Postpartum Psychology and Physiology (Unit 9)
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Questions and Answers

What changes to the lochia should a mother expect after giving birth?

  • It should become heavier and more painful over time.
  • It should transition from bright red to yellowish and eventually cease. (correct)
  • It should be reported if it is absent for more than two weeks.
  • It will remain consistent in volume for six weeks.

What is the primary purpose of checking the episiotomy site after childbirth?

  • To confirm that the surrounding skin is cool to the touch.
  • To ensure the patient can commence sexual relations.
  • To assess for the presence of excessive blood loss.
  • To evaluate for signs of infection, inflammation, and proper healing. (correct)

What does a positive Homan's sign indicate?

  • The patient is likely to be experiencing postpartum depression.
  • The patient is at risk for deep vein thrombosis or thrombophlebitis. (correct)
  • There may be the presence of hemorrhoids requiring treatment.
  • The patient is experiencing normal postpartum swelling.

Which emotional changes are common for a mother following childbirth?

<p>Her emotions might shift unpredictably, and crying spells are normal. (A)</p> Signup and view all the answers

What is the role of a sitz bath in postpartum care?

<p>To alleviate pain and promote cleanliness in the rectal area. (D)</p> Signup and view all the answers

What was the percentage increase in postpartum depression diagnoses from 2014 to 2018?

<p>30% (A)</p> Signup and view all the answers

Which age group had the highest prevalence of postpartum depression diagnoses?

<p>18-24 (B)</p> Signup and view all the answers

What is a possible factor contributing to the rise in postpartum depression diagnoses?

<p>Increased awareness and screening (B)</p> Signup and view all the answers

What proportion of women with postpartum depression had at least one other behavioral health diagnosis before pregnancy?

<p>More than two thirds (C)</p> Signup and view all the answers

What percentage of women with postpartum depression had two or more pre-existing behavioral health conditions?

<p>More than 25% (D)</p> Signup and view all the answers

Which of the following statements is true regarding postpartum depression and age?

<p>Women aged 18-24 are at the highest risk for postpartum depression. (C)</p> Signup and view all the answers

What is the relationship between pre-existing behavioral health conditions and postpartum depression?

<p>Pre-existing conditions increase the risk of postpartum depression. (D)</p> Signup and view all the answers

The increase in postpartum depression diagnoses may indicate what broader issue?

<p>Need for more comprehensive mental health education (A)</p> Signup and view all the answers

How might the findings from the survey influence maternal health policies?

<p>Emphasis on prenatal education about mental health (B)</p> Signup and view all the answers

What should be assessed when examining engorgement in a lactating mother?

<p>Presence of firm nodules (B)</p> Signup and view all the answers

What finding might indicate unsatisfactory uterine involution?

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

Which symptom may suggest infection or urinary retention after parturition?

<p>Frequent small voiding episodes (B)</p> Signup and view all the answers

What is the expected color of lochia ruba during the first three days postpartum?

<p>Very red and similar to menstrual flow (D)</p> Signup and view all the answers

What should be done if a patient's bowels have not functioned by the second postpartum day?

<p>Start the patient on a mild laxative (B)</p> Signup and view all the answers

How should the bladder be inspected after childbirth?

<p>Through palpation while checking fundus height (A)</p> Signup and view all the answers

What is the normal expectation for the position of the uterus after delivery?

<p>At the level of the umbilicus (B)</p> Signup and view all the answers

What should be included in discussing breast care with a breastfeeding mother?

<p>How to perform a breast self-examination (D)</p> Signup and view all the answers

What dietary advice is beneficial for preventing constipation in postpartum patients?

<p>Drinking extra fluids and selecting fruits and vegetables (B)</p> Signup and view all the answers

What is the primary benefit of applying cold compresses during engorgement?

<p>Reduction of breast swelling (C)</p> Signup and view all the answers

If a patient presents with sore nipples, what aspect should be assessed?

<p>Quality of latch during breastfeeding (B)</p> Signup and view all the answers

Which of the following practices is NOT recommended for breast care during the postpartal period?

<p>Using soap to cleanse breasts (C)</p> Signup and view all the answers

What is a recommended method to support uterine involution during the postpartal period?

<p>Lying on the abdomen with abdominal support (B)</p> Signup and view all the answers

Why should fluid restriction and pumping be avoided during breast engorgement?

<p>They are ineffective and could be harmful (A)</p> Signup and view all the answers

What does the ‘BUBBLE-HE’ acronym stand for in postpartum nursing assessment?

<p>Breast, Uterus, Blood, Bowel, Lochia, Episiotomy (D)</p> Signup and view all the answers

Which position should be avoided until at least the third week after delivery due to potential risks?

<p>Knee-chest position (D)</p> Signup and view all the answers

What is one potential result of excessive washing of the breasts post-delivery?

<p>Skin irritation and dryness (D)</p> Signup and view all the answers

When conducting a postpartum assessment, how often should vital signs be taken in stable patients during the first hour after delivery?

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

What is the purpose of placing a small pillow under the abdomen when lying on it?

<p>To provide comfort to sore breasts (D)</p> Signup and view all the answers

What is a common misconception about washing breasts during the postpartum period?

<p>Breasts should be washed multiple times a day (B)</p> Signup and view all the answers

What is the primary focus of assessment during the postpartal period?

<p>Assessing both physiologic and psychological changes (D)</p> Signup and view all the answers

Which of the following changes is NOT typically observed during the postpartal period?

<p>Immediate return to pre-pregnancy weight (B)</p> Signup and view all the answers

What is the recommended approach to integrate knowledge of postpartal changes into nursing care?

<p>Combining physiologic and psychological assessments with the nursing process (B)</p> Signup and view all the answers

Which method is NOT a typical component of assessing a woman in the postpartal period?

<p>Routine administration of sedatives (D)</p> Signup and view all the answers

How can nursing care effectively aid in the transition of a postpartal woman?

<p>By implementing educational strategies about breastfeeding and maternal care (D)</p> Signup and view all the answers

In what way should nursing students demonstrate professionalism during class discussions?

<p>Listening attentively and respecting others' ideas (C)</p> Signup and view all the answers

What is the psychological focus during the postpartal assessment of women?

<p>Recognizing emotional responses and adaptational challenges (A)</p> Signup and view all the answers

What is a foundational aspect of the postpartal period according to nursing education?

<p>The significance of recognizing cultural factors in care (C)</p> Signup and view all the answers

Flashcards

Puerperium

The period of time following childbirth, typically lasting 6 weeks.

Uterine involution

The process by which the uterus returns to its pre-pregnancy size and shape after childbirth.

Lactation

The production of breast milk following childbirth.

Postpartum menstruation

The return of the menstrual cycle after childbirth.

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Parenthood

The process of taking on the roles and responsibilities of a parent.

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Postpartum assessment

The assessment of a woman's physical and emotional health during the postpartum period.

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Postpartum changes

Changes in a woman's body and emotions after childbirth.

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Postpartum care

The care provided to a woman and her family during the postpartum period.

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Postpartum Depression (PPD)

A mental health condition that can occur after childbirth, characterized by feelings of sadness, anxiety, and fatigue.

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Pre-existing Behavioral Health Conditions and PPD

The likelihood of developing postpartum depression (PPD) is increased in women who have pre-existing mental health issues.

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Trends in PPD Diagnosis

The prevalence of postpartum depression (PPD) diagnoses has risen significantly in recent years, possibly due to increased awareness and screening.

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Age and PPD Risk

Women aged 18-24 are more likely to be diagnosed with postpartum depression (PPD) than other age groups.

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PPD and Pre-existing Conditions

More than two-thirds of women diagnosed with postpartum depression (PPD) had at least one pre-existing mental health diagnosis before pregnancy.

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Prevalence of PPD

The study revealed a significant increase in postpartum depression (PPD) diagnoses from 2014 to 2018.

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Impact of PPD

Postpartum depression (PPD) is a serious condition that can affect a mother's ability to care for her baby and herself.

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Early Detection of PPD

Recognizing postpartum depression (PPD) early and providing appropriate support can greatly improve outcomes for mothers.

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The Health of America Report®

The Health of America Report® is a comprehensive resource providing insights into health trends in the United States.

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PPD as a Public Health Issue

Postpartum depression (PPD) is a significant public health concern that requires attention and support for affected mothers.

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Breast Engorgement

A condition where the breasts become swollen, firm, and tender, often due to an increase in blood flow and milk production.

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BUBBLE-HE Assessment

A technique used for postpartum assessment that involves evaluating the breasts, uterus, bladder, bowels, lochia, episiotomy, extremities, and emotional status.

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Lying on the Abdomen

The process of lying flat on the abdomen, which is recommended for postpartum women to help the uterus contract back to its normal size.

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Knee-Chest Position

A position where the woman kneels with her chest resting on the bed, which should be avoided in the early postpartum period.

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Air Embolism

A medical emergency where air enters the circulatory system, often through an open cervix.

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Breast Hygiene

The daily washing of the breasts with clear water to maintain hygiene, especially during lactation.

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Breast Nodules

Nodules felt in the breast that may indicate the milk ducts haven't been emptied completely.

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Nipple Fissures

A condition where the nipples become cracked or sore, often due to dryness or improper latch.

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Breast Abscess

A localized collection of pus in the breast, often caused by infection.

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What is lochia?

Postpartum assessment of normal vaginal discharge that consists of blood, fragments of decidua, white blood cells, and mucus.

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What is a Sitz bath?

A type of therapy done by sitting in warm, shallow water. It's often used to soothe pain and inflammation in the perineal area after childbirth.

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What is a positive Homan's sign?

A positive Homan's sign is an indication of thrombophlebitis, a condition where blood clots form in the veins. You'll notice pain or tenderness in the calf when the foot is flexed.

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What is involution?

After childbirth, it's the process of returning to the pre-pregnancy state. This includes the uterus shrinking, hormones stabilizing, and the body returning to its normal size.

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What does a postpartum assessment involve?

It's the assessment of a woman's physical and emotional well-being after childbirth. It includes checking the uterus, lochia, perineum, and assessing for emotional changes.

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What is uterine involution?

The process where the uterus shrinks back to its normal size after childbirth.

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What is lochia rubra?

The reddish discharge from the vagina after childbirth, lasting for the first few days.

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What is lochia serosa?

The watery pink discharge from the vagina after childbirth, lasting from a few days to a week or two.

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What is lochia alba?

The thin, yellowish-white discharge from the vagina after childbirth, lasting for a few weeks.

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What is bladder distention?

The condition where the bladder is full and distended after childbirth.

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What is lactation?

The process of breast milk production and release.

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What is manual expression?

A technique to release milk from the breast by gentle squeezing.

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What is breast engorgement?

The condition when the breasts become swollen, hard, and painful after childbirth.

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What is a breast self-examination?

A type of exam where you check the breast for lumps, bumps, or any other changes.

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What is perineal care?

The process of cleaning the perineal area after childbirth.

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Study Notes

Course Unit: Postpartum

  • Course Module: 3
  • Course Unit: 9
  • Week: 10
  • Topic: Postpartum

Checklist

  • Discuss course and unit objectives
  • Understand study guide before class
  • Review course materials and jargon
  • Actively participate in class discussions
  • Complete and submit assigned tasks on time
  • Participate in weekly online discussions

Unit Expected Outcomes (UEOs)

  • Students are expected to describe and assess psychological and physiological changes in the postpartum woman and family.
  • Students are expected to integrate knowledge of these changes into maternal and child health nursing care.
  • Students are expected to participate actively in discussions and demonstrations of appropriate nursing care.

Cognitive Learning Objectives

  • Describe the psychological and physiological changes in a postpartum woman.
  • Assess the woman and family for physiological and psychological changes after childbirth.

Affective Learning Objectives

  • Listen attentively during class discussions.
  • Demonstrate tact and respect for other students' opinions.
  • Accept comments and reactions from classmates openly.

Psychomotor Learning Objectives

  • Participate actively in class discussions.
  • Follow class rules and use appropriate netiquettes.
  • Implement nursing care to support physiological and psychological transitions in the postpartum woman and family.

Required Readings

  • Adele Pillitteri, Maternal & Child Health Nursing: Care of the Childbearing & Childrearing Family, 6th Edition
  • Lipscomb, K., & Novy, M. J. (2007). The normal puerperium. In A. H. DeCherney & L. Nathan (Eds.). Current diagnosis and treatment in obstetrics and gynecology (10th ed.). Columbus, OH: McGraw-Hill.

Study Guide

  • The postpartum period (puerperium) is the 6-week period after childbirth.
  • This period encompasses both retrogressive (involution of organs) and progressive (lactation, menstrual cycle) changes in the mother.
  • Assessments during this period should include health interviews, physical examinations, and laboratory data evaluation.

Physiological Changes of the Postpartum Period

  • Reproductive System: The reproductive organs return to their pre-pregnancy state. The uterus shrinks, seals the placental site, and diminishes in size.
  • Uterus: The uterus contracts immediately after childbirth. Thrombi form and permanently seal the area, effectively preventing further bleeding,
  • Lochia: A discharge of blood, tissue fragments, and mucus. This flow changes in color and consistency over time, progressing from red to pinkish-brown to whitish.
  • Cervix: The cervix becomes firm again and returns to its pre-pregnancy state.
  • Vagina: The vagina becomes soft and less rugae (folds) but returns to its normal state over time.
  • Perineum: The perineum may be edematous and tender following childbirth due to vaginal birth, episiotomy or other perineal trauma.
  • Urinary System: Increased diuresis (urination) occurs to get rid of extra fluid retained during pregnancy.
  • Gastrointestinal System: Digestion and absorption recover; hemorrhoids may occur from straining during labor.
  • Integumentary System: Stretch marks may remain or appear more prominent, and pigment changes will fade with time.
  • Circulatory System: Blood volume returns to pre-pregnancy levels.
  • Vital signs: Temperature, pulse, and blood pressure may fluctuate, but generally return to pre-pregnancy states.

Nursing Responsibilities

  • Perineal care: Inspection for swelling, bleeding, hematoma, and pain.
  • Pain relief: Intense pain from uterine contractions can be relieved.
  • Muscular aches: Relieving pain and discomfort through activities like massage and application of heat/cold.
  • Cold and hot therapy: Managing edema and discomfort (first 24 hrs use ice)
  • Lochia inspection: Observe and document (color, amount, clots)
  • Emotional support: Recognize and address potential postpartum emotional responses.
  • Other: Providing perineal care; assessing peripheral circulation; promoting rest.

Further Readings - and References

  • Textbooks, journal articles, and online resources listed in the provided text.

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Course Unit 9 Week 10 PDF

Description

This quiz focuses on the psychological and physiological changes experienced by postpartum women and their families. Students will assess these changes and integrate their knowledge into nursing care strategies. Active participation in discussions will enhance understanding of maternal and child health nursing.

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