Nursing Concepts: Fundus and Hemorrhoids

Questions and Answers

What does it mean when a fundus is boggy?

It is firm and healthy

It is swollen due to fluid retention

It is in the correct position

It may indicate hemorrhage (correct)

What should you do for hemorrhoids?

Lay on her side, maintain a high-fiber diet, and begin moderate exercise.

How much weight do you expect to lose right after delivery?

10-12 lbs initially, plus an additional 5 lbs due to postpartum diuresis.

How do you assess the healing of a placental site?

Evaluate lochia for type, amount, and consistency. Signup and view all the answers

What is Homan's sign?

It indicates thrombosis in the leg veins, causing slight pain at the back of the knee. Signup and view all the answers

What does it mean if a fundus is not at midline?

It means the patient has a full bladder. Signup and view all the answers

What would it mean if there's a steady trickle of blood?

It could mean there are lacerations that still need sutures. Signup and view all the answers

When should a rubella vaccine be administered?

Rubella vaccine should be given early postpartum, right after childbirth. Signup and view all the answers

What is RhoGAM?

It is a vaccine that prevents Rh negative mothers from forming antibodies against their Rh positive babies. Signup and view all the answers

What are the feeding requirements for breastfeeding mothers?

140-160 ml/kg/day caloric requirement and 100-115 kcal/kg/day. Signup and view all the answers

What do you do for engorgement?

Apply moist heat, cold compress, wear a supportive bra, and may need antibiotics. Signup and view all the answers

What contraception is recommended for breastfeeding moms?

Progestin-only hormonal contraceptives. Signup and view all the answers

Match the following normal vitals for a newborn:

Respiratory Rate = 30-60 Heart Rate = 120-160 Systolic Blood Pressure = 70-100 Diastolic Blood Pressure = 50-65 Weight (lbs) = 4.5-7 Temperature (°F) = 97.7-98.9 Signup and view all the answers

What is the most common form of heat loss in babies?

Radiation. Signup and view all the answers

What is hyperbilirubinemia?

It is accelerated destruction of fetal RBCs and impaired conjugation of bilirubin. Signup and view all the answers

Study Notes

Fundus Assessment

A boggy fundus indicates a lack of firmness, often signifying hemorrhage due to uterine atony.
Interventions include fundal massage, administering Pitocin, or encouraging breastfeeding to firm the uterus.

Hemorrhoid Care

Recommend lying on the side and tightening buttocks while sitting to reduce perineal pressure.
Advise maintaining a high-fiber diet and fluid intake, along with moderate exercise like walking.

Postpartum Weight Loss

Expect an initial weight loss of 10-12 lbs from the infant, placenta, and fluids, with an additional loss of 5 lbs due to postpartum diuresis.

Assessing Placental Healing

Full healing of placental site can take 6-7 weeks, primarily through exfoliation.
Monitor lochia for type, amount, and consistency, noting the progression from lochia rubra to serosa and finally to alba.

Homan's Sign

A clinical sign indicating the potential presence of thrombosis, characterized by pain at the back of the knee or calf during dorsiflexion of the ankle.

Uterine Positioning

A fundus that is not midline suggests a full bladder, indicated by bulging lower abdomen and spongy mass below the fundus.
A full bladder can hinder uterine contraction and potentially cause postpartum hemorrhage; encourage the patient to void.

Steady Trickling of Blood

A consistent trickle of blood may indicate lacerations that require suturing.

Rubella Vaccination

Rubella vaccine is advised early postpartum and should be administered immediately after childbirth.

RhoGAM Usage

RhoGAM is a vaccine used to prevent Rh-negative mothers from developing antibodies against Rh-positive babies, essential to be given before discharge.

Breastfeeding Interventions

Breastfeeding requirements include 140-160 ml/kg/day and caloric needs of 100-115 kcal/kg/day.
Regular assessments of breastfeeding technique, infant weight, and feeding history are necessary; provide breast pump instructions as needed.

Managing Engorgement

Engorgement results from inadequate breast emptying, leading to painful swelling and potential complications like mastitis.
Treatment includes applying moist heat, using cold compresses, wearing a supportive bra, and possibly needing antibiotics if infection occurs.

Contraception for Breastfeeding Mothers

Pregnancy can occur before the first postpartum menstruation; recommend progestin-only contraceptives to avoid decreasing milk production.

Normal Vital Signs for Newborns

Respiratory rate: 30-60 breaths per minute.
Heart rate: 120-160 beats per minute.
Blood pressure: systolic 70-100, diastolic 50-65.
Normal weight: 4.5-7 lbs.
Temperature range: 97.7-98.9°F.

Heat Loss Prevention in Newborns

Common heat loss occurs through radiation; preventive measures include maintaining a warm environment and minimizing exposure to cooler surfaces.
Other heat loss types: convection (cool air currents), evaporation (water turning to vapor), and conduction (direct skin contact with cool surfaces).

Hyperbilirubinemia Overview

Hyperbilirubinemia involves accelerated destruction of fetal red blood cells and inefficiency in bilirubin conjugation and elimination.
Bilirubin aids in fat digestion and is processed by the liver; jaundice develops when the liver fails to efficiently manage bilirubin levels.

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Description

This quiz covers important nursing concepts related to fundus assessment and management of hemorrhoids. Understand the implications of a boggy fundus and learn appropriate interventions for patients experiencing hemorrhoids. Test your knowledge on these key nursing topics to enhance your clinical skills.