Postpartum Nursing Care and Assessments
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Questions and Answers

Which symptom is characteristic of Postpartum Depression (MDD)?

  • Swelling in legs
  • Mood swings
  • Delusions
  • Persistent sadness (correct)

What is the recommended immediate action for a patient with Postpartum Psychosis?

  • Initiate counseling
  • Administer antidepressants
  • Admit to psychiatric care (correct)
  • Provide emotional support

Which of the following is an abnormal finding in postpartum care?

  • Foul odor from lochia (correct)
  • Lochia rubra
  • Normal involution
  • Breastfeeding discomfort

Which symptom might indicate Paternal Postnatal Depression?

<p>Fatigue and low mood (D)</p> Signup and view all the answers

What should be monitored in a neonate during transition to extrauterine life?

<p>Symmetrical movements of limbs (A)</p> Signup and view all the answers

Which age range is appropriate for Baby Blues symptoms to appear?

<p>1-2 weeks postpartum (D)</p> Signup and view all the answers

What is a key element of teaching during the transition to parenthood?

<p>Meet personal needs first (D)</p> Signup and view all the answers

What should new parents be informed about regarding contraception?

<p>Ovulation can happen before first menses (D)</p> Signup and view all the answers

What is the recommended assessment frequency for a patient in the first hour postpartum?

<p>Every 15 minutes (A)</p> Signup and view all the answers

Which color of lochia indicates the immediate postpartum period?

<p>Rubra (C)</p> Signup and view all the answers

What vital sign change may indicate possible hemorrhage in a postpartum patient?

<p>Hypotension (C)</p> Signup and view all the answers

Which assessment finding is concerning for hemorrhage in a postpartum fundus assessment?

<p>Boggy fundus (B)</p> Signup and view all the answers

What is a critical sign of infection in a postpartum patient?

<p>Purulent discharge (C)</p> Signup and view all the answers

What is included in the BUBBLE-HE assessment during postpartum evaluations?

<p>Breasts and uterus (B)</p> Signup and view all the answers

What does Homan's sign assess for in postpartum care?

<p>Deep vein thrombosis (C)</p> Signup and view all the answers

What defines excessive bleeding in a vaginal delivery postpartum?

<p>Greater than 500 mL (D)</p> Signup and view all the answers

What is the first intervention to take if a patient shows signs of hemorrhage with a boggy and deviated fundus?

<p>Massage the fundus until it is firm. (B)</p> Signup and view all the answers

Which symptom is NOT associated with severe preeclampsia/eclampsia?

<p>Hypotension (C)</p> Signup and view all the answers

In the case of secondary (late) postpartum hemorrhage, what is a common cause?

<p>Retained placental fragments (A)</p> Signup and view all the answers

Which management strategy is appropriate for treating mastitis?

<p>Encourage breastfeeding and apply warm compresses. (D)</p> Signup and view all the answers

What symptom is commonly associated with a urinary tract infection (UTI)?

<p>Dysuria (C)</p> Signup and view all the answers

What is a significant risk factor for wound infection following a cesarean section?

<p>Immunocompromised status (B)</p> Signup and view all the answers

Which of the following is a sign of Disseminated Intravascular Coagulation (DIC)?

<p>Petechiae and purpura (C)</p> Signup and view all the answers

When managing anaphylaxis, what is the first line treatment?

<p>Administer epinephrine. (D)</p> Signup and view all the answers

What is a common treatment for pathologic jaundice that occurs within the first 24 hours?

<p>Phototherapy (bili lights) (A)</p> Signup and view all the answers

Which of the following is NOT a possible cause of pallor, dusky appearance, or cyanosis in an infant?

<p>Exposure to cold (C)</p> Signup and view all the answers

What does bulging fontanel in an infant typically indicate?

<p>Increased intracranial pressure (ICP) (D)</p> Signup and view all the answers

Which vital sign abnormality could indicate tachypnea in an infant?

<p>Respiratory rate &gt; 60 breaths/min (A)</p> Signup and view all the answers

What immediate actions should be taken upon noticing hypotonia and seizures in an infant?

<p>Assess oxygen levels and administer O2 if needed (B)</p> Signup and view all the answers

What does a lack of meconium within 48 hours in a neonate generally suggest?

<p>Hirschsprung's disease (A), Meconium ileus (D)</p> Signup and view all the answers

What condition is indicated by see-saw or paradoxical breathing patterns in an infant?

<p>Respiratory distress (C)</p> Signup and view all the answers

What signifies immediate emergency when it comes to apnea in infants?

<p>Apnea lasting more than 15 seconds (B)</p> Signup and view all the answers

Flashcards

VTE

A blood clot in a vein, usually in the legs (DVT) or lungs (PE).

DVT symptoms

Swelling, redness, and pain in one leg.

PE symptoms

Sudden shortness of breath, chest pain.

Postpartum Depression

A persistent feeling of sadness, fatigue, and difficulty bonding with the baby after childbirth.

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Postpartum Psychosis

A severe mental illness with symptoms like delusions, hallucinations, and suicidal thoughts after childbirth.

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Lochia

Vaginal discharge after childbirth, normally changing colors (red, pink, white).

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Involution

The uterus shrinking back to its normal size after childbirth.

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Afterpains

Cramps in the uterus after childbirth, especially while breastfeeding.

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Boggy Fundus

A soft, spongy uterus that does not contract properly. A common cause of postpartum hemorrhage.

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Uterine Atony

Lack of uterine muscle tone, resulting in a weak, often dilated, uterus that cannot constrict blood vessels and stop bleeding.

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Postpartum Hemorrhage (PPH)

Excessive bleeding after childbirth. Classified as primary (within 24 hours) or secondary (after 24 hours).

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Preeclampsia

A serious pregnancy complication characterized by high blood pressure and protein in the urine. Can progress to a seizure (eclampsia).

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Mastitis

Infection of the breast tissue, often characterized by redness, warmth, pain, and fever.

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Metritis

Infection of the uterus, often accompanied by fever, foul-smelling discharge, and abdominal tenderness.

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Disseminated Intravascular Coagulation (DIC)

A serious clotting disorder where the body uses up all its clotting factors, leading to excessive bleeding and bruising.

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Postpartum Assessment Frequency (First Hour)

Assess vital signs, lochia, fundus, and BUBBLE-HE every 15 minutes for the first hour after delivery.

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Postpartum Assessment Frequency (Next Hour)

Assess vital signs, lochia, fundus, and BUBBLE-HE every 30 minutes for the second hour after delivery.

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Anaphylaxis

A severe, life-threatening allergic reaction that can cause swelling, difficulty breathing, and even death.

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Postpartum Assessment Frequency (Next 22 Hours)

Assess vital signs, lochia, fundus, and BUBBLE-HE every 4 hours for the following 22 hours.

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Postpartum Assessment Frequency (After 24 Hours)

Assess vital signs, lochia, fundus, and BUBBLE-HE every shift after 24 hours.

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Fundal Assessment Position

Have the patient void first, then assess the fundus while she is supine.

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Lochia Rubra

Bright red lochia, occurring immediately after delivery and lasting for the first 3 days.

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Lochia Serosa

Pink to brown lochia, occurring from 3 to 7 days post-delivery.

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Jaundice within 24 hours

Jaundice appearing within the first 24 hours of life, indicating a possible serious issue like hemolytic disease, infection, or metabolic disorders.

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What is Phototherapy?

A treatment for jaundice using special lights (bili lights) to break down bilirubin in the blood.

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Pallor, Dusky, Cyanosis

These skin color changes can signal problems like anemia, hypoxia, respiratory distress, or congenital heart defects.

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Hypotonia

Low muscle tone, indicating neurological issues, hypoxia, infection, or metabolic disturbances.

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Bulging Fontanel

A bulging soft spot on a baby's head can suggest increased intracranial pressure (ICP).

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Sunken Fontanel

A sunken fontanel is a sign of dehydration.

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See-saw Breathing

A breathing pattern where the chest and abdomen move in opposite directions, indicating respiratory distress.

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Tachycardia or Bradycardia

A heart rate that is abnormally fast (tachycardia) or slow (bradycardia) can be a sign of respiratory distress syndrome (RDS), infection, or cardiac anomalies.

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Study Notes

Postpartum Physiological Assessments, Nursing Care, and High-Risk Postpartum Care

  • Postpartum Assessments and Frequency:

    • First Hour: Every 15 minutes for 1 hour
    • Next Hour: Every 30 minutes for 1 hour
    • Next 22 Hours: Every 4 hours
    • After 24 Hours: Every shift

  • Assessing for Hemorrhage and Other Complications:

    • Hemorrhage: Check for signs of DIC (Disseminated Intravascular Coagulation), AFE (Amniotic Fluid Embolism), PE (Pulmonary Embolism), HELLP, or Eclampsia.

Vital Signs

  • Temperature: Low-grade fever is normal, higher suggests infection.
  • Blood Pressure (BP): Hypotension may indicate hemorrhage; hypertension can signify preeclampsia/eclampsia.
  • Heart Rate (HR): Tachycardia may indicate hemorrhage, infection, or PE.
  • Respiratory Rate (RR): Elevated RR may signify infection, PE, or hemorrhage.
  • SpO2: A drop in O2 saturation may indicate PE, hemorrhage, or anaphylaxis.
  • Pain: Document and treat appropriately.

Lochia

  • Color, Amount, and Odor:
    • Rubra: Bright red; immediately post-delivery (days 1-3)
    • Serosa: Pink to brown; after 3-7 days
    • Alba: White/yellowish; 10 days to 6 weeks
    • Check for foul odor (possible infection).

Fundus

  • Position: Patient should void first, then assess while supine.
  • Height (U): Should be at or below the umbilicus after delivery.
  • Tone: Should be firm (boggy fundus is concerning for hemorrhage).
  • Location: Should be midline (deviation may indicate a full bladder).
  • Additional Assessments: BUBBLE-HE

Critical Findings

  • Infection: Purulent discharge; check for foul odor, fever, tachycardia, and pain. This can be mastitis, metritis, or wound infection.
  • Excessive Bleeding: Greater than 500 mL for vaginal delivery or greater than 1000 mL for cesarean delivery. Signs include tachycardia, hypotension, cool/clammy skin, dizziness, and pallor.
  • Boggy and Deviated Fundus (Hemorrhage Signs): Weigh pads or measure output for quantitative blood loss. Have the patient void; massage the fundus until firm; administer Oxytocin (IV or IM). Reassess every 30 minutes.

Preeclampsia/Eclampsia, HELLP (DIC)

  • Symptoms: Hypertension (>160/100), headache, nausea, visual disturbances, RUQ pain, edema, bleeding.
  • Severe Symptoms: Petechiae, purpura

Sudden Drop in O2 Saturation

  • Causes: Anaphylaxis, PE, or hemorrhage; Immediate assessment, provide O2, and call for assistance.

Hemorrhage Management

  • Fundus should be firm and midline for proper involution.

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Related Documents

Postpartum Physiological Assessments Study Guide PDF

Description

This quiz focuses on postpartum physiological assessments, vital signs monitoring, and nursing care practices to identify high-risk conditions. Explore the critical elements required for effective postpartum care, including management of complications and vital sign interpretation.

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