Term
| What is the 4th stage of labor? |
|
Definition
| starts with delivery of placenta and lasts 1-4 hrs/body begins to adjust to prepregnancy state and parent-infant bonding begins |
|
|
Term
| What is the 4th trimester? |
|
Definition
| first 12 weeks after birth/a time of transition for parents and siblings/refers more to role definition and bonding process |
|
|
Term
|
Definition
| starts with delivery of placenta and ends when body returns to prepregnancy state (about 6 weeks) |
|
|
Term
|
Definition
| The time immediately after the delivery of a baby. (In Latin a "puerpera" is a woman in childbirth since "puer" means child and "parere" means to give birth.) Puerperal fever is childbirth (or childbed) fever due to an infection usually of the placental site within the inus. |
|
|
Term
| What does an increase in oxytocin cause? |
|
Definition
|
|
Term
| What does oxytocin do to uterine contraction? |
|
Definition
| Coordinates and strengthens them |
|
|
Term
| What does breast feeding stimulate the release of? |
|
Definition
|
|
Term
| What is a natural way of decreasing bleeding post partum? |
|
Definition
|
|
Term
|
Definition
to improve uterine contractibility
Firm uterus prevents excessive bleeding |
|
|
Term
| What is the effect of birth on estrogen? |
|
Definition
Decrease estrogen
breast engorgement, diaphoresis, diuresis, decreased vaginal lubrication |
|
|
Term
| What is the effect of birth on progesterone? |
|
Definition
Decreased progesterone
increased muscle tone |
|
|
Term
| What is the effect of birth on insulinase? |
|
Definition
Decrease insulinase
decreased blood sugar |
|
|
Term
| What remains increased with lactation? What does this cause? |
|
Definition
Prolactin.
Suppresses ovulation |
|
|
Term
| When does menstrual flow resume with no breastfeeding? |
|
Definition
|
|
Term
| When does menstrual flow resume with breastfeeding? |
|
Definition
|
|
Term
| What is uterine involution? |
|
Definition
| Returning back to normal size pre-pregnancy state. 1cm a day |
|
|
Term
|
Definition
| Bleeding experienced after birth. Dcreases in 3-4 wks in amount and color changes.. |
|
|
Term
| What are the physiologic changes postpartum? |
|
Definition
Uterine involution
Lochia flow
Cervical involution
Decrease in vaginal distention
Changes in ovarian function and menstruation
Breast changes
Cardiovascular system/Vital Signs
Gastrointestinal system
Urinary tract changes
Integumentary system
Thermoregulation |
|
|
Term
| How long does colostrum last? |
|
Definition
|
|
Term
| How do you assess the uterus height? |
|
Definition
One hand lateral, other hand find the uterus.
Easy to find, well defined. |
|
|
Term
| How do you assess the uterine placement? |
|
Definition
(Fingerbreadths)
If bladder is full, it can distend the uterus L or R |
|
|
Term
| How do you assess uterine consistency? |
|
Definition
(Firm/Boggy)
Want it to be firm. If boggy, massage. |
|
|
Term
| How does fundal height descend? |
|
Definition
|
|
Term
| Where is the fundus immediately after delivery? |
|
Definition
|
|
Term
| Where is the fundus 12 hours after delivery? |
|
Definition
|
|
Term
| Where is the fundus 6 days after birth |
|
Definition
| 1/2 way between U and symphysis pubis |
|
|
Term
| Where is the fundus on day 10? |
|
Definition
|
|
Term
| What are the 3 processes that occur in uterine involution? |
|
Definition
Contraction of muscle fibers
Catabolism-converts living cells into simpler compounds/involved in involution
Regeneration of uterine epithelium |
|
|
Term
| What is the most accurate way to assess blood loss? |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| 2-5 - 10cm/ 1-4 inch stain |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| What medicines are administered for uterine involution |
|
Definition
Pitocin
Methergine
Ergonate
IM or IV |
|
|
Term
| What is the adverse effect of oxytocin? |
|
Definition
|
|
Term
| What is the adverse effect of methergine? |
|
Definition
|
|
Term
| What should you encourage for uterine involution? |
|
Definition
1.) Early breastfeeding for lactating mom
2.) Frequent bladder emptying |
|
|
Term
| What are the 3 stages of lochia? |
|
Definition
1.) Rubra
2.) Serosa
3.) Alba |
|
|
Term
|
Definition
| bright red/bloody/may have small clots/ 1-3 days/transient flow increase when breastfeeding and upon standing |
|
|
Term
|
Definition
| pinkish brown color/serosanguineous/4-10 days after delivery |
|
|
Term
|
Definition
| yellowish/white color/fleshy odor/lasts from 11 days to 6 weeks and beyond |
|
|
Term
| What should be assessed in lochia? |
|
Definition
-Color
-Amount
-Consistency |
|
|
Term
| What are abnormal lochia findings? |
|
Definition
Spurts of bright red blood
Numerous large clots or excessive bleeding
Foul odor
Lochia rubra beyond 3 days postpartum
Continued lochia serosa/alba beyond normal time |
|
|
Term
| What does lochia rubra more than 3 days indicate? |
|
Definition
| retained placental fragments |
|
|
Term
| What does continued lochia alba indicate? |
|
Definition
| endometritis? (fever/pain/tenderness) |
|
|
Term
| What should you assess in the cervix? |
|
Definition
Soft, edematous, bruising after birth
Shortens, regains form in 2-3 days |
|
|
Term
| What should you assess in the vagina? |
|
Definition
| Muscle tone never fully restored |
|
|
Term
| What should you assess in the perineum? |
|
Definition
Approximation and Drainage
1st, 2nd, 3rd, 4th degree tears
Hematomas
Hemorrhoids |
|
|
Term
| Is Bright red trickle from episiotomy is normal early PP? |
|
Definition
|
|
Term
| What nursing considerations are there for PP clients? |
|
Definition
Promote measure to soften stools
Educate on proper cleansing
Comfort measures |
|
|
Term
| What nursing interventions are there for proper cleansing? |
|
Definition
Wash hands
Use squeeze bottle filled with warm H2O or antiseptic solution after each voiding
Clean front to back
Blot, not wipe
Topical antiseptic sprays sparingly
Change pad after each toilet use |
|
|
Term
| What interventions are there for comfort measures? |
|
Definition
Ice packs first 24-48 hrs
Sitz baths 2x daily (100-104 degrees)
Analgesics (non-opoiods-Tylenol) (ibuprofen) (opoids-codeine with Tylenol)
PCA for C/S
Topical Anesthestics (Americaine Spray/Dermoplast) to perineum
witch hazel compresses (TUCKS) to rectal area for hemorrhoids
Sitting---squeeze buttocks together and lower weight slowly to prevent stretching of perineal tissue/use pillows/sit slightly on side |
|
|
Term
| What teaching should be involved with breast assessment? |
|
Definition
| clean breast first in shower, release suction with finger, avoid soap on nipples, use disposable bra pads |
|
|
Term
| What should be taught about colostrum? |
|
Definition
| Colostrum secretion-occurs during preg and 2-3 days after birth/milk production begins 2-3 days |
|
|
Term
|
Definition
result of lymphatic circulation, milk production, venous congestion
Redness and tenderness |
|
|
Term
| What are complications from breast feeding? |
|
Definition
Redness and tenderness, mastitis
Cracked nipples
Infant has “latched on” correctly
Ineffective feeding patterns |
|
|
Term
| What are the nursing considerations r/t breastfeeding mothers? |
|
Definition
Encourage early demand breastfeeding
Warm soaks or shower to stimulate milk production
Assist client into comfortable position
Teach importance of proper latch techniques
Inform client breastfeeding releases oxytocin
Breast pump; breast massage |
|
|
Term
| What does help in positioning assist with? |
|
Definition
| prevents nipple soreness and cracking |
|
|
Term
| What is the proper breast feeding technique? |
|
Definition
| areola and nipple/not just tip |
|
|
Term
| What should you do for non breastfeeding mothers? |
|
Definition
Avoid nipple stimulation
Apply a breast binder/snug bra
Ice pack or mild analgesia |
|
|
Term
|
Definition
LATCH: a breastfeeding charting and documentation tool. LATCH was created to provide a systematic method for breastfeeding assessment and charting. It can be used to assist the mother in establishing breastfeeding and define areas of needed intervention
L- Latch
A - Audible swallowing
T - Type of nipple
C - Comfort
H - Hold (positioning) |
|
|
Term
|
Definition
| Erythema and swelling are present in the upper outer quadrant of the breast. Axillary lymph nodes are enlarged and tender |
|
|
Term
| What is important to note with the cardiovascular assessment? |
|
Definition
- Changes in temp/pulse
- Increase in cardiac output
- Decrease in stroke volume
- Increase in Hemoglobin and Hematocrit
- Increase in WBC
- Increase in Clotting Factors |
|
|
Term
| What does increase cardiac output prevent? |
|
Definition
| HELPS PREVENT HYPOVOLEMIC SHOCK FROM BLOOD LOSS) |
|
|
Term
| What causes increased cardiac output? |
|
Definition
1-increased blood flow back to heart when blood from uretoplacental unit returns to circulation (500-700mL)
2-decreased pressure from pregnant uterus on vessels
3-mobilizaiton of excess extracellular fluid into vascular system |
|
|
Term
| What does pulse change to? |
|
Definition
|
|
Term
| How long does sweating last? |
|
Definition
|
|
Term
| Why do WBC increase and what is the range? |
|
Definition
Postpartum as high as 30,000 (avg. range is 14,000-16,000)
Mostly due to increase in NEUTROPHILS (response to stress, inflammation, pain) NO WONDER!!!
Coagulation factors (Plasma fibrinogen) increase to prepare for delivery. FIBRINOLYTIC ACTIVITY (breakdown clots) DECREASES DURING PREG. |
|
|
Term
| What does an increase in clotting factors cause? |
|
Definition
Elevations in clotting factors continues for a few days after delivery=INCREASES RISK FOR THROMBUS FORMATION
HIGHER RISK: C/S, varicose veins, history of thrombophlebitis
Monitor lower extremities/Consider sequential compression device (SCD) |
|
|
Term
| What nursing considerations are there for cardiovascular assessment? |
|
Definition
Monitor VS per protocol and lab values
Encourage standing slowly
Encourage early ambulation-prevent thrombosis
Application of TED hose
Administer medications as prescribed |
|
|
Term
| What is the normal temp change in pp patients? |
|
Definition
|
|
Term
| What is the normal pulse range in PP patients? |
|
Definition
| May decrease to 50-60 bpm REPORT GREATER THAN 100 |
|
|
Term
| What is the indication of lowered BP? |
|
Definition
| Hemorrhage, hypovolemic shock, orthostatic hypotension |
|
|
Term
| What does an increase in pulse mean? |
|
Definition
|
|
Term
| What if there is a change in respirations? |
|
Definition
| consider PULMONARY EMBOLUS, UTERINE ATONY, HEMORRHAGE if increase significantly |
|
|
Term
| Why is there an issue with urinary rentention? |
|
Definition
| due to loss of elasticity and tone/loss of sensation due to trauma/meds/anesthesia/lack of privacy |
|
|
Term
| What does a distended bladder cause? |
|
Definition
| may cause UTERINE ATONY/displaced to one side/may need catherization |
|
|
Term
| What may you see with retention? |
|
Definition
| increased fundal height/fundus displaced/bladder bulges/excessive lochia/tenderness/decreased volume when voiding |
|
|
Term
| What needs to be assessed in the urinary system? |
|
Definition
Assess for retention due to diuresis
Encourage fluids and void every 2-3 hrs
Measure first few voids |
|
|
Term
| What do you need to assess with GI after birth? |
|
Definition
Increased hunger after delivery
Assess for constipation/hemorrhoids (gastric motility)
Hemorrhoids, trauma, dehydration, pain, fear, immobility, meds
Promote bowel function
Ambulation, fluids, fiber |
|
|
Term
| What do you need to assess with musculoskeletal system? |
|
Definition
Assess for diastasis recti
Teach postpartum strengthening exercises
Kegel exercises |
|
|
Term
| What do you need to teach w/ musculoskeletal? |
|
Definition
Muscle tone and joint return to normal state after placenta removed and progesterone decreases
Separation of rectus muscle may occur (2-4cm) resolves in 6 weeks
C/S avoid abdominal strengthening for 4 weeks
Good posture! |
|
|
Term
| What is postpartum chill? |
|
Definition
| normal/get warm blankets/occurs first 2 hrs PP |
|
|
Term
| What do you need to teach about sleep and rest? |
|
Definition
Time management
Advocate for patient |
|
|
Term
A 27 year old G4, P4 was admitted from L&D 2 hours after the birth of a 3600g (8-lb) baby boy. An hour later, her fundus is slightly boggy, located three fingerbreadths above the umbilicus, and displaced to the right. Her perineal pads, changed just before transfer, are saturated
What do these data suggest? Why?
. |
|
Definition
| The birth of a large infant and multiparity increase the risk of postpartum hemorrhage. Saturation of pads in a short time suggests heavy bleeding. The location of the fundus above the umbilicus and displaced to the side indicates that the cause of bleeding might be a distended bladder. |
|
|
Term
| What nursing action should be taken first? What follow up assessments are necessary? |
|
Definition
Assisting the mother to void is the priority nursing action. If, after voiding, the fundus is located at the level of the umbilicus and firmly contracted, the cause of the bleeding was probably a distended bladder, which made it difficult for the
to contract firmly. The location and consistency of the uterus, amount of lochia, BP, and pulse should be assessed frequently so that further excessive bleeding can be identified and controlled. |
|
|
Term
| What patient education is necessary? |
|
Definition
| The woman does not experience the urge to void because the bladder has not regained the muscle tone lost during pregnancy, and the sensitivity to pressure is decreased. |
|
|
Term
|
Definition
Breasts – Soft, filling, firm, Nipples
Uterus – consistency, position, height, C/S
Bladder – voiding pattern
Bowels – bowel sounds, hemorrhoids, BM
Lochia – type, amt, clots, odor
Episiotomy – laceration, bruising, swelling
Homan sign – present or not
Emotional status – bonding, blues |
|
|
Term
|
Definition
Oxytocins
Immunoglobulin
Stool Softeners
Analgesics
Immunization
Lactation Suppression |
|
|
Term
|
Definition
Given to RH negative mothers/RH positive babies
Administer within 72 hrs of birth
Given IM |
|
|
Term
| What else is important to note for RhoGam? |
|
Definition
check prenatal records-necessary if Mom is RH negative and newborn is RH positive---and mom not already sensitized
Prevents development of maternal antibodies that would affect future pregnancies
Administered IM 72 hours after delivery
Assess for previous pregnancies/miscarriages |
|
|
Term
| Should pregnant women be immunized for Rubella? |
|
Definition
NO!
LIVE VIRUS CAUSES SERIOUS FETAL DEFECTS IF BECOMES PREG AFTER ADMINISTERING/administered immediately after delivery-advise not to get pregnant for 28 days |
|
|
Term
| What is important to note about Rubella? |
|
Definition
Check immunity to rubella-less than 1:8
If NOT immune, administer rubella vaccine
Need informed consent
May not get pregnant for 3 months
Given SUB-Q |
|
|
Term
| For a Vaginal Birth, what needs to be assessed? |
|
Definition
Breast
Uterus
Bowel
Bladder
Lochia
Episiotomy
Homan’s Sign
Emotions |
|
|
Term
| What needs to be assessed for C-Section? |
|
Definition
BUBBLE HE
Pain
Respiratory status
Abdomen
REEDA
Intake/Output |
|
|
Term
|
Definition
| Redness/edema/ecchymosis/discharge/approximation |
|
|
Term
| What are the teaching priorities for PP> |
|
Definition
Process of involution
Self care
Nutritional counseling
Bowel regularity
Body mechanics
Sexual activity
Follow-up appointments
Signs and symptoms to report
Supportive resources |
|
|
Term
| What self care points are important? |
|
Definition
Hand washing
Breast care
Measures to suppress
Care of C/S incision
Perineal care
Kegel exercises
Promote sleep/rest
Bladder – diuresis first 24 hours
Stomach – resume exercise after Dr says
Menstruations – 6 weeks, delayed with lactating mothers, STILL ovulate
Sex – resume after first menstruation, after episiotomy some loose interest for one year
Rest, Rest, Rest |
|
|
Term
| How long does uterine involution take? |
|
Definition
| 6-7 wks, descent of uterus midline, then 1cm/day |
|
|
Term
| What are the s/s to report? |
|
Definition
| Fever, signs of breast infection/abdominal pain/change in lochia/pain or warmth in legs/abdominal incision drainage |
|
|
Term
| What are the high risk factors for hemorrhage? |
|
Definition
Vag birth –more than 500 cc
C/S—1000cc loss
Grand multiparty
Hgb<9 requires tretment
Overdistention of uterus
Precipitous/prolonged labor
Retained placenta
Placenta previa/abruptio placenta
Induction/augmentation of labor
Operative procedures |
|
|
Term
| What are the high risk factors for infection? |
|
Definition
TEMP OVER 100.4
Operative procedures
Multiple cervical exams
Prolonged labor
Prolonged rupture of membranes
Manual extraction of placenta
Diabetes
Catheterization
Anemia |
|
|
Term
| What hemoglobin level requires treatment? |
|
Definition
|
|
Term
| What is the most common cause of atony? |
|
Definition
|
|
Term
| What are the indications of thrombophlebitis? |
|
Definition
| pain and redness, +Homan – send for venous scan |
|
|
Term
| What are the indications of pulmonary embolism? |
|
Definition
| sudden onset chest pain, SOB |
|
|
Term
| What are the signs of placenta fragments? |
|
Definition
| bleeding returns to rubra or foul odor noted – more common with “Dirty Dunkin" |
|
|
Term
| What is the most common cause of hemorrhage? |
|
Definition
|
|
Term
| What are other causes of hemorrhage? |
|
Definition
| retained placenta fragments, or infection, hematoma, lacerations |
|
|
Term
| What is the initial treatment of hemorrhage? |
|
Definition
| initial is fundal massage |
|
|
Term
| What are the s/s of hemorrhage? |
|
Definition
| saturate more than one pad/hr, “boggy” uterus, increased lochia with clots, severe perineal pain (with hematoma), tachycardia, hypotension |
|
|
Term
| What technique is used to stop hemorrhage? |
|
Definition
| Manual compression of the uterus and massage with the abdominal hand usually will effectively control hemorrhage from uterine atony. |
|
|
Term
| What procedure can be done to stop bleeding? |
|
Definition
| Manual removal of placenta. Performed only by the medical clinician. |
|
|
Term
| What is the nursing care for PP hemorrhage? |
|
Definition
Inspect placenta for missing parts
Administer oxytocics
Maintain IV line
Apply ice to perineum
Keep bladder empty
Massage fundus if boggy
Monitor lochia with amount and type
Discharge teaching: report if return to rubra, fever over 100.4, foul smelling lochia, flu-like symptoms |
|
|
Term
| What is a puerperal infection? |
|
Definition
| Puerperal infection is any infection of the reproductive tract that occurs within 28 days after abortion or childbirth. |
|
|
Term
| What is the 1st sign of infection? |
|
Definition
|
|
Term
| What are the symptoms of infection? |
|
Definition
| Chills, flu-like symptoms, elevated WBC (over 30,000), tachycardia |
|
|
Term
| What is a reproductive tract infection? |
|
Definition
| back ache, abd pain, foul smelling lochia, purulent discharge |
|
|
Term
| What is a wound infection? |
|
Definition
| erythema, warmth, swelling, tenderness, drainage. |
|
|
Term
| What are common sources of infection? |
|
Definition
| endometritis , mastitis, episiotomy or incision infection, UTI and respiratory infections. |
|
|
Term
| What are the symptoms of a UTI? |
|
Definition
| pain, burning, urgency or freq of urine |
|
|
Term
| What are the symptoms of mastitis? |
|
Definition
| erythema, warmth in breast, flue-like symptoms |
|
|
Term
| How do you diagnose an infection? |
|
Definition
| Diagnosis with culture, vag exam, CBC |
|
|
Term
| What is the nursing care associated w/ an infection? |
|
Definition
| assess VS, lochia, incisions, attend to pain, ensure food and fluid intake, obtain specimens, monitor response to antibiotic. |
|
|
Term
| What is thrombophlebitis? |
|
Definition
| Inflammation of vessel wall with thrombus |
|
|
Term
| What does thrombophlebitis cause? |
|
Definition
| stasis and hypercoagulability |
|
|
Term
| What are the symptoms of superficial venous thrombus? |
|
Definition
|
|
Term
| What are the symptoms of deep being thrombosis? |
|
Definition
| occurs in larger veins, positive Homan’s, pain |
|
|
Term
| What are the risk factors for thrombophlebitis? |
|
Definition
| immobility, C/S, PIH, DM, smoking, over 40 yr, multiparity, anemia |
|
|
Term
| How do you prevent thrombophlebitis? |
|
Definition
| early ambulation and hydration |
|
|
Term
| What is the nursing care associated w/ thrombophlebitis? |
|
Definition
Bedrest with leg elevated
Change positions frequently, not flexed knees
Teach no to rub area
Daily measurements of calf and thigh
Support stockings, moist heat application
Assess for complication: embolism, S&S of pulmonary embolism |
|
|
Term
| What is Rh incompatibility? |
|
Definition
| Antibodies cross placenta and attach to fetal red blood cells destroying them |
|
|
Term
| When does Rh incompatibility occur? |
|
Definition
Mother Rh- negative and fetus Rh positive
If Rh positive blood enters system of Rh negative mother reacts by developing antibodies to destroy RBCs with Rh positive antigens
Blood may mix during third stage of labor
First child not effected |
|
|
Term
| Is the first child effected by Rh incompatibility? |
|
Definition
|
|
Term
| What is the pathophys. of Rh incompatibility? |
|
Definition
As the placenta separates, the mother is further exposed to the Rh-positive blood.
The body acts as it would any foreign body and develops antibodies to destroy the invading antigen.
Most exposure occurs during the third stage of labor. The first child is not affected. Next pregnancy will cross the placental barrier and destroy fetal blood cells. As fetal blood cells are destroyed, fetal bilirubin levels increase which lead to neurological disease. The fetus is anemic it is termed Erythroblastosis fetalis.
In subsequent pregnancies with an Rh-positive fetus, Rh-positive red blood cells are attacked by the anti-Rh-positive maternal antibodies, causing hemolysis of the red blood cells in the fetus |
|
|
Term
A nurse is planning care for a postpartum client who had a vaginal delivery 2 hours ago. The client had a midline episiotomy and has had several hemorrhoids. What is the priority nursing diagnosis for this client?
Acute pain
Disturbed body image
Impaired urinary distention
Risk for imbalanced fluid volume |
|
Definition
|
|
Term
A 27 year old gravida 4, para 4 was admitted from labor, delivery, and recovery unit 2 hours after the birth of a 3600g (8-lb) baby boy. An hour later her fundus is slightly boggy, located 3 fingerbreadths above the umbilicus, and displaced to the right. Her perineal pads, which were changed just before transfer, are saturated.
What do these data suggest? Why? |
|
Definition
| The birth of a large infant and multiparity increase the risk of postpartum hemorrhage. Saturation of pads in a short time suggests heavy bleeding. The location of the fundus above the umbilicus and displaced to the side indicates that the cause of bleeding might be a distended bladder. |
|
|
Term
| What nursing action should be taken first? What follow-up assessments are necessary? |
|
Definition
| Assisting the mother to void is the priority nursing action. If, after voiding, the fundus is located at the level of the umbilicus and firmly contracted, the cause of the bleeding was probably a distended bladder, which made it difficult for the uterus to contract firmly. The location and consistency of the uterus, amount of lochia, BP, and pulse should be assessed frequently so that further excessive bleeding can be identified and controlled. |
|
|
Term
| Why is it necessary to remind and assist the woman to void? |
|
Definition
| The woman does not experience the urge to void because the bladder has not regained the muscle tone lost during pregnancy, and the sensitivity to pressure is decreased. |
|
|
Term
| What are the Psychosocial/Developmental Considerations? |
|
Definition
Maternal Attachment and Bonding
Paternal Attachment/Engrossment
Sibling Responses
Other Family Members |
|
|
Term
| What are the Maternal and infant behaviors to be assessed? |
|
Definition
en-face
touching
reciprocity
care taking activities |
|
|
Term
| How do you assess bonding? |
|
Definition
| initial attachment/often right after birth/newborn is quiet and alert |
|
|
Term
| How do you assess attachment? |
|
Definition
| process of forming an enduring bond/develops over time/facilitated by positive feedback |
|
|
Term
|
Definition
| holding the infant in the same vertical plane/gazing |
|
|
Term
|
Definition
-fingertipping initially
identifies specific features-”look at his fingers….just like mine” |
|
|
Term
| How do you assess reciprocity? |
|
Definition
-fingertipping initially
identifies specific features-”look at his fingers….just like mine” |
|
|
Term
| What are Rubin's Puerperal Phases? |
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Definition
Taking-in
Taking-hold
Letting-go |
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Term
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Definition
| mother focused on own needs/passive/allows others to care for infant/lasts 2 days or less |
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Term
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Definition
| assumes responsibility for her own care/shifts attention to baby/may verbalize anxiety about being a mom/several days/teachable moment |
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Term
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Definition
: giving up previous roles/expectations for birth/preconceived ideas for their child
NURSES MUST BE CAREFUL NOT TO TAKE OVER CARETAKING RESPONSIBILITIES |
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Term
| What are the stages of maternal role attainment? |
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Definition
Anticipatory Stage
Begins in pregnancy
Seek role models
Formal Stage
Birth to 4-6 weeks
Task: become familiar with infant cue’s
Informal Stage
Begins when cue’s are learned
Follow own instinct verses role models
Personal Stage
Comfort in new role
Infant is central |
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Term
| What is the father's adaptation? |
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Definition
Engrossment - fathers developing bond with infant
Increases when baby awake and responds
May lack confidence/not sure of expectations
INVOLVE IN CHILD-CARE ACTIVITIES
Expectations |
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Term
| What are sibling's adaptation? |
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Definition
Competition
Negative behaviors |
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Term
| What are grandparent's adaptation? |
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Definition
Proximity a factor
Source of support |
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Term
| What are factors affecting family adaptation? |
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Definition
Discomfort and fatigue
Knowledge of infant needs
Previous experience
Expectations about newborn
Maternal age
Maternal temperment
Infant temperment
Support system |
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Term
| What are cultural influences on adaptation? |
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Definition
Communication - Assure comprehension—nodding not enough/repeat back. Obtain interpreter
Health Beliefs - Integrate practices
Southeast Asian—rest very important after birth/assures good health later
Southeast Asian/Hispanics-hot/cold balance/keep mother warm/eat hot foods
Dietary Habits
Allow gifts of food |
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Term
| What are postpartum blues? |
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Definition
| Mild, normal, transient condition; depression |
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Term
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Definition
| Begins 3-4 days after childbirth, peaks on the 4-5 day and resolves within 2 wks |
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Term
| What are the s/s of pp blues? |
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Definition
| Insomnia, irritability, fatigue, tearfulness, mood changes, anxiety |
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Term
| WHat is important to do w/ pp blues? |
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Definition
Offer support, empathy, education
Nursing care: encouraged to rest, take care of self, discuss feelings, it is self-limiting
Distinguish from more severe--Postpartum Depression/Postpartum Psychosis |
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Term
| What are the s/s of postpartum depression? Tx? |
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Definition
starts first 4 wks and last several months, fatigue, loss of self, suicide thoughts crying
combination of psychotherapy, social, meds |
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Term
| What are the s/s of pp psychosis? |
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Definition
| rare, bipolar disorder or major depression, frightening thoughts, delusions of dead baby and hallucinations, need psychiatric Tx, will not resolve itself |
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Term
| What teaching is important with infant care? |
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Definition
Cord care
Diapering
feeding
Stools
Urine
Baths
How to take temp |
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