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31 Cards in this Set
- Front
- Back
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Assessment of lochia
day 1-3 |
lochia rubra- boody;small clots, fleshy, earthy color
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Assessment of lochia
Day 4-10 |
decreased amount; serosanguineous; pink or brown
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Assessment of lochia
day 11-21 |
white, cream colorod or light yellow; decreasing amounts
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Invlution def:
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the changes that the reproductive organs undergo after childbirth
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Involution
Process |
1) contraction of muscle fibers
2) catabolism 3) regeneration of the uterine epithelium |
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Decent of uterus
after 24 hours |
1 cm per day
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Lacerations of the Vagina
1st degree |
involves the vaginal mucousaor perineal skin
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Lacerations of the vagina
2nd degree |
involves vaginal mucousa, perineal skin and deeper tissues which may include the muscles of the perineam
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Lacerations of the vagina
3rd degree |
same as 2nd degree but also invloves anal schpincter
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Lacerations of the vagina
4th degree |
extends through the anal schincter into the rectal mucousa
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Increase in maternal cardiac output is caused by
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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 |
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Postpartum
WBC |
marked increased (to 30,000) back to normal by 4-7 days postpartum
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Postpartum
realxin |
-relaxin levels decrease to help pelvis and hips return to normal position, but may cause achiness in these areas
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preeclampsia s/s
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HA
blurred visison photophobia abd pain protenuria |
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resumption of menstration
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-usually within 7-9 weeks after childbirth
-if lactating- 12 weeks to 18 months |
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Prolcatin
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initiates breast fmilk within 2-3 days
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oxytocin
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necessary for milk ejection or "let down)
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Postpartum weight loss
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-about 5.5 lbs during childbirth
-5-8.8 lbs is lost by diuresis nd involution |
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Focussed assesment
post vsg birth |
vitals
fundus lochia perineum bladder elimination breasts lower extremities |
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HIgh risk for Hemorrhage
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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 |
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High risk for infection
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Operative procedires
multiple cervical exams prolonged labor manual extraction of placenta DM indwelling catheter Anmeia |
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Signs of distended bladder
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-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 |
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REEDA
used for perineuam assessmen |
R- redness
E- ecchymosis E- edema D- discharge A- approximation |
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Post epidural repirations- if declining or less than 12
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- 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 |
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paralytic ileus
s/s |
-abd distension
-absent or decreased bowels - no passage of flatus or stool |
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First 24 hours Postpartum C section
interventions |
- Providing pain relief
-overcoming effects of immobility( BR for 8-12 hours) |
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After 24 hours Interventinos
C Section |
-resuming normal activities
-assist with infant feeding -preventing abd distention - |
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Measures to supress lactation
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-well fitted support bra or binding
- ice |
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Post patum s/s that should be reported
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-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 |
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Post partum blues
time |
begins at first week and lasts no longer than the 2nd week
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Post partum blues
s/s |
insomnia
irritabilty fatigue tearfulness mood instability anxiety |
