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Questions and Answers
What are the recommended actions to help prevent SIDS?
What are the recommended actions to help prevent SIDS?
Which statement about circumcision is accurate?
Which statement about circumcision is accurate?
What condition is characterized by tachypnea and retractions in infants?
What condition is characterized by tachypnea and retractions in infants?
What is a key consideration when advising on diapering for newborns?
What is a key consideration when advising on diapering for newborns?
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Which of the following factors is NOT a treatment for Bronchopulmonary Dysplasia (BPD)?
Which of the following factors is NOT a treatment for Bronchopulmonary Dysplasia (BPD)?
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Which statement about STI transmission is correct?
Which statement about STI transmission is correct?
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What is the critical threshold for glucose levels in infants to monitor for potential issues?
What is the critical threshold for glucose levels in infants to monitor for potential issues?
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What is the primary risk associated with Poorly Managed Jaundice in infants?
What is the primary risk associated with Poorly Managed Jaundice in infants?
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Which of the following is a proper guideline for breastfeeding?
Which of the following is a proper guideline for breastfeeding?
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What should be avoided before a PAP smear?
What should be avoided before a PAP smear?
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Which treatment is recommended for necrotizing enterocolitis (NEC) in infants?
Which treatment is recommended for necrotizing enterocolitis (NEC) in infants?
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What is an appropriate action for handling women's health needs in LGBTQIA patients?
What is an appropriate action for handling women's health needs in LGBTQIA patients?
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What is the typical presentation indicating meconium aspiration syndrome?
What is the typical presentation indicating meconium aspiration syndrome?
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What is a common symptom of bacterial vaginitis?
What is a common symptom of bacterial vaginitis?
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Which of the following is NOT a common sign of infection in newborns?
Which of the following is NOT a common sign of infection in newborns?
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What condition is most likely associated with increased blood flow through pulmonary vessels in infants?
What condition is most likely associated with increased blood flow through pulmonary vessels in infants?
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What is the assessment frequency for vital signs during the first 22 hours postpartum?
What is the assessment frequency for vital signs during the first 22 hours postpartum?
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What does a boggy and deviated fundus indicate?
What does a boggy and deviated fundus indicate?
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Which symptom is NOT associated with eclampsia or HELLP syndrome?
Which symptom is NOT associated with eclampsia or HELLP syndrome?
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Which characteristic would indicate a possible infection in a postpartum patient?
Which characteristic would indicate a possible infection in a postpartum patient?
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In a postpartum assessment, which condition should be suspected with sudden drop in O2 saturation?
In a postpartum assessment, which condition should be suspected with sudden drop in O2 saturation?
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What does a quantitative blood loss of more than 500 ml following vaginal birth suggest?
What does a quantitative blood loss of more than 500 ml following vaginal birth suggest?
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Which finding suggests retained placental fragments in a postpartum patient?
Which finding suggests retained placental fragments in a postpartum patient?
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What is the first action to be taken if a fundus is found to be boggy and deviated?
What is the first action to be taken if a fundus is found to be boggy and deviated?
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What is the recommended first step to address a plugged duct?
What is the recommended first step to address a plugged duct?
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Which symptom is NOT typically associated with postpartum depression?
Which symptom is NOT typically associated with postpartum depression?
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What is the appropriate action for breast milk that has pus present?
What is the appropriate action for breast milk that has pus present?
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For which condition is Keflex typically prescribed?
For which condition is Keflex typically prescribed?
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What is a common sign of infection in the postpartum period?
What is a common sign of infection in the postpartum period?
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What is a distinguishing feature of postpartum psychosis compared to postpartum depression?
What is a distinguishing feature of postpartum psychosis compared to postpartum depression?
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Which complication is characterized by flank pain during the postpartum period?
Which complication is characterized by flank pain during the postpartum period?
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What is a potential outcome of untreated postpartum hemorrhage (PPH)?
What is a potential outcome of untreated postpartum hemorrhage (PPH)?
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What is the normal respiratory rate for a neonate?
What is the normal respiratory rate for a neonate?
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Which assessment finding is considered abnormal in a neonate?
Which assessment finding is considered abnormal in a neonate?
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What is a critical finding indicating respiratory distress in a neonate?
What is a critical finding indicating respiratory distress in a neonate?
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Which of the following is a normal finding in the genitalia of a female neonate?
Which of the following is a normal finding in the genitalia of a female neonate?
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What indicates a normal finding upon assessing a neonate's skin?
What indicates a normal finding upon assessing a neonate's skin?
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Which sign might indicate a need for further assessment in a neonate?
Which sign might indicate a need for further assessment in a neonate?
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What finding should be monitored for symmetry during a neonatal assessment?
What finding should be monitored for symmetry during a neonatal assessment?
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In the context of transitioning to parenthood, what is essential to provide before teaching?
In the context of transitioning to parenthood, what is essential to provide before teaching?
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Study Notes
Postpartum Physiological Assessments and Nursing Care
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Postpartum assessments should be conducted at 15 minutes intervals for the first hour, 30 minutes for the next hour, then every 4 hours for the first 22 hours, and then as needed
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Assess for hemorrhage (complications, like DIC, AFE, or PE, HELLP/Eclampsia), noting vital signs (temperature, blood pressure, heart rate, respiratory rate, oxygen saturation, and pain level).
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Lochia: Evaluate color, amount, and odor.
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Fundus: Assess uterine position and firmness (height, tone, and location). Assess midline displacement.
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Shift head-to-toe add-ons: Assess for BUBBLE-HE and REEDA factors.
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Critical Findings: Look for purulent discharge, significant bleeding (>500ml vaginal birth, >1000ml C-section) which should trigger quantitative blood loss measurement, hypotension, tachycardia, tachypnea, dizziness, pale, cool clammy skin, and a boggy/deviated fundus.
Postpartum Hemorrhage
- Primary PPH (Early): (first 24 hours) evaluate for uterine atony (boggy, displaced fundus, urinary retention, may need a straight cath for PVR or Foley catheter).
- Assess for uterine lacerations (red bleeding with normal fundus) or hematomas (normal fundus, ecchymosis, swelling, severe pain).
Infection
- Mastitis: Redness, localized pain, warmth, fever and/or HA.
- Plugged ducts: Warm showers, compresses, and massage towards the nipple
- Metritis ( > 24 hrs): Suspect retained tissue, intercourse, STI, pain, fever with odorous discharge. Assess for ongoing infection and possible need for antibiotics.
Other Complications
- DIC: Disseminated Intravascular Coagulation
- Anaphylaxis: Immediate intervention is crucial
- VTE/DVT & PE
- Postpartum Depression (MDD): Unable to perform ADLs, changes in sleep, appetite, or self-care habits, thoughts of self-harm or harm to the baby
Neonatal Assessment
- Tone: flexed
- Head: fontanels should be flat and symmetrical. Assess eyes, ears, and nares
- Chest: Check for crackles, Resp 30-60 and count for full minute. Apical pulse 110-160.
- Abdomen: Soft, round, belly breathing, cord (AVA).
- Genitalia: Assess for any abnormalities (female spotting, swollen labia; male testes palpated)
Critical Findings
- Jaundice: (within the first 24 hours - pathologic)
- Pallor, dusky, cyanosis
Hypothermia
- Preventing and treating: Early warming measures, including skin-to-skin contact, warm blankets, and a neutral thermal environment are crucial.
Hypoglycemia
- Symptoms and treatment: Decreases first hour after delivery and stabilizes by hour 2-3, look for jitters, poor latch or feeding, Hypotonia and hypothermia. Monitoring and treatment are essential for preventing complications from hypoglycemia.
Other Important Considerations
- Infection: Assess for signs of infection (fever, foul-smelling lochia, pain) and utilize appropriate antibiotics and nursing care.
- Nutritional Needs: Assess for adequacy of nutrition and consider supplemental feeding as appropriate
- Pain Management: Assist patients with pain management strategies to facilitate optimal postpartum recovery.
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Description
This quiz focuses on the essential postpartum physiological assessments and nursing care practices necessary for monitoring mothers after childbirth. Key topics include the evaluation of lochia, fundal assessments, and identification of critical findings that may indicate complications. Test your knowledge on timing, techniques, and interventions relevant to postpartum care.
