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31 Cards in this Set

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Assessment of lochia
day 1-3
lochia rubra- boody;small clots, fleshy, earthy color
Assessment of lochia
Day 4-10
decreased amount; serosanguineous; pink or brown
Assessment of lochia
day 11-21
white, cream colorod or light yellow; decreasing amounts
Invlution def:
the changes that the reproductive organs undergo after childbirth
Involution
Process
1) contraction of muscle fibers
2) catabolism
3) regeneration of the uterine epithelium
Decent of uterus
after 24 hours
1 cm per day
Lacerations of the Vagina
1st degree
involves the vaginal mucousaor perineal skin
Lacerations of the vagina
2nd degree
involves vaginal mucousa, perineal skin and deeper tissues which may include the muscles of the perineam
Lacerations of the vagina
3rd degree
same as 2nd degree but also invloves anal schpincter
Lacerations of the vagina
4th degree
extends through the anal schincter into the rectal mucousa
Increase in maternal cardiac output is caused by
1) increased blood flow back to the heart when blood from uteroplacental unit has returned to central circulation
2) the mobilization of excess extracellular fluid into the vascular complartment
Postpartum
WBC
marked increased (to 30,000) back to normal by 4-7 days postpartum
Postpartum
realxin
-relaxin levels decrease to help pelvis and hips return to normal position, but may cause achiness in these areas
preeclampsia s/s
HA
blurred visison
photophobia
abd pain
protenuria
resumption of menstration
-usually within 7-9 weeks after childbirth
-if lactating- 12 weeks to 18 months
Prolcatin
initiates breast fmilk within 2-3 days
oxytocin
necessary for milk ejection or "let down)
Postpartum weight loss
-about 5.5 lbs during childbirth
-5-8.8 lbs is lost by diuresis nd involution
Focussed assesment
post vsg birth
vitals
fundus
lochia
perineum
bladder elimination
breasts
lower extremities
HIgh risk for Hemorrhage
Multiparity
overdistension of the uterus
precipitous labor
prolonged labor
rtained palcenta
placenta previa/abruptos placenta
induction/augmeantaion
admin of tocolytics to stop contractions
operative procedures
High risk for infection
Operative procedires
multiple cervical exams
prolonged labor
manual extraction of placenta
DM
indwelling catheter
Anmeia
Signs of distended bladder
-fundus is above baseline level(when empty)
-displaced fundus
-excessive lochia
-bladder discomfort
-buldge of bladder above symphysis
-frequent voidings of less tham 150 mL
REEDA
used for perineuam assessmen
R- redness
E- ecchymosis
E- edema
D- discharge
A- approximation
Post epidural repirations- if declining or less than 12
- nptify anesthesiologist immediatly
-elevate HOB
-administer O2 and apply pulse ox
-follow proticol for narcan
-observe for reoccurance of decreased resp
-narcan effects pain relief
paralytic ileus
s/s
-abd distension
-absent or decreased bowels
- no passage of flatus or stool
First 24 hours Postpartum C section
interventions
- Providing pain relief
-overcoming effects of immobility( BR for 8-12 hours)
After 24 hours Interventinos
C Section
-resuming normal activities
-assist with infant feeding
-preventing abd distention
-
Measures to supress lactation
-well fitted support bra or binding
- ice
Post patum s/s that should be reported
-fever
-redness, swelling or pain in either breast that is not relived by support or analgesics
-perisistant abd tenderness
- feelings of pelvic fullness or pressure
- persistant perineal pain
-frequency, urgency or burning on urination
-change in character of lochia
-localized redness, tenderness or warmth of the legs
-separation of of or foul drainage from c sect ins
Post partum blues
time
begins at first week and lasts no longer than the 2nd week
Post partum blues
s/s
insomnia
irritabilty
fatigue
tearfulness
mood instability
anxiety