57 Peds

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57 Peds
2011-08-16 03:37:46
Postpartum Care

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  1. A yellowish fluid rich in antibodies
  2. Postpartum assessment BUBBLE is
    • B - Breasts
    • U - Uterus
    • B - Bowels
    • B - Bladder
    • L - Lochia
    • E - Episiotomy/laceration/C-section
  3. Assessment of the bowel
    Inspect for abdominal distention and auscultate for othe presence of bowel sounds.

    Check if patient received an enema.

    Anus can be inspected when episiotomy as well as hemorrhoids
  4. Assessment of Lochia

    Rubra - 1st discharge, red large amt of blood
    Serosa - thinner brownish pink
    Endometrium - The uterine lining (the womb). Inner layer of the uterus.
    • Ask mother to lie down supine with knees flexed, so that the peripad can be lowered in front.
    • Color
    • Amount
    • Odor
    • Presence of clots
    • Ask mother to turn on her side to see if lochia has pooled under her buttocks

    • Amount of lochia - difficult to estimate the amount on a peripad. A estimate method for the amt of lochia discharged in 1 hr. The mother who has had a C-section birth will have less lochia after the 1st 24 hrs than a mother with a vaginal birth. The lochia also changes from rubra to serosa b/c the inside of the uterus is wiped w/ a sponge during a C-sec, removing some endometrium.
    • Odor - nonoffensive odor - if foul, an infection is present and the CNM must be notified.
    • Presence of clots - Few small clots is normal. If large, requires further investigation. LARGER THAN THE SIZE of an EGG and should be assessed by the nurse.
  5. Assessment of the episiotomy

    Labia outer part of the vagina
    • Assess mother in the Sim's position (can be done with the mother is on her side from the lochia)
    • Gloved hand, gently raise upper buttock
    • Changes should be noted
    • Follow memory trick
    • Gently touch the the external labia & note any pain
    • Should be inspected for ecchymosis or edema
    • Anus can inspect for hemorrhoids
  6. Memory trick for Episiotomy is REEDA
    • R - Redness and inflammation
    • E - Ecchymosis (bruising)
    • E - Edema - swelling
    • D - Disharge - from incision
    • A - Approximation of suture line

    Assess VS q15mins for the 1st 1-2 hrs after birth. If nothing is identified then proceed q8hrs.
  7. Inflammation of the breast, generally during breastfeeding is
  8. Causes of mastitis can be from
    Staphylococcus aureus and Candida albicans

    • Staphy - gram positive cocci that are microscopically observed as individual organisms, in pairs, and in irregular grape-like clusters.
    • Candidas - a diploid fungus (a form of yeast) oral and genital infections.
  9. Symptoms appear for mastitis when
    2-4 weeks after birth
  10. Usually a crack in the fissure in the nipple for teh portal of entry. Nipple soreness may result in shorter breastfeeding times, allowing milk stasis which is a good medium for bacterial growth

    Fissure - a narrowing opening or crack - common during breast feeding
    Stasis - a state of stability
  11. A newborn from the birth of 28 days of life

    (family adaptation)
  12. A parent's intense interest and preoccupation in the newborn is

    regular definition - to occupy exclusively, absorb
  13. What are family adaptations to a neonate?
    • Bonding - 1st 30-60 mins after birth
    • Attachment - long-term process
  14. Family identifies the infant's "likeness" to and the "differences" from family members, and the infant's unique qualities is
    Claiming process

    The return of the uterus to its prepregnancy size and condition is

    pg 1792
  16. Reproductive system consists of what
    • Cervix
    • Uterus
    • Vagina and Perineum
  17. Endocrine system consists of what
    • Lactation
    • Menstrual cycle
  18. Cardiovascular system consists of what
    • Cardiac output
    • Coagulation
    • Vital signs
    • Varicosities
    • Blood values
    • Blood volume
  19. Mother's encounter difficulty in bowel movement after giving birth. What are the reasons?
    • Peristalsis has been decreased by the effects of the increased progesterone level during pregnancy; this may take several days to become normal again.
    • Prelabor diarrhea
    • Lack of blood during labor
    • Dehydration
    • Perineal trauma, espisiotomy repair, or hemorrhoids.
    • Mothers anticipation of discomfort
    • Certain pain medications can cause constipation.

    • page 1795
    • progesterone - a female hormone produced by the ovaries during release of a mature egg from an ovary (ovulation). Prepares the lining of the uterus (endometrium) to receive an egg if it becomes fertalized by a sperm. Progesterone levels drop and menstural bleeding begins.
  20. Urinary System consists of
    • Physical Changes
    • Chemical Changes