B – Breasts

U – Uterus

B – Bladder

B – Bowels

L – Lochia

E – Episiotomy or incisions

H – Homans / leg exam

E – Emotions

B – Bonding

retrogressive changes that return the reproductive organs, particularly the uterus, to their nonpregnant size and condition

• aka: Afterpains

~ when the uterus becomes "tired" of contracting

~ #1 cause of postpartum hemorrhage

~ give Pitocin (oxytocin) or Methergine (methylergonovine) to induce uterine contractions

~ Uterine overdistension (large baby, multiple gestation)

~ Bladder distention

~ Prolonged first and/or second stage labor

~ Precipitous labor

~ Labor induction and augmentation

~ Tocolytic therapy (esp mag sulfate)

~ High parity

~ Prolonged third stage of labor

How much should the uterus weigh at...

A) after delivery

B) 6-7 days

C) after 6 weeks

A) 1000 gm

B) 500 gm

C) 60 gm

acronym for:

~ Redness

~ Ecchymosis (bruising)

~ Edema

~ Discharge

~ Approximation

useful for assessing wound healing or the presence of inflammation or infection

ovulation

~ FSH increases as estrogen and progesterone disappear, but the presence of high levels of prolactin inhibit the ovary from responding and making more follicles.

~ Prolactin nearly gone by 3 weeks postpartum.

~ Ovulation occurs approximately 27 days postpartum if not breastfeeding.

Cardiac output:

Increases _______% immediately after delivery as blood that was shunted through the uteroplacental system returns to the _______.

~ 30-60

~ maternal system

~ 100.0*F

~ 24 hours

~ 100.4*F

~ infection

~ low blood volume

~ S/S include: cold hands and feet, light headedness, infrequent urination, increased heart rate, and weakness.

an emergency condition in which severe blood and fluid loss makes the heart unable to pump enough blood to the body.

~ This type of shock can cause many organs to stop working.

~ S/S include: increased heart rate and decreased blood pressure

~ diuresis (increased excretion of urine)

~ diaphoresis (profuse perspiration)

~ normal

~ emotional

~ crying

~ 28 days

~ live virus

~ 72 hours

~ Rh-

~ Rh+

1) headache

2) abdominal pain (usually in right upper quaderant)

3) vision changes (usually double)

deep tendion reflexes

~ check by bending leg and having pt relax and tapping knee cap

~ normal DTR is 2+

~ 4+ is not ok unless its "normal" for the pt

beat rhythm of foot as its released from flexed postion

~ count beats as the foot relaxes

~ Bonding

~ Attachment

~ Maternal Touch

~ Verbal Behaviors

~ How is your pain? Scale of 1-10

~ Tell me about your bleeding? How often are you saturating a pad? Is it like a regular period for you, or is it heavier, lighter?

~ When was your last bowel movement?

~ Have you been getting up to void? How often? (Remind to void q 2 hrs)

~ Are you breast or bottle feeding? How is everything going with feeding? Any problems or questions? Any breast bleeding, cracking, or pain?

~ Have you been bothered by a headache? Upper abdominal pain? Vision changes?

~ Blood pressure

~ Heart rate

~ Respirations

~ Temp

~ neuro: LOC, speech pattern, orientation etc.

~ Auscultate heart

~ Auscultate lungs

~ Inspect spinal/epidural site

~ Auscultate bowel sounds

~ Inspect breasts: bleeding, scaling, problems

~ Palpate and assess fundus: firmness, midline, location

~ Inspect C/S incision dressing or incision

~ inspect the perineumb(vag del): REEDA, hemorrhoids

~ Check patellar DTR’s

~ Check Homan’s sign, DVT, leg pain

~ Check clonus

~ Edema