Postpartum Assess.
Signs of a postpartum hemorrhage.
What are:
Uterus larger than expected
Saturating a pad in less than an hour
Clots larger than a quarter-half dollar
Steady trickle of blood
Tachycardia
Tachypnea
Hypotension
Lasts 1-2 weeks
No medications are needed
Up to 80% of women experience it
What is postpartum blues?
Interventions for plugged milk duct
What is: Apply heat, Massage, Breastfeed to affected side, Pump?
Treatment for mastitis
What are antibiotics, continue breastfeeding (need to empty breasts), and ibuprofen?
Amount of kcal need postpartum for breastfeeding and non-breastfeeding patients
What are 200 kcal over pregnancy requirements for breastfeeding moms (500 kcal over pre-pregnancy requirements)?
What are 300 kcal less than pregnancy requirements (bottlefeeding moms)?
Fundus: Boggy, @u, to left
Displaced bladder
Bonus question:
What can a displaced bladder cause?
Common pains from uterine contractions
What are afterpains?
Interventions for breast engorgement: Bottlefeeding Mom
What is wear a supportive bra, ice to breast, cabbage leaves, avoid hot water on breasts?
Postpartum patient on narcotic pain medications and being fatigued
What is fall risk for mom and baby?
REEDA for wound assessment
What is redness, edema, ecchymosis, discharge, approximation?
Primary cause of a postpartum uterus larger than expected (not deviated to the side)
What are clots/postpartum hemorrhage in the uterus?
Priority treatment for afterpains
When to give analgesics before breastfeeding?
Engorgement interventions for breastfeeding mom
What is wear a supportive bra, heat before nursing, cold compresses after nursing, pumping, regular feeding?
Common vaccinations given on the postpartum floor
What are rubella, Tdap, flu, and pneumovax?
Lochia amounts on a pad
What is:
Scant: less than 1 inch
Light: less than 4 inches
Moderate: less than 6 inches
Heavy: saturated pad?
Taking in vs. Taking hold
What is:
•Taking in”–Dependent; first 24-48 hours; Woman tends to be passive, follows suggestions, hesitates to make decisions, preoccupied with her needs (food and sleep). Need to review birth with others?
•“Taking hold”–Occurs from day 2 to day 10; Dependent/independent; ready to resume control of her body, her mothering, and life in general; and breastfeeding worries; needs reassurance?
Nursing interventions to prevent thromophlebitis
What are ambulate, teach s/s of thrombophlebitis (edema, redness, tenderness, and warmth), SCDs (Sequential Compression Devices) and VTE prophylaxis for high risk patients?
Most important intervention for nipple soreness
What is to correct breastfeeding technique?
Hemorrhoid treatments
What are sitz bath, ice packs, peribottle, topical agents, rectal suppositories, Tucks pads, side lying position, fluids, high fiber diet, and stool softeners?
Etiology of fundus +4, midline
What are blood clots?
Uterus at delivery, 6-12 hours after delivery, postpartum, 1st postpartum day after delivery
What is normal involution?:
▪The fundus will be midline and approximately halfway between the symphysis pubis and the umbilicus at delivery.
▪Then, at the level of the umbilicus the 6−12 hours postpartum.
▪Fundus will be 1 cm below the umbilicus on the first postpartum day.
▪Fundus will descend 1 cm per day until it is in the pelvis on the 10th day.
Risk for thrombophlebitis postpartum
What are: maternal age, operative delivery, immobilization, obesity, malignancy, caucasian descent, history of thrombosis, thrombophilia, and familial thrombosis?
Interventions for cracked nipples
What is correct latch, analgesics, nurse on the best side first, lanolin, shells, colostrum, aloe vera peppermint gel, lactation consultant?
BUBBLEHE for postpartum assessment
What is Breast, Uterus, Bladder, Bowel, Lochia, Episiotomy, Homan's sign, and Emotional status?
Amount of blood loss that defines postpartum hemorrhage
What loss involves 500 mL at vaginal delivery or 1000 mL during a C/S?