Post Partum
Things that are involved in slow uterine involution
Prolonged labor
Anesthesia
Difficult birth
Grand Multiparity
Full Bladder
Overdistended uterus
Infection
Incomplete explosion of membranes
Abdomen
Loose wall
Uterine ligaments stretched
Diastasis recti (Separation of abdominal muscles)
Striae (stretch marks)
What are PP chills?
Intense tremors immediately after birth
*30mins- 1 hour
*No fever no concern*
NB and mothers Health Protection Act of 1996 prohibits...
Hospital stays for vaginal PP to less than 48hr
and C-section PP less than 96hr
Why does bleeding stop with breastfeeding (less anemia)
Breastfeeding releases oxytocin which clamps the uterus helping bleeding to stop
Normal cervix location post birth
One finger breathe below umbilicus; midline
Sometimes they don't. Why?
PP Diuresis
PP urinary retention
Eye to eye contact (nipple to eye or close up on chest) with a baby is called...
En face positions
Most preventable complication with PP
Hemorrhage
WNL baby vitals
Pulse 120-160
Breathing less than 20 sec of apnea is WNL
BP: 75/45
Resp: 30-60
Temp: 97.5-99
Types of lochia
Rubra: red for 2-3 days pp: small clots
Serosa: Pinkish from day 3-10
Alba: Lighter color for a week or two afterward
*Keep all clots and weigh fully saturated (in one hour or less) pads (100 ml)
Temp after birth
First 24 hours: slight increase
After 24 hr anything above 100.4 is a fever
Day 3/4 small increase with milk coming in
How often should PP assesmtns happen?
Every 15mins (First hour)
Every 30 mins (Second hour)
Every 4hr following
DO NOT LEAVE ALONE FOR THE FIRST 1-4 HOURS
Is the eye cream required?
Yes by law erythomyocin
Fontal sunk in means
Dehydrated
How to assess perineum?
R: redness
E: edema or swelling
E: ecchymosis or bruising
D: drainage
A: approximation of episiotomy or laceration
Pluse
Decreases to the end of the week
anything above 100 is tachy and could be shock, fear, anxiety, pain, excitement, physical exertion or medication
B-U-B-B-L-E-H-E assessment
Breast
Uterus
Bowel
Bladder
Lochia
Episiotomy
Hemorrhoids
Emotions
When do we know a baby is sick?
When their temp is low but we have put in interventions for them to be warm (blankets, clothes, warming on an adult)
They do not run fevers
Teaching for contraception
BFing is not a reliable form of contraception
You can ovulate w/o menstruating
estrogen only or non hormonal birth control if breastfeeding
Tylpical Blood loss
Vaginal: 300-500
C-Section: 500-1000
When is RhoGAM given?
RH- mother with a RH+ baby
Care of a NB
Maintain airway
Thermal regulate
Protect from infection and injury