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Chapter 28 Maternal
nur 438
88
Nursing
Graduate
10/18/2016

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Cards

Term
What sloughs off to make Lochia?
Definition
Spongy layer of the decidua
Term
How does the placenta site heal?
Definition
Exfoliation and then endometrial tissue grows
Term
How long does it take placental site to heal?
Definition
May take up to 6 weeks to heal
Term
Why do uterine cells atrophy?
Definition
Due to decreased level of circulating estrogren and progesterone
Term
Where will the fundus be at 6-12 hours postpartum?
Definition
At level of the umbilicus
Term
During the first postpartum day, where will the fundus be?
Definition
1 cm below umbilicus
Term

How much will the fundus descend per day?

 

Where is it on the 10th day?

Definition

1 cm per day

 

In pelvis on 10th day 

Term
What does it mean if the uterus is extra boggy and is above umbilicus?
Definition
Excessive uterine bleeding
Term
What is a boggy uterus mean?
Definition
Uterine Atrophy
Term
The uterus descends much more slowly if there is an ___________
Definition
Intrauterine infection
Term
Does breastfeeding affect the involution (Descent) of the uterus?
Definition
Yes. the release of oxytocin from breastfeeding (posterior pituitary) hastens involution
Term
What color lochia occurs first 2-3 days?
Definition
Lochia rubra
Term
What color lochia is associated day 3 to day 10?
Definition
Lochia serosa pink
Term
What lochia occurs before/until cervix is closed?
Definition
Lochia alba
Term
Does lochia have an odor that is offensive?
Definition
It has a musty stale odor, not offensive
Term
Microorganisms are always present in lochia but are they virulent?
Definition
No, not virulent
Term
Do C section moms have more or less lochia than vaginal delivery mothers?
Definition
C section moms have less lochia
Term
Do multiparous moms have less or more lochia than nulliparous moms?
Definition
Multi has more normally
Term
What is average mL of lochia?
Definition
225 mL
Term
Discharge is __________ in morning due to pooling while mom sleeps
Definition
Discharge is greater in morning due to pooling while mom sleeps
Term
Why is evaluating lochia important?
Definition
Helps determine if involution is occuring or not and if healing/hemorrhage is occuring
Term
How long until uterus reaches pre-pregnant size?
Definition
5-6 weeks postpartum
Term
If uterus firmed and expected to have been healed, what may be causing bleeding?
Definition
Lacerations may answer to discharge or bleeding
Term
Clotting is normally the reason for pooling of blood in upper portion of vagina. What size clots is okay? What is not?
Definition
Nickel size is okay especially in first few days after birth. But any plum size is not okay.
Term
What does it mean if discharge is stopped? What decreases?
Definition
Due to closing of cervix and chances of infection decreases
Term
Is the external OS forever changed after pregnancy? What shape does it change to?
Definition
Yes. Changes to a lateral slit
Term
Will a woman need to be refitted for the diaphragm after pregnancy?
Definition
Yes
Term
What is the cervix like after birth?
Definition
Spongy, flabby and may appear bruised
Term
How long does it take for vagina to get back to normal?
Definition
6 weeks
Term
When does rugae appear on the vagina?
Definition
When size decreases and rugae appears within 3-4 weeks
Term
Labia majora and labia minora are more _______ in multiparrous woman than nulliparous woman
Definition
Flaccid
Term
What can you do to help vagina get back to normal after birth?
Definition
Kegel Excerises
Term
How long may it take the episiotomy or lacerations to heal initally? How about fully?
Definition
Initially 2-3 weeks after birth but may take up to 4-6 months
Term
In non-breast feeding woman, when may the menstruation return?
Definition
Between 7-12 weeks
Term
In breastfeeding woman, how long may it take for menstruation to come back?
Definition
May take up to 3 years
Term
When does ovulation occur in non breastfeeding woman?
Definition
After 70-75 days
Term
How long may ovulation occur after birth in lactating women?
Definition
6 months
Term
When ovulation returns, what may make this happen?
Definition
Increased Progesterone Level
Term
Is breastfeeding a reliable source of contraception?
Definition
NO
Term
Suckling by infant releases gonadotrophin releasing hormone that may be causing the ___________
Definition
Amenorrhea
Term

After birth, the abdomen is loose and flabby, will it respond to exercise?

If yes, How long?

Definition
Yes it will respond but may take 2-3 months
Term
Does straie differentiate in different skin colors?
Definition
Yes, they also may gradually fade but are still visible
Term
What is the separation of abdomen muscles?
Definition
Diastatis Rectus Abdomnis
Term
What is Diastatis Rectus Abdomnis common in?
Definition
C SECTIONS
Term
Diastatis Rectus Abdomnis may result in _________ abdomen and increases what?
Definition
Pendulous abdomen and increases backache
Term
Does Diastatis Rectus Abdomnis respond to exercise?
Definition
YES but may depend on mother's previous or recent physical condition
Term
After birth, woman may experience what two things?
Definition
Hunger and thirst
Term
Will bowel movements be active after birth?
Definition
NO, they will be sluggish
Term
Why are the bowel movements sluggish after birth?
Definition
May be due to lingering effects of progesterone, decreased GI tone, and bowels may have evacuated during labor process
Term
What are two remedies that can be used for Gas?
Definition
Peppermint tea and chamomile tea
Term
What may cause a woman to be fearful of elimination?
Definition
They may have lacerations or episitomy and afraid it may hurt. However, delaying this may cause more discomfort because they may become constipated (Narcotics could also affect this)
Term
What may cause urine retention after/during child birth?
Definition
The oxytocin infusion may cause urinary retention. Once discontinued, person may feel urge to void
Term
In postpartum period, why may the bladder output increase?
Definition
Due to pueperal diruesis
Term
Is a fever common after childbirth?
Definition
Yes. May be 100 degrees for up to 24 hours after birth (may be due to lactation)
Term
Blood pressure may __________ during postpartum
Definition
BP may rise and then return to normal
Term
What may a low BP indicate in patients?
Definition
Hypovolemia secondary to hemorrhage (this is late sign)
Term
BP eleveation may be related to what?
Definition
Due to oxytocin or vasopressor medications
Term
Why may bradycardia occur during first 6-10 days?
Definition
Due to decreased blood volume because of placenta separation
Term
High pulse during postpartum period may be related to what causes?
Definition
hypovolemia, stress, fear, pain, infection and much more
Term
What may reduce the risk for thromboembolism?
Definition
Early mobilization!
Term
What may occur during early postpartum period but is non-pathologic?
Definition

Non-pathologic leukocytosis 

 

25,000-35,000 WBCS

Term
What is the average blood loss for vaginal births? And what about c section birth?
Definition

200-500 mL for vaginal birth

700-1000mL during C-section

Term
When do the plasma levels reach pre-pregnant state?
Definition
4-6 weeks postpartum
Term
What levels fall due to placental separation?
Definition
Platelet count
Term
Platelet levels return to normal by __________ week
Definition
6th
Term
Does CO increase or decrease during labor process?
Definition
INCREASE
Term
What helps to decrease ICF?
Definition
Diuresis
Term
What may happen to the mother if diuresis doesnt happen?
Definition
Pulmonary edema and subsequent cardiac problems (more common in woman who have preeclampsia or history or cardiac problems)
Term
When does CO return to normal?
Definition
6-12 weeks
Term
What is the most common neurologic symtpom in postpartum women?
Definition
Headache
Term
Are seizures more likely to happen during pregnancy or postpartum period?
Definition
More likely in postpartum period (these are woman are prediposed seizure)
Term
How much weight should the mom lose when the baby, placenta, and amniotic fluid is expelled?
Definition

10 pounds

 

An additional 5 pounds may be lost due to diuresis in postpartum period

Term
How long should it taken for woman to get back to pre-pregnant weight?
Definition
6-8 week
Term
Are tremors or chills common in pregnancy?
Definition
YES
Term
Why may a postpartum woman wake up drenched?
Definition
Due to postpartum diaphoresis
Term
How long do afterpains last?
Definition
2-3 days
Term
Why do after pains occur?
Definition
intermittent uterine contractions
Term
Do oxytocin or breastfeeding increase or decrease afterpains?
Definition
INCREASE PAINS
Term
Afterpains are more common in multi or nulli women?
Definition
Multi women
Term
What may be used to decrease afterpains?
Definition
Lyseine (an essential amino acid)
Term
Lyseine is an essential AA used to decrease afterpains... what are some food examples where lyesine is common?
Definition
Eggs, meats, fish, cheese, soybean, nuts
Term

What phase: taking hold or taking in?

 

Woman tends to be passive, dependent, follows suggestions, hestiates to make decisions, and preoccupied with her own needs

Definition

What phase: taking hold or taking in?

 

Ready to resume control of her body, her mothering and her life in general 

Term
What is the new term for Maternal Role Attainment meaning woman transforms persona into her mom self
Definition
BAM-Becoming A New Mother
Term
How long does it take for postpartum blues to result?
Definition
10-14 days
Term
How should you assess the perniuem?
Definition
SIMS position
Term
What does it mean if the Homans sign is positive?
Definition
When nurse dorsiflexes floot and there is a pain... patient should not feel pain...pain is due to inflammation of vessel
Term
How many calories does the breastfeeding woman need to increase in her diet?
Definition
200 kcalories more (500 more than her pre-pregnant diet)
Term
Engrossment is a term relating to what?
Definition
Father newborn attachment
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