Questions and Answers
What is the postpartum period?
What does primigravida mean?
First pregnancy
What does multigravida refer to?
Multiple pregnancies
What is bonding in the context of postpartum care?
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What is breast engorgement?
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What is involution after childbirth?
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What does the acronym B-U-B-B-L-E H-E-R stand for in postpartum assessment?
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What are abnormal findings in breast assessment?
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How should the uterine fundus be assessed?
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What indicates abnormal findings in the uterus?
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What is lochia?
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What are the types of lochia?
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What is postpartum hemorrhage?
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What characterizes baby blues?
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What is postpartum depression?
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What is postpartum psychosis?
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What is RhoGam?
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What does MMR stand for?
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Study Notes
Postpartum Period
- Extends from birth until the reproductive system returns to its non-pregnant state, typically around 6 weeks.
Primigravida and Multigravida
- Primigravida refers to a woman in her first pregnancy.
- Multigravida refers to a woman who has had multiple pregnancies.
Bonding
- Emotional relationship development between parents and their newborn.
Breast Engorgement
- Occurs 72 to 96 hours postpartum, characterized by swollen breast tissue due to increased blood and lymph flow as milk production begins.
Involution
- The process by which the uterus returns to its pre-pregnancy state after childbirth.
Postpartum Assessment
- Includes B-U-B-B-L-E H-E-R components: Breasts, Uterine fundus, Bladder function, Bowel function, Lochia, Episiotomy, Homan's sign, Emotions, Rhogam/rubella/other immunizations.
Assessment of Breasts
- Palpation needed to check for softness or filling; vital to educate on milk promotion and prevent engorgement.
- Nipple condition should be intact, soft, pliable, and everted.
- Avoid breast assessment if the mother is not breastfeeding.
Abnormal Findings (Breasts)
- Indicators include redness, heat, pain, cracked/fissured or inverted nipples, palpable masses, and any lesions.
Assessment of Uterine Fundus
- Ensure the bladder is empty; patient should lie supine.
- Fundus should be firm; if it’s boggy, massage until firm.
- Fundus post-birth should be at 2 cm below the umbilicus and descends about 1 cm per day.
Abnormal Findings (Uterus)
- Fundus may be deviated from the midline, boggy, or above the umbilicus after 24 hours; often related to distended bladder.
Assessment of Bowel Function
- Examine abdomen for distention, bowel sounds, last bowel movement, and hemorrhoids.
Abnormal Findings (Bowel)
- Issues to note include constipation, diarrhea, and epigastric pain.
Assessment of Bladder Function
- Check the time since the last void and assess for urinary retention.
Abnormal Findings (Bladder)
- Symptoms like inability to void, frequent urges, or dysuria are concerning.
Assessment of Lochia
- Observe characteristics: amount, color, consistency, odor, and presence of clots, related to time post-delivery.
Abnormal Findings (Lochia)
- Heavy flow, foul odor, or bright red bleeding are abnormal post-delivery.
Types of Lochia
- Lochia rubra (red) lasts 3-5 days.
- Lochia serosa (pink) lasts 22-27 days.
- Lochia alba (white) continues for 10-14 days.
Assessment of Episiotomy (Perineum)
- Use the REEDAO method; check for hemorrhoids and abdominal incisions post-C-section.
Abnormal Findings (Perineum)
- Signs include pronounced edema, lack of integrity, or infection indications.
Assessment of Legs
- Examine for peripheral or sacral edema, varicose veins, and Homan's sign risk factors.
Abnormal Findings (Legs)
- Positive Homan's sign, painful or reddened areas, and warmth in the calf can indicate issues.
Assessment of Emotions
- Look for sleep deprivation, anxiety, appetite changes, bonding behaviors, and level of support.
Postpartum Hemorrhage
- Defined as blood loss exceeding 500 mL after vaginal birth or 1000 mL after cesarean; also includes a 10% hematocrit change.
- Types: Early (within 24 hours) and Late (1-6 weeks postpartum).
Assessment of Attachment Behavior
- Parents should demonstrate comforting techniques, identify with their infant, and engage in physical and verbal affection.
Baby Blues
- Mild emotional lability with symptoms like crying and fatigue; typically short-lived and normal for new mothers.
Postpartum Depression
- Severe and persistent mood swings and sadness beyond typical baby blues.
Postpartum Psychosis
- Severe mental health condition marked by depression, delusions, and harmful thoughts towards oneself or infant.
Risk Factors for Postpartum Hemorrhage
- Early causes include uterine atony and lacerations; late causes consist of subinvolution of the uterus and endometritis.
Mastitis
- Inflammation of breast tissue, usually unilateral and may develop after milk flow is established; untreated can lead to breast abscess.
RhoGam
- Administered to Rh-negative women giving birth to Rh-positive infants to prevent antibody formation; given at 28 weeks gestation as a preventive measure.
MMR Vaccine
- Given post-delivery if not immune to measles, mumps, or rubella; rubella is also known as German measles.
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Test your knowledge on key terms related to the postpartum period with these flashcards. Covering definitions from 'postpartum period' to 'bonding', this quiz is perfect for new parents and health professionals alike. Enhance your understanding of the emotional and physical aspects of the postpartum experience.