Postpartum Physiological Assessments
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Questions and Answers

What are the recommended actions to help prevent SIDS?

  • Swaddle the baby tightly during sleep
  • Place the baby on their back to sleep (correct)
  • Keep the room at an extremely warm temperature
  • Allow the baby to sleep with a stuffed animal

Which statement about circumcision is accurate?

  • Infection and bleeding are potential risks after the procedure (correct)
  • Circumcision has no impact on cleanliness
  • Pain management is not necessary post-surgery
  • Swelling is irrelevant to the procedure

What condition is characterized by tachypnea and retractions in infants?

  • Jaundice
  • Meconium aspiration
  • Respiratory Distress Syndrome (RDS) (correct)
  • Bronchopulmonary Dysplasia (BPD)

What is a key consideration when advising on diapering for newborns?

<p>The cord area should be kept entirely dry and pressure-free (C)</p> Signup and view all the answers

Which of the following factors is NOT a treatment for Bronchopulmonary Dysplasia (BPD)?

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

Which statement about STI transmission is correct?

<p>Chlamydia and gonorrhea can lead to serious reproductive health issues (C)</p> Signup and view all the answers

What is the critical threshold for glucose levels in infants to monitor for potential issues?

<p>15 seconds (D)</p> Signup and view all the answers

What is the primary risk associated with Poorly Managed Jaundice in infants?

<p>Neurological damage (B)</p> Signup and view all the answers

Which of the following is a proper guideline for breastfeeding?

<p>Mothers should discuss any breastfeeding concerns with a healthcare provider (A)</p> Signup and view all the answers

What should be avoided before a PAP smear?

<p>Having unprotected intercourse for 48 hours prior (C)</p> Signup and view all the answers

Which treatment is recommended for necrotizing enterocolitis (NEC) in infants?

<p>IV fluids and antibiotics (B)</p> Signup and view all the answers

What is an appropriate action for handling women's health needs in LGBTQIA patients?

<p>Support and affirm the patient's preferred pronouns (A)</p> Signup and view all the answers

What is the typical presentation indicating meconium aspiration syndrome?

<p>Floppy appearance and poor air entry (C)</p> Signup and view all the answers

What is a common symptom of bacterial vaginitis?

<p>Fishy odor with grey discharge (A)</p> Signup and view all the answers

Which of the following is NOT a common sign of infection in newborns?

<p>Hyperthermia (D)</p> Signup and view all the answers

What condition is most likely associated with increased blood flow through pulmonary vessels in infants?

<p>Patent Ductus Arteriosus (PDA) (C)</p> Signup and view all the answers

What is the assessment frequency for vital signs during the first 22 hours postpartum?

<p>Every 15 minutes for the first hour, every 30 minutes for the second hour, and then every 4 hours. (D)</p> Signup and view all the answers

What does a boggy and deviated fundus indicate?

<p>Signs of hemorrhage. (C)</p> Signup and view all the answers

Which symptom is NOT associated with eclampsia or HELLP syndrome?

<p>Fever and chills. (B)</p> Signup and view all the answers

Which characteristic would indicate a possible infection in a postpartum patient?

<p>Purulent discharge with an offensive odor. (D)</p> Signup and view all the answers

In a postpartum assessment, which condition should be suspected with sudden drop in O2 saturation?

<p>Pulmonary embolism. (B)</p> Signup and view all the answers

What does a quantitative blood loss of more than 500 ml following vaginal birth suggest?

<p>Possible hemorrhage requiring intervention. (C)</p> Signup and view all the answers

Which finding suggests retained placental fragments in a postpartum patient?

<p>Lochia rubra with foul odor and color changes. (B)</p> Signup and view all the answers

What is the first action to be taken if a fundus is found to be boggy and deviated?

<p>Perform a uterine massage. (A)</p> Signup and view all the answers

What is the recommended first step to address a plugged duct?

<p>Apply warm compresses and massage toward the nipple (D)</p> Signup and view all the answers

Which symptom is NOT typically associated with postpartum depression?

<p>Increased energy and motivation (B)</p> Signup and view all the answers

What is the appropriate action for breast milk that has pus present?

<p>Dump the breast milk (B)</p> Signup and view all the answers

For which condition is Keflex typically prescribed?

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

What is a common sign of infection in the postpartum period?

<p>Presence of odor and severe pain (B)</p> Signup and view all the answers

What is a distinguishing feature of postpartum psychosis compared to postpartum depression?

<p>Presence of suicidal thoughts and harm to the baby (C)</p> Signup and view all the answers

Which complication is characterized by flank pain during the postpartum period?

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

What is a potential outcome of untreated postpartum hemorrhage (PPH)?

<p>Increased mortality and morbidity (C)</p> Signup and view all the answers

What is the normal respiratory rate for a neonate?

<p>30-60 breaths per minute (C)</p> Signup and view all the answers

Which assessment finding is considered abnormal in a neonate?

<p>Jaundice within the first 24 hours (B)</p> Signup and view all the answers

What is a critical finding indicating respiratory distress in a neonate?

<p>Accessory muscle use (C)</p> Signup and view all the answers

Which of the following is a normal finding in the genitalia of a female neonate?

<p>Vaginal discharge and swollen labia (A)</p> Signup and view all the answers

What indicates a normal finding upon assessing a neonate's skin?

<p>Core should have normal coloration (A)</p> Signup and view all the answers

Which sign might indicate a need for further assessment in a neonate?

<p>Absence of meconium for more than 48 hours (A)</p> Signup and view all the answers

What finding should be monitored for symmetry during a neonatal assessment?

<p>Palpation of testes in male infants (B)</p> Signup and view all the answers

In the context of transitioning to parenthood, what is essential to provide before teaching?

<p>Meet the physical needs of the parent (C)</p> Signup and view all the answers

Flashcards

Postpartum Hemorrhage (PPH)

Excessive bleeding after childbirth. Defined as >500ml vaginal delivery or >1000ml Cesarean section.

Uterine Atony

A common cause of PPH where the uterus doesn't contract effectively, leading to continued bleeding.

Fundal Assessment

Checking the position, tone, and height of the uterus after childbirth.

Lochia

Vaginal discharge after childbirth. Normally changes over time, from red to pink to white.

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REEDA

Assessment of the perineum after delivery: Redness, Edema, Ecchymosis, Discharge, Approximation.

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BUBBLE-HE

Postpartum assessment: Breasts, Uterus, Bladder, Bowels, Lochia, Episiotomy/lacerations, Homan's sign, Emotional status.

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Mastitis

Inflammation of the breast tissue, often caused by infection.

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Preeclampsia/Eclampsia

A serious pregnancy complication characterized by high blood pressure, protein in urine, and potentially seizures.

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Plugged Duct

A blockage in the milk duct, causing pain, redness, and warmth in the breast. It is a common issue during breastfeeding.

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Incision/Laceration (Wound)

A cut or tear in tissue, commonly occurring during childbirth. It can be from a C-section, episiotomy, or other trauma.

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UTI (Urinary Tract Infection)

An infection in the urinary system, commonly caused by bacteria.

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Baby Blues (Postpartum Blues)

A common, mild mood swing experienced by new mothers within the first few weeks after childbirth. It's characterized by sadness, anxiety, and fatigue.

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Postpartum Depression (MDD)

A more severe form of depression occurring after childbirth, lasting for longer than two weeks. It can significantly interfere with daily functioning and self-care.

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Postpartum Psychosis

A rare but serious mental health condition after childbirth, characterized by hallucinations, delusions, and erratic behavior.

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Normal Neonate Tone

A healthy newborn will have flexed muscle tone, meaning their limbs will be bent and not floppy.

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Cephalohematoma

A collection of blood under the periosteum (outer covering of the skull bone) caused by pressure during delivery, usually from a vacuum.

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Caput Succedaneum

A swelling of the scalp that crosses the suture lines caused by pressure during delivery. It's filled with serous fluid (clear fluid similar to lymph).

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Neonatal Respiration

A newborn should have a respiratory rate of 30-60 breaths per minute and the breathing pattern should be regular.

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Neonatal Apical Pulse

The apical pulse (heart rate) in a newborn should be between 110-160 beats per minute and might be slightly irregular due to the influence of breathing.

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Neonatal Abdomen

A healthy newborn's abdomen should feel soft and rounded, with evidence of belly breathing. The umbilical cord should also have visible blood vessels.

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Neonatal Genitalia: Female

A female newborn may have a small amount of spotting or vaginal discharge and slightly swollen labia.

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Neonatal Genitalia: Male

For a male newborn, both testes should be palpable (can be felt) and the scrotum may appear slightly swollen.

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RDS (Respiratory Distress Syndrome)

A breathing problem in premature babies caused by underdeveloped lungs and a lack of surfactant. Symptoms include rapid breathing with retractions.

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BPD (Bronchopulmonary Dysplasia)

A chronic lung disease that affects premature infants, often caused by prolonged ventilation and oxygen therapy. This leads to thickened lung tissue, making breathing difficult.

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PDA (Patent Ductus Arteriosus)

A condition where the ductus arteriosus (a blood vessel connecting the aorta and pulmonary artery) remains open after birth. This increases blood flow to the lungs, potentially leading to heart failure.

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ROP (Retinopathy of Prematurity)

A potential eye condition that can affect premature babies, caused by abnormal development of the blood vessels in the retina. This can lead to vision problems or even blindness.

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What are signs of sepsis in a newborn?

Signs of sepsis include fever, rapid breathing (tachypnea), rapid heart rate (tachycardia), and hypoglycemia (low blood sugar) in a newborn.

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When does jaundice appear?

Jaundice that appears within 24 hours of birth is called pathological jaundice and can indicate serious problems. It needs immediate treatment.

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What is PKU?

PKU (Phenylketonuria) is a genetic condition that affects the way the body breaks down phenylalanine, an amino acid. It can cause severe neurological damage if untreated.

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What is NEC (Necrotizing Enterocolitis)?

NEC is a serious intestinal disease that mostly affects premature babies, causing inflammation and damage to the bowel. It can be life-threatening.

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Abusive Head Trauma (Shaken Baby Syndrome)

A serious brain injury caused by shaking a baby, often resulting in lifelong disabilities or death.

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Circumcision Care

Proper cleaning, monitoring for infection, and understanding the potential for pain, bleeding, and swelling after circumcision.

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SIDS Prevention

Steps taken to reduce the risk of Sudden Infant Death Syndrome, including safe sleep practices, avoiding overheating, and breastfeeding.

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Safe Bathing Practices

Never leaving a baby unattended near water, spot cleaning, and drying the baby thoroughly after bathing.

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Breastfeeding Challenges

Challenges faced by breastfeeding mothers, including engorgement, nipple care, and techniques for pumping and storing breast milk.

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Bottle Feeding Preparation

The process of correctly preparing and storing formula for bottle feeding.

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LGBTQIA+

The importance of asking patients about their gender identity and using appropriate pronouns and body part terms to avoid re-traumatization. Providing support and safety.

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STIs: Transmissible Without Symptoms

Some sexually transmitted infections can be transmitted even if a person has no symptoms, highlighting the importance of safe sexual practices.

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Study Notes

Postpartum Physiological Assessments and Nursing Care

  • 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

  • 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).

  • Lochia: Evaluate color, amount, and odor.

  • Fundus: Assess uterine position and firmness (height, tone, and location). Assess midline displacement.

  • Shift head-to-toe add-ons: Assess for BUBBLE-HE and REEDA factors.

  • 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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Week 13 Review for Last Maternity Exam PDF

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.

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