Questions and Answers
What characterizes a fourth-degree laceration?
Which type of episiotomy typically heals quicker and causes less pain?
What does the 'R' in REEDA stand for?
Which symptom does NOT indicate pathological breast engorgement?
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What is a possible consequence of severe breast engorgement?
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What is the primary purpose of hearing screening in newborns?
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What is considered a passing result for CCHD screening using pulse oximetry?
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Why is hearing screening not performed immediately at birth?
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Which circumcision method involves leaving a plastic bell on the penis?
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What is an essential postoperative consideration after circumcision?
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What is the most common cause of postpartum hemorrhage?
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How much blood loss during a vaginal delivery is considered hemorrhage?
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What is lochia commonly described as?
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What should be monitored closely to assess postpartum blood loss?
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When does primary postpartum hemorrhage occur?
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Which treatment is typically employed for uterine atony?
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What is a potential indication of a hematoma in a postpartum patient?
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What does lochia contain after the placenta is delivered?
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What is a common method to promote bonding and attachment between a newborn and their caregiver?
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Which of the following is NOT a sign or symptom of postpartum blues?
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What behavior can help reduce sibling rivalry when a new baby is introduced into the family?
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In which time frame does postpartum depression (PPD) typically develop?
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Which of the following symptoms is common in postpartum psychosis?
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What is a distinctive feature of postpartum depression compared to postpartum blues?
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What is one recommended approach to help integrate an older sibling with a newborn?
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What hormonal changes are associated with postpartum blues?
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What does the 'H' in the effective feeding assessment represent?
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Which breastfeeding position is recommended for C-section patients?
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Which of the following nipple types does NOT easily evert with stimulation?
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What is one disadvantage of bottle-feeding formula?
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How should breastmilk be stored in the refrigerator for best preservation?
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Which of these is a reason why it is advised to remove the bottle immediately after feeding?
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What is a common symptom of intolerance to milk protein casein in formula?
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What is the proper procedure for hand expression of breast milk?
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Study Notes
Postpartum Hemorrhage
- Primary hemorrhage occurs within the first 24 hours post-delivery, while secondary hemorrhage occurs from 24 hours to 12 weeks after delivery.
- Most significant risk for secondary hemorrhage is within the first 7 to 14 days after birth.
- Defined hemorrhage: Vaginal delivery ≥ 500 mLs and Cesarean section ≥ 1000 mLs quantified blood loss.
Uterine Atony
- Most common cause of postpartum hemorrhage.
- Managed with fundal massage followed by uterotonics like oxytocin (Pitocin).
Endometrium and Lochia
- Endometrium, the uterus lining, regenerates post-placenta delivery.
- Lochia is the bloody discharge containing RBCs and decidual tissue.
- Lochia classification:
- Scant: < 1 inch pad
- Light: < 4 inches pad
- Moderate: < 6 inches pad
- Heavy: saturated within 1 hour, excessively heavy if soaked within 15 minutes.
Vaginal and Perineal Lacerations
- Degrees of lacerations:
- Second-degree: vaginal mucosa, perineal skin, fascia.
- Third-degree: all above plus rectal sphincter.
- Fourth-degree: involves rectal mucosa and lumen.
- Midline episiotomies heal faster and are less painful compared to mediolateral.
REEDA Assessment
- Assessment criteria for episiotomy or laceration: Redness, Edema, Ecchymosis, Discharge, Approximation.
Breast Care and Assessment
- Breast engorgement can be physiological (swelling) or pathological (hardness, redness, warmth).
- Severe engorgement can inhibit infant latching.
Bonding and Attachment
- Techniques for bonding include skin-to-skin contact, maternal touch, and nurturing communication.
Sibling Rivalry
- Involve older siblings in the new infant's care to reduce feelings of displacement.
- Introduce siblings to the newborn as soon as possible during hospitalization.
Postpartum Blues and Depression
- Postpartum blues last a few weeks; characterized by sadness, mood swings, and emotional lability.
- Postpartum depression appears within 6 to 12 months, affecting daily functioning, sleep, appetite, and concentration, along with possible weight changes and feelings of worthlessness.
Postpartum Psychosis
- Official diagnosis for severe mental status disruption occurring within 2 to 3 days post-delivery.
Newborn Screening
- Hearing screening to avoid amniotic fluid interference; requires multiple tests.
- Critical Congenital Heart Defects (CCHD) screening checks oxygen saturation levels to identify heart defects.
Circumcision
- Elective procedure to remove the foreskin; methods include Gomco clamp, Plastibell (requires care for yellow crust), and Mogen clamp.
- Post-operative care includes monitoring for bleeding and proper positioning.
Effective Feeding Assessment
- LATCH system evaluates newborn latching:
- L: Latch quality
- A: Audible swallowing
- T: Nipple type
- C: Mother's comfort
- H: Assistance needed
Nipple Assessment
- Types: Everted, Inverted, Flat, Retracted, with implications for breastfeeding success.
Milk Expression and Storage
- Proper hand hygiene, techniques for manual expression, and pump selection are crucial.
- Breastmilk storage should be in the fridge, away from the door, and never microwaved.
Bottle-Feeding
- Advantages: Shared feeding responsibility, convenience; disadvantages: cost, preparation time, risk of infections, and obesity risk due to formula.
- Formula intolerance manifests through gastrointestinal distress and requires quick disposal of opened bottles.
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Description
This quiz covers the critical aspects of postpartum hemorrhage, including signs and symptoms, monitoring protocols, and distinguishing between primary and secondary hemorrhage. It is essential for healthcare providers to understand these concepts to ensure patient safety and effective management after childbirth.
