post
partum
partum
List symptoms of postpartum blues?
mood swings (mild depression interspersed with happy feelings), self-limiting, irritable, overly sensitive, episodic tearfulness without cause, difficulty sleeping, feeling of being let down, anxiety
Your patient is reporting feeling uterine tenderness, a temperature of 103 F, chills, and foul smelling lochia. What do you suspect is causing these symptoms?
Endometritis
what is it called when the breasts are bilaterally hard and painful and what should mom do to help with the pain?
Engorgement
hand express or pump to soften breast before feeding and apply a wam compress and use a cold compress between feeding to slow milk production
what med is given for "after pains" and at what dose?
Motrin 600 mg PO q8h PRN
What does Homan's sign assess?
Thrombophelebitis, assesses for signs of DVT's
List some ways to encourage attachment/bonding
Incorporate family goals in care plan
May postpone eye prophylaxis for 1 hour after delivery
Provide private time for the family to become acquainted
Encourage skin-to-skin contact (kangaroo care)
Encourage mother to tell her birth story
Encourage involvement of the sibling
Prepare parents for potential problems with adjustment
Initiate and support measures to minimize fatigue
Help parents identify, understand, and accept feelings
What is the first intervention should you do for a post partum hemorrhage?
Massage the fundus - uterine massage
How often should a mom feed her infant?
Every 1.5 to 3 hours
How long post partum is magnesium sulfate administered for?
When should a client expect to have her first bowel movement after delivery?
Day 3
What is the name of the acronym for the postpartum assessment and what does it stand for?
B- breast
U- uterus/abdomen
B- bowel
B- bladder
L-lochia
E- episiotomy/lacerations/incisions
H- homans sign / hemorrhoids
E- Emotions
What are some possible causes of a boggy uterus?
Uterine atony, high levels of oxytocin, multipara, LGA, red haired women
what is it called when one breast is reddened and painful and mom has chills and fever and what is the treatment?
Mastitis
Go to doctor and take full round of antibiotics
what is the 1st line treatment for postpartum depression?
Sertraline (zoloft)
What is the acronym used to evaluate the perineum and what does it stand for?
E - edema or swelling
E- Ecchymosis or bruising
D- discharge
A - approximation
what color should the lochia be at each day postpartum?
Lochia rubra is red (first 2-4 days)
Lochia serosa is pink (day 4-10 days)
Lochia alba is white (10-20th continues until the cervix is closed)
List the difference between postpartum blues, postpartum depression, and postpartum psychosis.
Postpartum blues: mood swings (mild depression interspersed with happy feelings), self-limiting, irritable, overly sensitive, episodic tearfulness without cause, difficulty sleeping, feeling of being let down, anxiety
Postpartum depression: Depression not characterized by mood swings. Can contemplate suicide as a way of escape and to protect baby - dying seem more favorable than living.
Postpartum psychosis: agitation, hyperactivity, insomnia, confusion, difficulty remembering or concentrating, delusions and hallucinations/illogical thinking, suicide risk/infant risk
Name 4 ways to suppress lactation for a non-breastfeeding mom
1. Well-fitting bra or ace binder wrap
2. Cold compress
3. Cabbage leaves
4. no water or stimulation of breasts
In what case would you not administer Methylergonovine Maleate (methergine) to a pregnant woman?
NOT to bed used with woman with high blood pressure
6 weeks
When do menstruation and ovulation occur after having a baby? How does it differ for non-breast feeding vs breastfeeding moms?
Non-breastfeeding
Menstruation usually occurs in 7-12 weeks
Ovulation usually occurs within 70 to 75 days
Breastfeeding
Menstruation may be delayed 3 months or longer, depending on exclusively breastfeeding or not
list some signs of postpartum hemorrhage?
Excessive or bright-red bleeding (saturation of more than one pad per hour)
A boggy fundus that does not respond to massage
Abnormal clots
High temperature
Any unusual pelvic discomfort or backache
Persistent bleeding in the presence of a firmly contracted uterus
Rise in the level of the fundus of the uterus
Increased pulse or decreased BP
Hematoma formation or bulging/shiny skin in the perineal area
Decreased level of consciousness
Explain weaning and what specifically should be substituted
Substitute one cup feeding or bottle feeding for one breastfeeding session over a few days to a week so breasts gradually produce less milk
List the three medications used to treat hypertension and what the contraindications are for each
Labetalol - asthma
Nifedipine - tachycardia
Hydralazine - tachycardia
What is the change in cardiac output postpartum?
Cardiac output decreases by 30% in the first 2 weeks and reaches normal levels by 6-12 weeks