Birth Control
What women should not be prescribed contraception that contains Estrogen?
Hypertension
History CVA/MI
VTE risk factors or history of clots
Smokers
Reproductive cancer history
Women that are pregnant
What is the usual fundal height of a woman's uterus in the 1st 24 hours postpartum?
At the umbilicus
What change in heart rate would you anticipate in a newly postpartum woman?
Should be lower (increased volume for body needs)
How long can breast milk be stored for? (3 times)
4 hours at room temperature
4 days in the fridge
Up to 1 year in freezer
What are 5 risk factors for a primary PPH?
Macrosomia
Multiple gestation
Polyhydramnios
Chorioamnionitis
Prolonged or rapid labor
Use of Magnesium or Oxytocin in labor
What signs & symptoms of complications should you educate your client about when they are prescribed hormonal contraception?
Headache/Changes in vision
Chest pain/SOB
Leg Pain
Abdominal pain
What are your top 2 priorities (in order) you should do for your patient with a boggy fundus?
1. Massage until firm
2. Assess/empty the bladder
What are signs of hypovolemic shock?
Pale/Diaphoretic skin
Hypotension
Tachycardia
Oliguria
Thirst
Change in LOC
Feeling anxious or impending doom
What teaching would you provide a breastfeeding woman to ensure a good latch & avoid nipple trauma?
Compress breast tissue
Wait for baby's mouth to be wide open
Bring baby to the breast
Break the seal by inserting 1 finger in their mouth when feed is over
What are the signs & symptoms of a postpartum hematoma?
Discoloration of perineum
Unrelenting perineal pain
Vaginal/rectal pressure
Edema
Bleeding (non-lochial)
Signs of shock
Which contraceptive method is not recommended for women with an elevated BMI?
Ortho Evra Transdermal Patch
What would the approximate fundal height be of a woman who is 4 days postpartum?
U-4
What are the characteristics of & the time frame of lochia serosa?
How long should bottle equipment be boiled for if sterilizing it? What should be done before placing the pieces in the boiling water?
5 minutes
Wash with warm/soapy water first
How can VTE be prevented when a patient is bedridden?
TED hose
SCDs
Leg movements in bed
Low-molecular-weight heparin
At least how long should a diaphragm, cervical cap or contraceptive sponge remain inside the body for following intercourse?
6 hours
What classification of analgesics tends to work best for women experiencing afterpains?
NSAIDS (usually Ibuprofen)
What 2 things should you assess in a woman postoperatively prior to her getting out of bed for the 1st time?
Vital Signs - BP especially
Hydration level - PO if stable, IV in unstable
How long is formula that has been prepared good for in the fridge?
48 hours
What are 3 potential signs of postpartum depression?
Symptoms lasting > 2 weeks like:
Fatigue
Sleep disturbances
Appetite changes
Irritability
Hopelessness
Lack of interest in caring for self/baby
What does excessive use of Nonoxynol-9 (spermacide) increase the risk of?
STIs and HIV infection (micro-tears to tissue)
What hormone is released by the pituitary gland that results in the postpartum uterus contracting?
Oxytocin
What instructions would you give a woman related heat & cold during the initial postpartum period?
Ice once an hour x 20 minutes for 1st 24 hours then warmth (sitz bath) 3 x a day & prn
How old should a baby be when first foods are introduced to their diet?
6 months
What are at least 3 signs & symptoms of endometritis?
Temperature > 100.4
Tachycardia
Firm uterus that is tender to touch
Foul smell to lochia
Chills/Fatigue/Malaise
Adominal discomfort