Normal Postpartum OB Lecture 1
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Questions and Answers

How long does involution last?

6 weeks

What are the 3 components of the assessment of the uterus and their normals?

Placement/size of the fundus, Tone, Lochia

If a fundus feels boggy, what should you do?

Massage it

How long does rubra serosa last and what color is it?

<p>1-3 days, dark red</p> Signup and view all the answers

How long does serosa lochia discharge last and what color is it?

<p>4-10 days, pinkish with tissue debris</p> Signup and view all the answers

How long does alba lochia discharge last and what color is it?

<p>11-21 days, creamy yellow/brown</p> Signup and view all the answers

What is the normal order of lochia?

<p>Rubra --&gt; Serosa --&gt; Alba</p> Signup and view all the answers

How do you perform a perineal assessment?

<p>Turn patient to Sims/lateral position and gently spread buttocks apart to inspect with light.</p> Signup and view all the answers

How often should a pad be changed?

<p>Every 3-4 hours, or as needed</p> Signup and view all the answers

What kind of peri care should be taught?

<p>Hygiene with a peri-bottle using warm water, wiping front to back, using tucks and dermoplast spray, applying ice as needed in 20-30 minute intervals.</p> Signup and view all the answers

How do you teach a breast self-assessment after pregnancy?

<p>Assess her own breasts to keep track of what's normal.</p> Signup and view all the answers

How should a woman care for her breasts while breastfeeding?

<p>No soap on nipples, use colostrum or lanolin, wear a supportive bra, relax for let-down.</p> Signup and view all the answers

How do you know if a newborn is feeding enough?

<p>Should be making 6-10 wet diapers and stool per day.</p> Signup and view all the answers

What is the key measure to suppress lactation?

<p>Teach measures to decrease stimulation to the breasts.</p> Signup and view all the answers

For a woman who does not breastfeed, how do you decrease stimulation of the breasts?

<p>Tight fitting bra or binder, do not express milk, shower with back to warm water, ice packs or cabbage leaves.</p> Signup and view all the answers

What should a woman be taught about urinating immediately after birth?

<p>First two voids should be with nurse to prevent falls, diuresis is common, empty bladder regularly to help the uterus stay contracted.</p> Signup and view all the answers

What is the most common problem relating to urinating after giving birth?

<p>Retention related to decreased elasticity, bladder tone, and decreased sensation from trauma, drugs, anesthesia.</p> Signup and view all the answers

What is the most common problem relating to bowel movements after giving birth?

<p>Constipation related to progesterone, decreased food and fluid intake, perineal tenderness, and fear of pain.</p> Signup and view all the answers

Which kinds of food should be avoided after birth to prevent too much gas?

<p>Cold foods such as ice chips and ice cream.</p> Signup and view all the answers

How many extra calories do lactating mothers need?

<p>500 calories</p> Signup and view all the answers

What happens to vital signs after birthing?

<p>Temperature may be transiently increased.</p> Signup and view all the answers

Study Notes

Postpartum Assessment Overview

  • Involution of the uterus lasts for 6 weeks post-delivery.
  • The assessment of uterus includes three components:
    • Fundus placement/size - should be level with umbilicus after delivery, roughly the size of a grapefruit.
    • Fundus tone should be firm and midline.
    • Lochia should have a non-offensive odor, medium amount is normal, with potential variations or issues noted.

Lochia Stages and Characteristics

  • Lochia rubra lasts for 1-3 days, appearing dark red.
  • Lochia serosa occurs from 4-10 days, is pinkish with tissue debris.
  • Lochia alba lasts from 11-21 days, presenting as creamy yellow or brown.
  • The normal sequence of lochia is Rubra --> Serosa --> Alba.

Perineal and Breast Care

  • Perform perineal assessment by positioning the patient in the Sims/lateral position, gently spreading buttocks to inspect with light for complications (episiotomy, lacerations, etc.).
  • Pads should be changed every 3-4 hours or as needed.
  • Teach proper peri-care including hygiene with a peri-bottle, front-to-back wiping, and use of soothing products like tucks, dermoplast spray, and ice as needed.

Breastfeeding Guidance

  • Encourage self-assessment of breasts to monitor for normalcy post-pregnancy.
  • For breastfeeding care, avoid soap on nipples and use colostrum or lanolin instead; wear a supportive bra and relax to facilitate let-down.
  • Newborns should produce 6-10 wet diapers and stool daily to indicate adequate feeding.
  • To suppress lactation, teach how to minimize breast stimulation.

Non-breastfeeding Care

  • For non-breastfeeding mothers, reduce breast stimulation using:
    • Tight fitting bras or binders
    • Avoid expressing milk
    • Shower using cool water on the back
    • Apply ice packs or cabbage leaves to reduce discomfort

Urinary and Bowel Movement Considerations

  • After birth, the first two urinations should be assisted by a nurse to prevent falls. Diuresis is common, and women should regularly empty their bladder to help the uterus contract and avoid hemorrhaging.
  • Common urinary issue post-birth is retention due to decreased bladder tone and sensation from trauma or anesthesia.
  • Constipation is the most frequent bowel movement concern, leading to:
    • Slowed GI tract from progesterone
    • Decreased food/fluid intake
    • Perineal tenderness, hemorrhoids, or fear of pain.
    • Recommend stool softeners and increased fluid intake.

Dietary and Caloric Needs

  • Avoid cold foods (e.g., ice chips, ice cream) after delivery to prevent excessive gas.
  • Lactating mothers require an additional 500 calories for energy and nourishment.

Vital Signs Postpartum

  • Vital signs may show a transient increase in temperature after childbirth, reflecting physiological changes.

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Description

This quiz focuses on the BUBBLE clinical assessment related to postpartum care. It covers key concepts including involution duration and the assessment of the uterus post-delivery. Enhance your understanding of normal postpartum practices and procedures with these flashcards.

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