Extras
How and where the fundus should be 24 hrs after birth.
What is firm, midline, and at the level of the umbilicus (fundus involutes about 1 cm per day)?
Two ways to suppress lactation.
- Wear a well-fitted support bra continuously for 72 hrs after giving birth
- Avoid breast stimulation (including newborn suckling, expressing milk, and running warm water over breasts in shower)
How often to bathe a newborn.
What is every 2-3 days? (Only sponge baths until cord falls off and site is healed.)
Feelings of extreme sadness or anxiety, difficulty bonding with baby, feeling like harming the baby or self-harming, and thinking about death or suicide.
What are s/s of peripartum depression?
What to do when fundus is deviated laterally.
What is obtain bladder scan, encourage/assist woman to void, and/or prepare for foley catheterization?
The interval from birth to return of the nonpregnant state. Usually lasts ~6 weeks.
What is the postpartum period?
How to treat breast engorgement.
What are periodic ice packs to the breasts, cabbage leaves, and mild analgesics or anti-inflammatory medications?
How to use a bulb syringe.
What is compressing the bulb, then slowly releasing while the tip is in mouth or nose? (Order: mouth then nose if suctioning both)
Mild depression after childbirth that does not interfere with ADLs.
What are the baby blues? (Peripartum depression interferes with ADLs).
What to do when fundus is soft, boggy, or higher than expected.
What is massaging the fundus?
a. Bright red lochia lasting 1-3 days.
b. Pinkish brown lochia from 4-10 days postpartum.
c. Whitish-yellow lochia from 10-14 days postpartum, lasting up to 3-6 weeks.
What is: a. rubra, b. serosa, c. alba lochia?
How often to teach to change pads.
What is every 2-4 hours?
How often to feed newborn.
What is about every 2-3 hours? (May vary per individual newborn.)
Peripartum depression lasts longer than ______.
What is 2 weeks?
How to position baby during sleep to prevent SIDS.
What is on their backs?
Time period during which a fever (100.4 F or higher) can indicate infection in postpartum women.
Fever > 100.4 F x 24 hrs, saturation of 1 or more pads in an hour, increased pain (vaginal, abdominal, perineal, or pelvic) that worsens and is unrelieved by medication, increased redness/warmth/pain at incision or laceration site, leg painful with warmth, redness, or swelling, or chest pain occurs.
When to call HCP?
How many wet diapers in first 24 hrs and how many wet diapers per day once milk comes in (3-4 days)?
What is at least 3 and 6-8 wet diapers?
What care management may include.
What is support, counseling, psychotherapy (CBT or interpersonal psychotherapy), and medication?
Four Ts for causes of postpartum hemorrhage.
What are tone (atonic), trauma, tissue (retained), and thrombin (deficiency)?
How often to burp newborn if bottle feeding?
What is every 1/2 to 1 oz of formula?
Severe headache not relieved by Tylenol, nausea, vomiting, blurred vision, sudden onset SOB (not associated with exertion), presence of clots larger than a quarter.
When to go to the ED?
At least 2 signs or symptoms for which the HCP would need to be called.
- Inactive, listless, or sluggish baby
- Vomiting each feeding or forceful vomiting
- Fewer wet diapers than 6-8 per day after 3-4 days of age
- Redness, drainage, oozing, bleeding, or foul odor from umbilical site
- Redness, drainage, swelling, excessive bleeding, or foul odor around circumcision
- Jaundice spreads covering abdomen, arms, and legs
- Temperature < 97 F or > 100.4 F underneath the arm
Synthetic neurosteroid/ GABA-A modulator for peripartum depression.
What is brexanolone?
How to treat mastitis.
What is continued lactation, rest, antibiotics, pain management (NSAIDs, cold compresses), adequate fluid intake, and a balanced diet?