
relaxation time or rest interval |
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The fetus lies in a two-layered sac filled with amniotic fluid commonly called__
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"bag of waters" |
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The breaking of the bag of water without medical intervention is termed
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spontaneous rupture of membranes (SROM) |
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In about 75% of births, the birth attendant may perform artificial rupture of the membranes (AROM), a procedure called |
amniotomy |
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amniotomy is performed using a special hook called |
amniohook |
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What should you do if you see any yellow, green, or cloudy amniotic fluid? |
report immediately! Normal amniotic fluid is clear and colorless, and slightly salty odor. |
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Yellow or green amniotic fluid may indicate |
the fetus has passed meconium |
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meconium is |
stool passed by the fetus |
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White or cloudy amniotic fluid may indicate what |
pus in response to infection |
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What is the Nitrazine test? |
a simple test that determines if the amniotic sac has ruptured. it detects the pH of the fluid |
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What color will the Nitrazine strip turn if the pH is correct for amniotic fluid?
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blue, but it may also turn blue for blood and urine so it's important not to touch other body fluids with the paper. |
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What do you record when providing nursing care to a woman whose membranes has ruptured?
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time, method of rupture- SROM or AROM, color of fluid, and fetal heart rate |
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What is an important nursing intervention that should be performed once the membranes have been ruptured? |
get a baseline temperature and check her temp every two hours until delivery |
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What is the first stage of Labor? |
Dilation |
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_ begins with the onset of true labor contractions and ends with complete cervical effacement and dilation. |
stage I of labor (dilation)
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Stage I of dilation is divided into three phases: ?
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latent, active, and transitional |
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latent stage freq of contractions, duration, intensity, and dilation |
5-20 min contractions, 30-50 sec duration, irregular & mild intensity, 0-4cm dilation |
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Active phase freq, duration, intensity, and dilation |
2-4 min contractions, 45-60 sec duration, reg (moderate to strong) intensity, and 4-8 cm dilation |
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transitional phase freq, duration, intensity, and dilation |
2-3 min freq, 60-90 sec duration, reg (very strong) intensity, 8-10 cm dilation |
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What are the two distinct changes that occur during stage I |
effacement and dilation |
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_refers to the thinning of the cervix |
effacement |
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_the cervical os(opening), normally held close in a tight circle, begins to open. |
dilation |
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What is Stage II of the stages of labor |
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_begins with the complete cervical effacement and dilation and ends with the expulsion of the fetus. |
stage II (expulsion)
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The rectum dilates, the perineum bulges, and the top of the fetal head appears. This know as
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crowning |
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What is Stage III of the stages of labor? |
Stage III (placental) |
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_extends from the time the newborn is delivered until the placenta and membranes are expelled. |
Stage III (placental)
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What is Stage IV of the stages of labor?
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Stage IV (recovery) |
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_includes the first 1 to 4 hours following the expulsion of the placenta. During this time, the woman's body begins the process of involution. |
Stage IV (recovery) |
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_ is the process of the woman's reproductive organs returning to their normal pregnant size. |
involution
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What are the two critical phases in Stage IV (recovery)
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involution and bonding
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What is an extremely important question that you should ask the woman upon admission that can prevent a life threatening problem? |
allergies to betadine, lidocain, and any other drugs, and latex |
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Why should you ensure the woman's bladder is empty?
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a full bladder prevents the fetal head from descending into the woman's pelvis and thereby slows labor's progress. It may also result in trauma to the bladder. |
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A small catheter is inserted into the epidural space within the spinal column. This is called _
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epidural anesthesia, aka lumbar epidural block |
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__is rarely used because the client receiving this type of anesthesia is asleep when the newborn arrives. Babies born this way may not breathe spontaneously and may be difficult to awaken. |
general anesthesia |
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What should you report for a woman receiving anesthesia that can be fatal to the woman and/or the fetus?
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-Inability to move the legs, numbness in the legs, ringing in the ears, dizziness, metallic taste, hypotension or seizures |
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What is the normal fetal heart rate (FHR)? |
120-160 |
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_ is to record the rate and quality of the fetal heartbeat during contraction and relaxation.
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fetal monitor |
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a pressure-sensitive device used to monitor the frequency of the contractions.
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tocodynamometer |
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upper curve of the uterus
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fundus |
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_is the vaginal discharge that occurs following delivery. |
Lochia |
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is seen for the first 2 days, It is mostly red and bloody, It should smell like blood (slightly metallic); a foul odor indicates infection.
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Lochia rubra |
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_starts after the bleeding diminishes, The color of the lochia changes to pink or brown-tinged for approximately the next 7 days. It has a slightly earthy odor.
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Lochia serosa |
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which is yellow or white, starts on about day 10. At this point, the lochia has decreased greatly in amount. It has an earth smell. |
Lochia alba |
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a thin yellowish secretion that provides vitamins and immune substances that protect the newborn against infection. |
colostrum |
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the secretion of breast milk
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lactation |
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What two hormones are responsible for the production of milk?
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prolactin and oxytocin |
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_is the response of the breast to the presence of an increased volume of milk and a sudden change in hormones. |
engorgement
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What measures help relieve engorgement for nursing mothers?
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-wearing a supportive bra, freq breastfeeding, applying warm packs to the breast for 15 minutes before nursing or standing in the shower
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What measures help relieve engorgement for non-nursing mothers?
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wearing a supportive bra, avoiding excessive fluid intake, placing cold packs on her breasts 3 to 4 times per day, avoiding stimulation (hot showers), using medications (acetaminophen) as prescribed for discomfort
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What are some abnormal urinary system findings for a mother after birth?
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voiding in small amounts, residual urine, dysuria, bladder infection, urinary retention |
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What are after-pains? |
painful cramps that occur bc the uterine muscles are contracting back to normal size |