Post Partum
When does menstruation return after childbirth.
Typically 7-9 weeks if the mother is bottle feeding. It varies in breastfeeding mothers. Some breastfeeding mothers will not experience menstruation while others experience menstration within 3 months.
Normal maternal vital sign variations in theh postpartum period.
Respirations - 12 to 20bpm
Blood pressure - within normal range
Heart rate - bradycardia (40-80)
Temperature - less than 100.4 (slightly elevated in the first 24 hours)
Describe findings consistent with a pulmonary embolism.
Sudden onset of sharp chest pain and difficulty breathing.
Describe three medications used for PP hemorrhage
Oxytocin
Misoprostol (Cytotec)
Methylergonovine
Describe Lochia
Rubra - Dark red lasting 3-5 days
Serosa - Pinkish brown lasting 4-10 days
Alba - Whitish yellow lasting 10-28 days
Identify risk factors associated with Dystocia
Multiple Gestation
Short Maternal stature
Maternal Obesity
Breech Presentation
Describe warning signs for PTL
Dull lower backache
Increased vaginal discharge
Dysuria
How should the nurse educate the new mother about abdominal pain while breasteeding.
Oxytocin is the hormone responsible for the "milk letdown" reflex and it stimulates the uterus which causing abdominal cramping similar to a contraction.
Describe Tachysytole
Greater than five contractions in a ten min period.
Describe TOLAC
Trial of labor after cesarean birth. Greatest risk factor - uterine rupture.
Describe Engorgement
The breast become swollen, hard, and tender to touch. Can be relieved by expressing milk via breast pump or feeding the newborn.
Nursing interventions for a suspected prolapsed ubilical cord.
Place the mother in trendelenburg position, apply oxygen, and keep the presenting part off of the umbilical cord.
When the nurse suspectes shoulder dystocia what interventions should be performed?
Request immediate assistance (HELLP)
McRobert's position - Suprapubic pressure per provider's request.
Describe a Fundal Assessment
Fundal massages are necessary to prevent uterine atony (r/t postpartum hemorrhage).
descends from the level of the umbilicus at a rate of 1 cm (one fingerbreadth) per day. By 3 days, the fundus lies two to three fingerbreadths below the umbilicus (or slightly higher in multiparous women). By the end of 10 days, the fundus usually cannot be palpated because it has descended into the true pelvis.
What risk factors are associated with a vacuum assisted delivery.
Vaginal tearing/lacerations; injury to bladder
Trauma to the newborn head: cephalohematoma
Describe four tocolytic drugs used in the treatment of PTL
Nifedipine
Magnesium Sulfate
Terbutaline
Indomethacin