Card Set Information
refers to the 6week period between delivery or termination of pregnancy and return of reproductive organs to their pre pregnant state
this is the time of emotional, social and physical adjustment
this takes palce the first 30 - 60 minutes after birth
what is enhanced for bonding?
enhanced when the parent and infant touch and interact
When the family finds likeness and differences to other family members
What factors affect family adaptation?
parental fatigue, previous experience w newborn, parental expectations, knowledge of and confidence in providing for newborn needs, temperament of the newborn
intense interest and preoccupation in the newborn
what are soem engrossment factors?
fingertipping, mothers voice and high pitched voices
does the father go thru engrossment period?
yes! he wants to touch, and share an active role in the process
when is it most difficult for a sibling to adaption to a neonate?
what do neonates have the ability to do?
make eye contact and move eyes to follow the parents, mutual gazing, grasp parents fingers and hold on, move in rhythm to parents voice
return of the uterus to its pre pregnancy size and condition?
vaginal discharge after childbirth
how long does it take for the vagina to regain its pre pregnancy size?
how does the fundus descend?
1 cm each day for 10 days
a full bladder will do what?
push the uterus upward
the lochia is usually what color?
first red, then pink, yellow and then white
is the odor the same after labor?
how long is the lochia red?
1st 3 days
after the red, what color does the lochia turn and when?
it turns a pink on the 4th day and decreases color changes
the 10th day the color turns what?
how long after birth is the fundus firm?
when does the cervical os close?
decreased levels of estrogen=?
decreased vaginal lubrication
what are the degrees of lacerations?
1st degree= skin and kucous membrane
2nd =skin, mucous and muscle
3rd=skin, mucous, muscle and anal sphinter
4th=skin, mucous, muscle, anal sphinter and rectal muscosa
neuro-hormonal relfec that causes milk to be expressed?
let down reflex
ovulation takes place as early as what after birth in non breast feeding women?
when is milk production initiated after birth?
non breastfeeind women start their menstrul cycle when?
ovulation does take place in breastfeeding women so how long should a woman wait to have sex with out birth control
yellowish fluid rich in antibodies and high in protein?
when does engorgement take place?
day 3 or 4 after birth
when does lactation cease if not used?
about a week
what do rural indian women believe about their colostrum?
they believe it harms the baby and discard it
what is the average time a mother breastfeeds?
what culture has the lower rate of breastfeeding?
blood loss average of vaginal birth? cescarean birth?
500ml, 1000 ml
what does the pregnant mothers temp right after labor?
what should remain consistant with baseline?
pulse should remain where?
less than 100 and there are times of bradycardia
women have a increased WBC what are they?
20m-30m X 10-12 days
what levels increase due to loss of plasma?
H AND H
there are increased clotting factors and fibrogen for a few days postpartume causing what?
a thrombus formation
what causes bladder distention?
what results in UTI for postpartum?
urinary stasis or incomplete emptying
what may cause edema on the urinary structures?
L and D
during L and D cause cause what?
adequate bladder emptying can help involution in how many days?
a distended bladder can displace the uterus and prevent contraction and cause what?
what parts of the body return to pre normal state except what?
how long will the abd muscles protrude ?
6 weeks, exercuse will help muscle tone
stiumulating hormone declines?
True or falso?
strai may still be visible?
when estrogen levels decrease what else will fade?
spider angiomas and palmar erythema
what is a huge symptom we can watch for after surgery? and what disease can worsen?
headache and PIH
weight loss after pregnancy?
13lb for fetus
what is the weight loss and returning of the uterus in the 6 wks?
how long does it take a woman to return back to normal prepregnant weight?
6mo - 1year
what helps the mother loose weight?
how long does the mothers passive phase last and what phase is this?
2-3 days, and Takin in phase where the mother must replenish her sleep, fluid and food
what is the taking hold phase?
last appx 10 days and where the mother wants to learn
letting go phase?
may be disappointed with gender, size or formaties and they must let go of pexpectations and take the role of parent
postpartum blues the are mild and may consist of crying for no reason, fatigue, anxiety, restlessness, let down feeling
how long do the "baby blues" last? and what percent of women?
2 weeks and 80 %
for the cescarean birth what phase last longer?
taking in phase
postpartum depression? what percent does it affect? and how many phases?
more severe than the blues, 12%, mild, mdoerate and severe
level 1 of postpartum depression?
mild- able to care but not feel love, irritable, sense of loss of self, last first few weeks?
level 2 of postpartum depression?
moderate- sleep disturbances, fatigue, decreased concentration
3 stage of postpartum depression?
severe- violent outbursts, neg feeling toward infant or other family members, wont discuss symptoms, and have harming thoughts
most dangerous with thoughts of harming self and infant and may be comes irrational, obbsesive
what is the percentage of births that cause psotpartum psychosis?
what percent commit suicide from postpartum psychosis?
what percent of postpartum psychosis cause infanticide?
when postpartum psyhchosis happens abotu how long after birth?
after 24 hrs
how long do women stay in the hospital ?
48 hrs vaginal, and 96 c-section
are home visits an option now?
YES! to see how mother are acting and their bonding techniques
what is BUBBLE?
Breast, Uterus, Bladder, Bowel, Lochia, Episiotomy
what are standard precautions in post partum care?
wearing gloves when touching anything that is the mothers fluid
when should we assess bubble?
what should we note in breast postpartum?
note size, shape, abnormalities, mastitis, check nipples for cracks, fissures, warmth and tenderness
waht shouldw e note of the uterus postpartum?
palpate to note consistancy, size, placement, firm, midline
how should the uterus feel?
firm, grapefruit size
how does the uterus move?
it rises to the umbillicus and then descends 1 finger breadth daily for 10 days
assess for signs of what on the uterus?
when movement occurs postpartum what is normal??
fever, chills, tenderness
a full bladder can displace the fundus where?
to the side
how long are I and O kept?
first 24 hours
when checking the episiostomy, check what?
the anus and for constipation
are clots normal after birth
yes a few
for an episiotomy what position should the mother be in?
what can be done to decrease discomfort levels after episiotomy?
tighten but before sitting, and release when sat down, rest daily with feet elevated, kegal exercise, use peri bottle to ease pain and cleaning
the Rh immune globulin given when to prevent what?
72 hrs to prevetn sensitization of rh negitive mothers who gave birth to rh pos infants
when is the rubella vaccine given?
postpartum if innsufficient titer to prevent fetal anomolies in future pregnancies
what can cause early hemorrhage?
uterine atony, retained placental fragments, laceration, hematomas
subinvolution, retained palcental fragments
what meds cause contraction or uterine smooth muscle?
pitocin, methergine, prostaglandins
what to do for hematomas?
apply ice, assess pain, size assessment
infectino occuring between birth and 6 wks postpartum?
peurperal include what?
wound infection, metritis, mastitis and UTI
inflammation of the uterus?
'inflammation of inside the uterus?
inflammation of the outside of the uterus?
metritis spead through fallopian tubes
metritis spread through out the ovaries?
the only symptom may be fever spikes?
when does masttits occur? and what does it cause? symptoms?
generally during breastfeeding, staph aureus or cadnida albicans and symptoms are 2-4 weeks of cracks, fissures in the nopple for port of entry
whats the odds of a pregnant woman having UTI?
how are UTI caused
by tauma to bladder and urethra or urinary stasis
risk factors for thromboembolic ?
venous stasis, hypercoagulation, older than 35, csection, obese, smoking, long time in stirrups, variscosities, history of
treatments of thromboembolic
analgesia, rest, evlevation of affected leg, local heat application, elastic stockings, coumadin
disseminated intravascular coagulation, abnormal stimulation of clotting mechanism, preexsisting problem, urine of 30ml/hr, blood and products can be given
how is DIC caused?
when the morther starts to hemmorhage