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Questions and Answers
What does the 'R' in the REEDA assessment stand for?
What does the 'R' in the REEDA assessment stand for?
Which of the following is NOT a recommended non-pharmacologic comfort measure for perineal discomfort?
Which of the following is NOT a recommended non-pharmacologic comfort measure for perineal discomfort?
What might severe edema indicate during an episiotomy wound assessment?
What might severe edema indicate during an episiotomy wound assessment?
Which treatment should be avoided because it interferes with blood clotting?
Which treatment should be avoided because it interferes with blood clotting?
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What does ecchymosis refer to in the context of episiotomy assessment?
What does ecchymosis refer to in the context of episiotomy assessment?
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How should a woman be encouraged to position herself for optimal comfort after an episiotomy?
How should a woman be encouraged to position herself for optimal comfort after an episiotomy?
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Which of the following options specifically aids in assessing a cesarean incision?
Which of the following options specifically aids in assessing a cesarean incision?
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What is a possible indication of pain with redness at the episiotomy site?
What is a possible indication of pain with redness at the episiotomy site?
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How long should a diaphragm be kept in place after coitus for optimal effectiveness?
How long should a diaphragm be kept in place after coitus for optimal effectiveness?
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What is a recommended method to improve the efficacy of the spermicide approach?
What is a recommended method to improve the efficacy of the spermicide approach?
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What is the maximum duration a foam-impregnated sponge can be left in place?
What is the maximum duration a foam-impregnated sponge can be left in place?
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What complication may arise if a sponge is left in place longer than 24 hours?
What complication may arise if a sponge is left in place longer than 24 hours?
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Which of the following is a characteristic of male condoms?
Which of the following is a characteristic of male condoms?
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Which condition makes the use of a sponge contraindicated?
Which condition makes the use of a sponge contraindicated?
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What might happen to the sperm if a spermicidal product is inserted too early?
What might happen to the sperm if a spermicidal product is inserted too early?
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What is the failure rate associated with the sponge method?
What is the failure rate associated with the sponge method?
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Which condition may require a woman to be monitored closely after birth due to potential complications?
Which condition may require a woman to be monitored closely after birth due to potential complications?
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What is a primary reason for providing privacy and support in the postpartum care environment?
What is a primary reason for providing privacy and support in the postpartum care environment?
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When can women typically resume sexual activity postpartum?
When can women typically resume sexual activity postpartum?
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Which exercise is recommended for postpartum women to facilitate recovery?
Which exercise is recommended for postpartum women to facilitate recovery?
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What is a common complication from challenging deliveries or certain risk factors postpartum?
What is a common complication from challenging deliveries or certain risk factors postpartum?
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Which factor may necessitate catheterization postpartum?
Which factor may necessitate catheterization postpartum?
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What should be monitored when a woman undergoes multiple vaginal examinations postpartum?
What should be monitored when a woman undergoes multiple vaginal examinations postpartum?
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Which postpartum condition is associated with the presence of bacteria in the fetal membranes?
Which postpartum condition is associated with the presence of bacteria in the fetal membranes?
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What is the primary purpose of skin-to-skin contact right after birth?
What is the primary purpose of skin-to-skin contact right after birth?
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Which stage of the transition to fatherhood involves the acceptance of reality?
Which stage of the transition to fatherhood involves the acceptance of reality?
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What does the term 'engrossment' refer to in the context of fatherhood?
What does the term 'engrossment' refer to in the context of fatherhood?
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What is the significance of the 'en face position' when interacting with a newborn?
What is the significance of the 'en face position' when interacting with a newborn?
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How long does rooming in typically occur for mother and child during the postnatal period?
How long does rooming in typically occur for mother and child during the postnatal period?
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What role do nurses play in promoting parental attachment?
What role do nurses play in promoting parental attachment?
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What emotion does abandonment closely resemble during the postnatal period?
What emotion does abandonment closely resemble during the postnatal period?
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What is the primary goal of the transition to parenthood process?
What is the primary goal of the transition to parenthood process?
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What is the ideal failure rate for a female condom?
What is the ideal failure rate for a female condom?
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Which of the following is a contraindication for using a cervical cap?
Which of the following is a contraindication for using a cervical cap?
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What type of device is an Intrauterine Device (IUD)?
What type of device is an Intrauterine Device (IUD)?
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What happens if a female condom is used incorrectly?
What happens if a female condom is used incorrectly?
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What must be performed before fitting a diaphragm?
What must be performed before fitting a diaphragm?
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Which condition should be avoided to use a cervical cap?
Which condition should be avoided to use a cervical cap?
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How does an IUD function to prevent pregnancy?
How does an IUD function to prevent pregnancy?
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What is a common misconception about male and female condoms?
What is a common misconception about male and female condoms?
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Study Notes
Episiotomy
- Episiotomy is a surgical incision made between the vaginal opening and the anus during childbirth.
- Episiotomy Wound Assessment (REEDA) is used to assess for healing:
- R: Redness - normal inflammation associated with healing. Pain with redness may indicate infection.
- E: Edema - mild edema is common, but severe edema can interfere with healing.
- E: Ecchymosis - refers to bruising. A few small bruises are common. Large bruises can interfere with healing.
- Sitz bath is a therapeutic technique done by sitting in warm, shallow water that is useful for assessing cesarean incision healing and providing perineal comfort.
- Comfort measures for perineal pain include:
- Pharmacologic: soothing anesthetic cream or spray, cortisone-based cream, witch hazel-impregnated pads.
- Non-Pharmacologic: warmth, distraction.
- Avoid aspirin as it interferes with blood clotting and can lead to hemorrhage.
Transition to Parenthood
- Period from deciding to conceive to the first months of having a child, involving a parent coming to love and accept a child, and a child coming to love and accept the parents.
- Three stages of transition to fatherhood:
- Expectations (stage 1)
- Reality (stage 2)
- Transition to mastery (stage 3)
- Skin-to-skin contact facilitates early attachment and bonding.
- En Face Position refers to looking directly at the newborn’s face with direct eye contact. It is a sign of effective attachment.
- Engrossment refers to a father’s absorption, preoccupation, and interest in their infant.
- Rooming In occurs when the infant remains in the woman’s room and the mother and child are together 23 out of 24 hours a day.
Maternal Concerns During Postpartum Period
- Abandonment is a sensation close to jealousy, with competitive feelings when the mother is no longer the center of attention.
- Common causes of postpartum concerns:
- Retained placental fragments
- Postpartal hemorrhage
- Preexisting anemia
- Prolonged and difficult labor
- Internal fetal heart monitoring
- Local vaginal infection
- Uterus explored after birth
- Cesarean section
- Chorioamnionitis (bacterial infection of the membranes surrounding fetus)
- Bladder catheterization
- Multiple vaginal examinations after rupture of membranes
- Epidural anesthesia
- Episiotomy or lacerations
Postpartum Discharge Instructions
- Provide assistance with:
- Limitations in movement
- Going to the bathroom (frequency of urination)
- Protection from falls
- Adequate clothing
- Wound care for episiotomy
- Exercise: Encourage simple exercises and gradual progression to more strenuous ones.
- Abdominal breathing, chin to chest, excellent for the second day after birth.
- Perineal contraction (Kegel’s exercise) - Recommended to start on the third day after birth, or the fourth day after the peak of mucus change.
Contraception
- Coitus is safe as soon as lochial discharge has returned to alba and episiotomy is healed (approximately 2 weeks postpartum).
- Various contraceptive methods:
- Film: glycerin impregnated with a spermicidal agent, folded and inserted vaginally.
- Cocoa butter and glycerin-based vaginal suppositories: containing a spermicide.
- Diaphragm: kept in place for at least 6 hours after coitus.
- Foams: impregnated synthetic sponges left in place for up to 24 hours. Easier to insert.
- Sponges: block sperm access to the cervix. Should remain in place for 6 hours after intercourse.
- Condom: Latex rubber or synthetic sheath placed over the erect penis before coitus begins.
- Cervical Cap: Made of soft rubber, fits snugly over the uterine cervix. Should not exceed 48 hours.
- Intrauterine Device (IUD): Small, T-shaped device placed inside the uterine cavity creating a sterile inflammatory condition to prevent implantation and fertilization.
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Description
This quiz covers key concepts related to episiotomy, including wound assessment using the REEDA method, comfort measures for perineal pain, and important notes on cesarean incision healing. Additionally, it touches on the transition to parenthood, preparing new parents for their journey. Test your understanding and reinforce your learning!
