Card Set Information
What must be present for true PTL
Requirements for PPROM
Membranes rupture <37wks and 1+ hrs before onset of labor
What are the MAJOR risk factors for PTL?
Hx of PTL
Uterine expansion (multifetal, polyhydramnios
Pelvic/uterine/severe systemic infection
: BV, pyelo, pneumonia
What are the MINOR risk factors for PTL?
Age extremes <17, >35
: lifting or standing long hours
: abuse, stairs at home
Neonatal risks with PTD:
Temp instability (less fat)
Resp immaturity (apnea, chronic lung disease)
: PDA, BP dysregulation
: jaundice, anemia
: difficulty feeding, poor digestion
: poor tone, retinopathy
What basic techniques do you want to utilize first with PTL
Transport (level III nursery)
What type of exam is performed to check cervic with suspected PTL
STERILE SPECULUM EXAM
DO NOT USE HANDS
What is the black box warning for Terbutaline?
If used >3 days potential for serious maternal heart problems and death
Name some drugs used for tocolysis:
B-mimetics (hypotension risk)
What size is the uterus at 7 days, 14 days, and 6 wks?
7 days: 50% weight decrease
14 days: returned to pelvic organ
6 wks: slightly larger than nulliparous
What is suspected if Lochia Rubra lasts more than 7 days?
There is some retained placenta in uterus
What are names and colors of lochia
Rubra - red or pink - up to 7 days
Serosa - lt brown or yellow - up to 14 days
Alba - clear
After how many wks with an open internal os do you suspect retained placental fragments?
When do FSH levels rise and menses usually start?
3 wks FSH begins to rise
6-8 wks menses
79-90% of women ovulate by 12 wks
What are some physical changes that affect libido?
Name the psychological changes tha have an effect on libido
Feelings of inadequacy
Increased dependency on partner
Role conflict (mother vs lover)
Work outside home
What triggers lactation (milk production)?
LOW Pg and Estrogen
dropping Pg&E decreases PIF
Continuation of this is dependent on suckling
What facilitates let down
Suckling stimulated Oxytocin release from PostPit
Causing contraction of alveoli
and Milk expulsion through ducts to sinuses
What does colostrum contain?
Protein and antibodies
Lower in calories
Engorgement management for Non-Lactating
Ice packs 3-4x/day
Motrin or tylenol for pain
Engorgement management for Lactating
Warm moist towels for 10-15 mins
Sore nipples management
air dry nipples
rotate infant position
break suction with finger
Treatment for Mastitis (staphylococcus)
frequent nursing (start with affected side)
Antibiotics for fever (beta lactams
Amoxicillin and Ceclor)
Emotional phases posptartum (3)
3rd & 4th
: absorbed in infant (loss of adult identity)
: external focus possible. Return of sexual feelings. Can attend to others