Flashcards
Postpartum Period (Puerperium) and Nursing Care
Flashcards do conjunto (35)
- 1Postpartum Period (Puerperium)-period of recovery
-first 6 weeks post delivery
-return of reproductive organs to pre-pregnancy state and function - 2Involutionfailure or delayed return of reproductive system to it's pre-pregnant state/function
- 3Involutionprocess of reproductive organs returning to nonpregnant state and function
- 4Causes of subinvolution-infection: endometritis
-retained placental fragments
-uterine atony - 5Clinical signs of subinvolution-excessive lochia
-foul odor of lochia
-uterine pain - 6Assessment of Uteruslocation: midline or displaced?
consistency: firm or boggy?
height: in relationship to umblicus - 7Action of nurse if uterus is boggy:massage gently, get vitals (except temp), check peri-pad for characteristics of lochia - should be lots of clots
- 8Lochia Rubra1-3 days - dark red, looks like menstrual period
- 9Lochia Serosa5-7 days; pink-brown, looks like end of menstrual cycle
- 10Lochia Alba1-3 weeks; no RBCs, tissue, discharge
the point is that pt. should never regress and no odor - 11Vitals signs if hemorrhaging:HR will increase BP may increase or stay the same but eventually it will drop
- 12What does the dr. need to know if you think pt. is hemorrhaging?hrs postpartum, vitals and type of delivery
- 13Meds given for uterine hemorrhageoxytocin, methergen, hemabate
- 14Note for MethergenIM; always raises BP so contraindicated in pt. with HTN
- 15REEDARedness
Edema of perineal floor
Ecchymosis - most likely from instruments
Drainage
Approximation - only appropriate finding - 16Return of menstrual cycle6-8 weeks post delivery when not breastfeeding
2-3 months w/ breastfeeding
multiparas will begin before primiparas - 17Engorgementhot, painful, firm, full distended breasts
- 18Management of engorgementLactating women should continue to nurse - consistent feeding; use analgesics/warm compresses; decrease distention by expressing some milk before latching on
non lactating: don't stimulate breasts at all. Put on bra and binder, turn back to water in shower, ice packs, cabbage leaves - 19Vital Signs for PP momHR: 50-70 bpm
BP: normal
RR: normal
temp: normal, after 24 hrs of above 100.4 = PP sepsis - 20How does PP mom get rid of extra blood volume?Diuresis and Diaphoresis (night sweats)
- 21Taking-inDependency
basic needs
relieves labor - enjoys reviewing and helps her understand then she moves into taking hold - 22Taking-holdself-directive
takes initiative
best period to teach - 23Prevent PPD-offer time to sleep, shop and babysit
-sleep deprivation & support are biggest factors
-after 2 weeks, PPD develops
-Edinburgh scale used to assess - 24Clinical Signs of Uterine Atony-palpates soft "boggy" = active hemorrhage
-pad has lots of lochia w/ clots
-increase HR to above 90 no change in BP, increase RR - 25Management of Uterine Atony1. Massage uterus
2. call for help
3. collect data
4. Oxytocin, methergen, hemabate - 26Clinical Signs of Lacerations-firm uterus, midline fundus
-bright red pads and soiled linens - 27Management of Lacerations1. Surgical intervention
2. Packing (both done by Dr)
--if dealing w/ hemorrhage, put a foley w/ urometer - 28Clinical Signs of Hematoma-pain that isn't relieved w/analgesics
-bruising on perineal floor
-not present immediately after birth but is filling after birth - 29Rained placental fragments-keeps uterus from clamping down all the way
-firm uterus but higher than normal, pain and odor
-heavy amount of bleeding w/clots
-surgical management - 30InfectionGroup B Beta strep/vaginitis gives way to infection of uterus called endometritis
- 31Infection that spreads via lymphatic systemParametrial cellulitis; peritonitis
- 32Infection that spreads via vascular system-septic pelvic thrombophlebitis
-bacteremia and septic shock - 33Early S/S of Postpartum Sepsis-temp: over 100.4 after first 24 hrs
-uterine pain during assessment
-odor of lochia - 34Cause of endometritisusually chorioamniotis, starting point is prolonged rupture of membrane
- 35Factors which contribute to thrombophlebitis-venous stasis: prolonged inactivity, dehydration
-hypercoagulability of blood
-injury to the intima (don't put in stirrups too early)
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- FlashCards sobre Sem título, criado por shaunaperras em 22-07-2014.
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