OB 57

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  1. First six weeks after birth of infant
  2. –Newborn from birth to 28 days
  3. –Rapid process of attachment for parent and child
  4. Long-term process that establishes enduring bond between parent and child
  5. Parents identify likenesses and differences
  6. factors affecting adaptation of newborn
    •Parental fatigue

    •Previous experience with newborn

    •Parental expectations of newborn

    • •Knowledge of and confidence in providing
    • for newborn needs

    •Temperament of newborn

    •Temperament of parents

    •Age of parents

    •Available support system

    •Unexpected events
  7. Return of uterus to pre-pregnancy size and condition
  8. –Vaginal discharge after childbirth
  9. Maternal Physiologic Changes: Reproductive System


    • •Takes six weeks for vagina to regain
    • pre-pregnancy contour

    •Many women have episiotomy
  10. Maternal Physiologic Changes: Endocrine System
    •Let-down reflex

    • •Breastfeeding not reliable method of
    • birth control

    • •Ovulation in non-breastfeeding mothers
    • takes place as early as 27 days after birth
  11. –Neurohormonal reflex that causes milk to be
    Let-down reflex
  12. •Ovulation in non-breastfeeding mothers
    takes place as early as ______ days after birth
    27 days after birth
  13. Yellowish fluid rich in antibodies and high in protein first two to three days after birth
  14. occurs by day three or four and caused by vasocongestion of breast tissues as milk production begins
    –Breasts distended, swollen, and tender
  15. ceases within one week if breastfeeding stopped or never begun
  16. when do BF clients menstruel period return
    BF clients menstrual cycle’s return is largely dependent on BF pattern
  17. can mom eta or drink after anesthesia or analgesia
  18. why might a BM be difficult to acheive after delivery
    Decreased peristalsis, prelabor diarrhea, lack of food during labor, dehydration, perineal trauma, hemorrhoids, mother’s anticipation of discomfort, and some pain medications
  19. vaginal birth avg. blood loss
    • –Vaginal birth
    • 500 ml
  20. c-section avg. blood loss
    1000 ml
  21. what should the nurse do if a client is going to ambulate the first time after surgery
    stay with her bc of VS changes or cardiac output
  22. cardiovascular maternal physiologic changes
    • Blood volume
    • Monitor blood values
    • Coagulation
    • Varicosities
  23. Maternal Physiologic Changes:
    Urinary System
    • •Mother may have problem with overdistention and emptying of bladder
    • •Urinary stasis can cause infection
    • •Full bladder displaces uterus up and to side
    • –Results in uterine atony
  24. Uterine involution may cause
    mild proteinuria, ketonuria, and elevated blood urea nitrogen (BUN)
  25. As level of hormone relaxin decreases what will happen
    ligaments and cartilage begin to revert to pre-pregnant position
  26. Takes ____ weeks for abdominal muscles to return to pre-pregnant state
  27. All joints return to normal pre-pregnant state except _____
    FEET–May have permanent increase in shoe size
  28. Hyperpigmentation lightens because
    Melanocyte-stimulating hormone declines
  29. neurologic maternal discomfort may be caused by
    Fatigue, afterpains, muscle aches, episiotomy or abdominal incision pain, and breast engorgement
  30. Carefully assess mother who has headache bc?
    Pregnancy-induced hypertension (PIH) can worsen after delivery
  31. Immediate weight loss of
    • 13 lbs bc of
    • –Infant, placenta, amniotic fluid, and blood loss
  32. how many punds are lost during the next 6 weeks after birth
    • 8-9 lbs
    • –Result of diuresis, diaphoresis, and involution
  33. Takes about _____ months to return to pre-pregnant weight
  34. maternal psychosocial changes
    • •Taking-in phase
    • •Taking-hold phase
    • •Letting-go phase
    • •Postpartum blues
    • •Unplanned cesarean birth
  35. look for signs of hurting herself or baby. Decreased concentration. Insomnia. Spontaneous crying.
    postpartum depression
  36. Obsessive concerns about the newborns health and wellness
    postpartum psychosis
  37. nursing process will focus on ____ areas
  38. normal assessment for fundus
    firm and midline
  39. Normal assessment should for fundus should reveal:
    (1) After delivery at _____
    (2) 12 hours PP uterus will be @ ___
    (3) 1 week PP uterus should be ___ below the level documented on the day of delivery
    • 1. 2 fbbu
    • 2. umbilicus
    • 3. 7 cm
  40. With mother in Sims’ position, assess episiotomy:
    • –Redness indicating inflammation
    • –Ecchymosis indicating bruising
    • –Edema indicating swelling
    • –Discharge from incision
    • –Approximation of suture line
  41. •Temperature may increase to 100.4º F during first 24 hours
    –After first 24 hours, may indicate _______
  42. Pulse rate may decrease to 50 to 70 beats per minute after first hour
    –Elevation may indicate ____
    pain, anxiety, and hemorrhage
  43. Blood pressure should remain consistent with baseline
    –Increased B/P May indicate ____
    –Decreased B/P May indicate _____
    • PIH
    • excessive bleeding
  44. Bonding should be seen and assessed within _____ AFTER delivery
    30-60 min
  45. RH immunization Given when if Rh-negative mothers who gave birth to Rh-positive infants
    within 72 hours after birth to prevent sensitization
  46. Classic s/s of PP hemorrhage is?
    increased pulse rate and decreased B/P
  47. The nurse caring for an expectant mother would monitor for the following predisposing risk of bleeding:
    • (1) Decreased platelet level
    • (2) History of alcohol abuse
    • (3) Obesity
    • (4) NSAID use
    • (5) Herbal supplement use
  48. Puerperal (postpartum) infection occurs when and treated how?
    –Occurs between birth and six weeks postpartum

    –Usually treated with IV Abx

    •Defined as temperature of 100.4º F or more on two separate occasions after first 24 hours
  49. risk factors for thrombophlebitis: inflammation in vein
    Maternal age over 35

    cesarean birth

    prolonged time in stirrups



    history of varicosities or venous thromboses
  50. The best nursing intervention to prevent thromboembolic conditions is to?
    encourage client to ambulate early & frequently AFTER delivery
  51. DIC Main “medical management goal” is
    to treat and correct the underlying cause
Card Set:
OB 57
2011-10-20 15:36:19

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