Post-Partum Hormonal Changes

Study Notes

Iron Deficiency Anemia

Iron fortified cereal recommended when appropriate
Daily iron requirement: 11-15mg
Limit milk intake to <32 ounces per day to prevent fatigue
Iron supplements: ferrous sulfate, given PO, IV, IM
- Dosage: 3mg/kg/day (mild), 4-6mg/kg/day (severe)
- Adverse effects: GI upset, anorexia, N/V, constipation, dark stools, stained teeth
- Absorbed best on empty stomach with water; avoid giving with milk or tea
- Give with vitamin C (ascorbic acid) to improve absorption

Croup (Laryngotracheobronchitis)

Inflammation of larynx, trachea, and major bronchi
Primarily affects children ages 6 months – 3 years old
Caused by viral infections (e.g., parainfluenza virus)
Incidence: fall/winter seasons
Reoccurrences common
Symptoms:
- Seal-like barking cough
- Inspiratory stridor
- Marked retractions
- Cyanosis rare, glottal obstruction possible
Interventions:
- Vital signs every 15 minutes
- Assess breath sounds and oxygen deprivation
- Humidified oxygen therapy
- Semi-Fowler's to high Fowler's position
- Corticosteroid via nebulizer
- IV therapy for hydration
- Reduce anxiety for child and family

RSV (Respiratory Syncytial Virus)

Common infection in infants and children
Causes infections of the lungs and respiratory tract
Severe infections in premature babies, infants, and children with heart and lung disease
Diagnosis: nasal swab, chest x-ray
Symptoms:
- Mild cases: congestion, runny nose, dry cough, low-grade fever, sore throat, wheezing, sneezing
- Severe cases: hospitalization, fever, severe cough, wheezing, nasal flaring, short, shallow, rapid breathing or difficulty breathing, cyanosis, retractions, poor feeding, lethargy, irritability, apnea
Interventions:
- Supportive care
- Assess respiratory system and signs of distress
- Monitor vitals and pulse ox
- Upright positioning
- Administer humidified oxygen
- Nasal saline drops and suction
- Keep child hydrated
- Monitor for signs of dehydration
- Administer intravenous fluids
- Collaborate with respiratory therapy
- Isolation precautions
- Educate parents and reduce anxiety

Pediatric Dehydration

Fluid and electrolyte balance
GI system main route for substance absorption
Dehydration occurs when fluid loss exceeds intake
Symptoms:
- Thirst (mild to extreme)
- Skin turgor changes
- Skin temperature changes
- Sunken fontanelle
- Sunken eyes
- Dry mucus membranes
- Rapid pulse
- Decreased or dark urine output
- Low activity level
- Weight loss
Treatment:
- Withhold food
- Offer ice chips and water in small amounts
- Increase fluids and diet as tolerated
- Oral electrolyte replacement
- IV fluids and electrolyte replacement may be necessary

Newborn Care

Health promotion and wellness
Disease prevention and immune system
Focus on transition from intrauterine to extrauterine life
Promote bonding and health of baby through parental education

Postpartum Care

Physiological changes:
- Thermoregulation
- Cardiovascular system
- GI system
- Urinary system
- Skin changes
- Mood changes
Potential complications:
- Hemorrhage leading to hypovolemic shock and cardiac arrest
- Infection
- Thromboembolic disorders
- Depression
Assessment:
- Vitals and fundus every 15 minutes for 1 hour, then every 30 minutes for 2 hours
- Arm band/allergy band
- Delivery information
- Gravida/para
- Last pain medication administered
- Overall appearance
- IV site
- Respiratory, cardiac, and extremity assessments
- Incision (if c-section)
- Post-operative complications (pneumonia, DVT)

Hormonal Changes

Relaxin:
- Loosens and relaxes joints and ligaments in the pelvis for delivery
- Affects other parts of the body (back, wrists, intestinal tract)
Human chorionic gonadotropin (hCG):
- Supports embryonic development
- Stimulates the corpus luteum to continue producing progesterone
- High levels in early pregnancy, decrease after the first trimester
- Disappears around 3 weeks postpartum
Estrogen:
- Decreases after delivery, associated with breast engorgement
- Helps uterine growth, blood circulation to uterus and placenta, and breast development
- Stimulates milk production, uterine contraction postpartum, and vaginal dryness
Progesterone:
- Maintains endometrium
- Decreases uterine contractility
- Essential for implantation of embryo
- Drops after delivery, returns to normal at ovulation
Oxytocin:
- Stimulates uterine contraction during labor
- Causes milk ducts to contract, propelling breast milk to nipples (letdown reflex)
Prolactin:
- Stimulates milk production
- Responsible for lactation, breast development, and other homeostatic functions

Description

Learn about the hormonal changes that occur after childbirth, including the role of relaxin in preparing the pelvis for delivery and the function of human chorionic gonadotropin (HcG) in jump-starting other pregnancy hormones. Explore how these hormones affect various parts of the body.