Psychological Complications
What is the typical onset and duration of baby blues
Begins within the first 1–2 weeks postpartum, lasts up to 2 weeks, resolves without medical treatment.
Which medication is the first-line treatment for postpartum hemorrhage?
Oxytocin (Pitocin).
A boggy fundus is most concerning for what complication?
Uterine atony leading to postpartum hemorrhage
Name the 4 “T’s” of postpartum hemorrhage causes.
Tone, Tissue, Trauma, Thrombin.
A postpartum patient should call 911 if she experiences which symptoms? (Name 1)
Chest pain, obstructed breathing, seizures, or thoughts of self-harm
A mother reports depressed mood, fatigue, and loss of interest in activities 3 months postpartum. Which condition is suspected?
Postpartum Depression
Why is Methergine contraindicated in patients with hypertension?
It causes vasoconstriction, which can worsen hypertension.
Which nursing intervention should be performed first when uterine atony is suspected?
Fundal massage.
A woman with prolonged rupture of membranes and cesarean delivery is most at risk for what infection?
Endometritis
What is considered abnormal postpartum bleeding?
Soaking more than one pad per hour or passing clots the size of an egg or larger.
What is the defining feature that makes postpartum psychosis (PPP) a medical emergency?
Presence of delusions, hallucinations, or disorganized thinking that pose imminent safety risks.
A patient with asthma should not receive which uterotonic medication?
Hemabate (Carboprost).
Describe the expected progression of fundal height postpartum
At the umbilicus immediately postpartum, then descends ~1 fingerbreadth per day.
Which symptom is most concerning for a DVT?
Unilateral leg pain/swelling with warmth and erythema.
What is the recommended follow-up timeline for postpartum visits?
1-2 weeks if high risk, as well as the regular 6-8 week visit.
About what percentage of postpartum women experience major mood disorders like PPD?
10–20%
A postpartum patient who is Rh- delivers a Rh+ baby. What medication is indicated, and when must it be given?
RhoGAM, within 72 hours postpartum.
A patient’s lochia is heavy, with clots the size of golf balls. What should the nurse prepare for?
Possible postpartum hemorrhage.
A patient reports fever, localized breast pain, and erythema. What is the likely complication?
Mastitis
What education should be given about sexual activity after receiving a rubella vaccine?
Avoid pregnancy for 12 weeks (teratogenic effects).
Name two nursing priorities when a patient shows signs of postpartum psychosis.
Ensure patient safety (prevent harm to self/infant), initiate immediate psychiatric/medical intervention.
Calculate: Order is Methergine 0.2 mg IM. Available is 0.4 mg/2 mL. How many mL do you give?
1 mL.
Name the elements of the BUBBLE-LE assessment.
Breasts, Uterus, Bowel, Bladder, Lochia, Episiotomy/Laceration, Lower extremities, Emotions.
Name two risk factors for thromboembolic disease in postpartum women
Hypercoagulability, venous stasis, obesity, smoking, infection, trauma, or history of VTE.
What is one strategy nurses can use to improve postpartum follow-up attendance?
Schedule appointments before discharge, reinforce importance, address barriers to attendance.