Postpartum Adaptations Flash Cards

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Title:	Postpartum Adaptations
Description:	Chapter 21: Maternal-Child Nursing
Number of Cards:	44
Save Count:	8
Author:	scrapmom2four9
Created:	2001-09-22
Tags:	medicine
Private	No

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- Question
- Answer
- Side 3

- What would you teach a postpartum woman about how to sit?
- You should advise her to squeeze her buttocks together before sitting and to lower her weight slowly onto her buttocks.
- Describe lochia alba and its duration.
- Lochia alba contains leukocytes, decidual cells, epithelial cells, fat, cervical mucus, and bacteria; it is white or colorless; its duration varies from the 11th day until the 3rd to 6th week.
- engrossment
- intense fascination between father and newborn
- attachment
- longer-term development of affection between the infant and significant other
- How would a normal leukocyte level for a postpartum woman be interpreted for a nonpregnant woman?
- Leukocyte level would be 5,000 to 10,000/mm3.
- entrainment
- movement of the newborn in rhythm with adult speech
- Describe intake and output nursing assessments and care for the woman who gave birth by cesarean.
- Monitor IV for rate of flow and site condition; observe urine for amount, color, and clarity.
- Describe abdomen nursing assessments and care for the woman who gave birth by cesarean.
- Assess for return of peristalsis by auscultating bowel sounds; observe for abdominal distention; observe surgical dressing for intactness and drainage; observe incision line after dressing removal for signs of infection (REEDA); palpate fundus gently.
- Describe respiratory nursing assessments and care for the woman who gave birth by cesarean.
- Observe respiratory rate and depth (every 30 minutes to 1 hour if epidural narcotics were used); monitor apnea for epidural narcotic administration; auscultate breath sounds for retained secretions; assist the mother to turn, cough, and deep-breathe; use the incentive spirometer.
- en face
- position that facilitates eye-to-eye contact between parent and newborn
- How does the leukocyte level change during the early postpartum period?
- Leukocytes increase up to 20,000 or 30,000/mm3.
- Describe postpartum changes in the uterine lining.
- Outer area of endometrium (decidua) is expelled with the placenta. Remaining decidua separates into two layers: the superficial layer is shed in lochia and the basal layer regenerates new endothelium.
- What would you teach a postpartum woman about sitz baths?
- They provide continuous circulation of water, cleanse and comfort the traumatized perineum.
- Describe lochia serosa and when it occurs.
- Lochia serosa contains serous exudate, erythrocytes, leukocytes, and cervical mucus; it is a pinkish color; and its duration is from the 4th to the 10th day.
- bonding
- development of an emotional tie to the infant
- Describe the influence of oxytocin on lactation.
- Oxytocin causes milk ejection from the alveoli into the lactiferous ducts.
- Explain how a full bladder at birth can lead to postpartum hemorrhage.
- A full bladder interferes with the ability of the uterus to contract firmly and occlude open vessels at the placental site. This allows them to bleed freely.
- catabolism
- conversioni of living cellular substances to simpler compounds
- Describe the influence of prolactin on lactation.
- Prolactin initiates milk production in the alveoli.
- Kegel exercises
- method to increase tone of muscles in the vaginal and urinary meatus area
- List signs and symptoms that the postpartum woman should report to her physician or nurse-midwife.
- Fever; localized area of redness, swelling, or pain in the ebreasts that is unrelieved by support or analgesics; persistent abdominal tenderness or feelings of pelvic fullness or pelvic pressure; persistent perineal pain; frequency, urgency, or burning when urinating; change in lochia character (increased amount, return to red color, passage of clots, or foul odor); localized tenderness, redness, or warmth of the legs.
- What teaching should you provide the postpartum woman to prevent constipation?
- Increase activity progressively, drink adequate fluids (at least 8 glasses of water) and add dietary fiber (found in fruits and vegetables, whole grain cereals, bread, and pasta) to prevent constipation. Prunes are a natural laxative.
- Describe the influence of estrogen on lactation.
- Estrogen and progesterone prepare the breasts for lactation.
- Homans' sign
- calf pain that occurs when the foot is dorsiflexed
- Describe lochia rubra and when it occurs.
- Lochia rubra contains blood, mucus, and bits of decidua; is red in color; and has a duration of about 3 days.
- involution
- retrogressive changes that return the reproductive organs to their prepregnancy states
- Describe the influence of progesterone on lactation.
- Estrogen and progesterone prepare the breasts for lactation.
- REEDA
- acronym that helps assess wound healing (redness, edema, ecchymosis, discharge, approximation)
- Describe postpartum changes in the uterine muscle cells.
- Number of uterine muscle cells remain the same, but each cell decreases in size through contraction.
- Describe the effect of breast-feeding on sexual intercourse.
- Lactation suppresses ovulation and estrogen secretion, causing more vaginal dryness than nonlactating mothers have. This may cause painful sexual intercourse unless lubrication is added.
- fingertipping
- initial touch characteristic between mother and newborn
- Describe the effect of breast-feeding on uterine involution.
- Breast-feeding stimulates release of oxytocin from the pituitary gland, which tends to intensify afterpaind but also maintains better uterine contraction. This facilitates involution.
- Describe the proper technique to massage a soft fundus.
- 1. explain step by step
  2. have mom empty bladder
  3. Mom supine, knees flexed
  4. Gloves, perineal pads
  5. Nondominant hand above symphysis pubis, to support and anchor lower uterus
  6. Flat part of fingers to palpate
  7. Begin palpation at umbilicusto locate fundus
  8. Massage if "boggy" or soft
  9. Documentation
- What factors increase the risk for venous thrombosis in pregnant and postpartum women?
- Those who have varicose veins, a history of thrombophlebitis, or a cesarean birth.
- stroke volume
- quantity of blood ejected from the ventricle with each heartbeat
- What is the significance of bradycardia during the early postpartum period?
- Blood volume and cardiac output increase as blood from the uteroplacental unit returns to the central circulation and as excess extracellular fluid enters the vascular compartment for excretion. Because stroke volume increases, pulse decreases.
- How should the nurse expel clots?
- Nurse must support the lower uterine segment, while applying firm pressure downward toward the vagina to express clots that have collected in the uterus.
- puerperium
- period from childbirth until reurn of the reproductive organs to their prepregnancy states
- What nursing measures help supress lactation and deal with the discomfort of breast engorgement?
- Tell the mother to wear a tight-fitting bra or bind her breasts. Ice applications and analgesics reduce discomfort. She should avoid actions that stimulate milk production, such as spraying with warm water during showers and pumping or massaging the breasts.
- What would you teach a woman about cold packs as postpartum comfort measures.
- Ice causes vasoconstriction and is most effective if applied soon after birth to prevent edema and numb the area.
- What would you teach the postpartum woman about perineal care?
- Perineal care consists of squirting warm water over perineum after each voiding or bowel movement. It cleans, comforts, and prevents infection.
- Describe postpartum changes in the uterine muscle.
- Stretched uterine muscle fibers contract and gradually regain their former size and contour.
- What would you teach a postpartum woman about topical medications?
- Anesthetic sprays decrease surface discomfort and allow for a more comfortable ambulation.
- What makes any pregnant and postpartum woman at risk for venous thrombosis?
- Pregnant and postpartum women have higher fibrinogen levels, which increase the ability to form clots. Factors that lyse clots are not also increased, however.