Podcast
Questions and Answers
What is a common symptom associated with Candidiasis?
What is a common symptom associated with Candidiasis?
What should be avoided prior to a cervical cancer screening?
What should be avoided prior to a cervical cancer screening?
What is a potential complication of a hysterectomy?
What is a potential complication of a hysterectomy?
Which of the following actions is recommended after a hysterectomy once the patient can ambulate?
Which of the following actions is recommended after a hysterectomy once the patient can ambulate?
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What is the main purpose of taking Metformin in patients with PCOS who are trying to conceive?
What is the main purpose of taking Metformin in patients with PCOS who are trying to conceive?
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Which condition is associated with postmenopausal women and poses an increased risk?
Which condition is associated with postmenopausal women and poses an increased risk?
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What is one of the symptoms of perimenopause?
What is one of the symptoms of perimenopause?
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Which of the following is a potential complication of fibroid surgery?
Which of the following is a potential complication of fibroid surgery?
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What is the recommended action to avoid complications after surgery for fistulas?
What is the recommended action to avoid complications after surgery for fistulas?
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What is a critical consideration in pregnancy regarding intimate partner violence (IPV)?
What is a critical consideration in pregnancy regarding intimate partner violence (IPV)?
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What is the appropriate timing for the initial postpartum assessments?
What is the appropriate timing for the initial postpartum assessments?
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Which of the following findings is indicative of a boggy and deviated fundus?
Which of the following findings is indicative of a boggy and deviated fundus?
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What is the best initial action when assessing for potential hemorrhage postpartum?
What is the best initial action when assessing for potential hemorrhage postpartum?
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Which symptoms are commonly associated with preeclampsia and eclampsia?
Which symptoms are commonly associated with preeclampsia and eclampsia?
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What findings indicate a potential infection in a postpartum patient?
What findings indicate a potential infection in a postpartum patient?
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What is a critical assessment finding indicating hemorrhage after a vaginal birth?
What is a critical assessment finding indicating hemorrhage after a vaginal birth?
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How should a nurse respond to a patient presenting with signs of infection such as fever, tachycardia, and purulent discharge?
How should a nurse respond to a patient presenting with signs of infection such as fever, tachycardia, and purulent discharge?
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What is the recommended intervention when a postpartum fundus is found to be boggy and deviated?
What is the recommended intervention when a postpartum fundus is found to be boggy and deviated?
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What is a significant difference between postpartum depression (MDD) and postpartum psychosis?
What is a significant difference between postpartum depression (MDD) and postpartum psychosis?
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What is a common cause of a secondary postpartum hemorrhage occurring after 24 hours?
What is a common cause of a secondary postpartum hemorrhage occurring after 24 hours?
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Which complication could result from retained tissue, improper wound care, or underlying conditions post-delivery?
Which complication could result from retained tissue, improper wound care, or underlying conditions post-delivery?
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Which of the following conditions is not usually associated with psychological disorders postpartum?
Which of the following conditions is not usually associated with psychological disorders postpartum?
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What is a primary objective of discharge teaching for new mothers?
What is a primary objective of discharge teaching for new mothers?
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Which critical finding in a neonate indicates a need for urgent medical attention?
Which critical finding in a neonate indicates a need for urgent medical attention?
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Which condition is described as requiring supervision of all interactions between the mother and baby?
Which condition is described as requiring supervision of all interactions between the mother and baby?
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In the context of neonatal assessment, what indicates a potentially pathological jaundice?
In the context of neonatal assessment, what indicates a potentially pathological jaundice?
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What is the recommended action if meconium aspiration occurs during delivery?
What is the recommended action if meconium aspiration occurs during delivery?
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Which of the following is true regarding RDS (Respiratory Distress Syndrome) in neonates?
Which of the following is true regarding RDS (Respiratory Distress Syndrome) in neonates?
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What should be included in the teaching for SIDS prevention?
What should be included in the teaching for SIDS prevention?
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What signifies that a newborn requires immediate intervention regarding their vital signs?
What signifies that a newborn requires immediate intervention regarding their vital signs?
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Study Notes
Postpartum Physiological Assessments and Nursing Care
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Assessment Frequency: Initial 15 minutes for 1 hour, then 30 minutes for 1 hour, 4 hours for 22 hours, then every shift.
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Hemorrhage Assessments: Include vital signs (temperature, blood pressure, heart rate, respiratory rate, SpO2, pain), lochia assessment (color, amount, odor), and fundus evaluation (void, supine position, height, tone, location). Critical findings include purulent discharge, bleeding exceeding 500 ml (vaginal birth) or 1000 ml (C-section), boggy or deviated fundus, and preeclampsia/eclampsia, HELLP (DIC) symptoms.
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Hemorrhage Management: A firm, midline fundus indicates good uterine involution. Primary PPH (first 24 hours) can be caused by uterine atony (boggy, elevated, deviated fundus) or lacerations/hematomas. Secondary PPH (after 24 hours) often involves retained placental fragments. Treatment includes voiding, fundus massage, oxytocin, and frequent reassessment.
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Postpartum Infection: Assess for breast mastitis (redness, pain, warmth, fever) and other infections like metritis (retained tissue, odor, pain, fever) or wound infections (incisions, lacerations). Treatment depends on the infection, including antibiotics (e.g., Keflex), pain relievers, and supportive care. UTI symptoms should be monitored, including pyelonephritis (kidney pain).
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Other Postpartum Complications: Consider DIC, anaphylaxis, VTE/DVT/PE as possible complications requiring prompt evaluation.
Psychological Disorders
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Postpartum Blues: Characterized by symptoms typically appearing within a few days or first two weeks after childbirth, individuals maintain adequate self-care and ADLs.
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Postpartum Depression (PPD): A more severe condition occurring within the first year postpartum. Individuals may experience changes in appetite, sleep, weight, and self-care, and are unable to perform all ADLs. Psychosis, self-harm, and/or baby harm may be involved.
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Postpartum Psychosis: This is a critical condition (can present as early as day 3) requiring immediate admission and supervision due to risk of self-harm, harm to baby, or inability to perform ADLs.
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Paternal Postpartum Depression: May exist and related to potential low testosterone; necessitates a provider visit, therapy, or hormone replacement medication.
Discharge Teaching
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Normal vs. Abnormal Findings: Postpartum teaching includes expected lochia patterns (rubra, alba, serosa), uterine involution, and afterpains. Rh-negative mothers should receive RhoGAM.
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Recognizing Symptoms of PPD: Educating on recognizing and reporting symptoms of postpartum depression.
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Addressing Complications: Provide education on the risks of PPH, infection, preeclampsia/HELLP/eclampsia, and the importance of appropriate nutritional, lifestyle and activity guidance.
Neonatal Assessment
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Assessment Guidelines: Evaluate the newborn's tone (flexed), head (fontanels, structures), chest (respirations, pulse), abdomen, genitalia, back, limbs, skin (color, lanugo, vernix), and reflexes. Acrocyanosis is normal in some newborns.
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Critical Findings: Pathological jaundice (within first 24 hours), pallor or cyanosis; hypotonia or seizures; bulging/sunken fontanels; breathing abnormalities (see-saw, retractions), tachycardia/bradycardia, tachypnea/bradynea, distension, poor bowel/urinary habits, unusual stools, abnormal vital signs (temperature, heart rate, respiratory rate, SpO2), rapid glucose response (<15 seconds critical) are all cause for immediate attention.
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Common Disorders: Address potential neonatal conditions including RDS/BPD,PDA,ROP, GBS infections, jaundice, PKU, NEC, and meconium aspiration syndrome.
Neonatal Teaching
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Abusive Head Trauma: Teach safe baby-care strategies, promote support systems for parents, and emphasize seeking professional help if needed.
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Circumcision and Cord Care: Provide guidelines for preventing infection, pain management, and wound monitoring. Establish routine cord care protocols.
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SIDS Prevention: Educate on safe sleep practices and environmental risk factors.
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Bathing, Diapering, Feeding: Teach hygiene techniques, safe environment, and appropriate feeding methods.
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Other topics: Address LGBTQIA+, STI screening, vaginal infections (bacterial/yeast), cancer screenings (cervical, breast, endometrial), surgeries (e.g., hysterectomy, fibroids, fistulas) , PCOS, menopause, and IPV.
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Description
This quiz focuses on the important aspects of postpartum physiological assessments and nursing care. It covers assessment frequencies, hemorrhage evaluations, and management techniques crucial for postpartum care. Understanding these elements is essential for ensuring patient safety and effective recovery.
