Puerperium and Breast Problems
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Questions and Answers

What is the immediate puerperium period?

  • The first 24 hours after delivery (correct)
  • Up to the 1st week postpartum
  • The time until breastfeeding establishes
  • Up to 6 weeks postpartum

    • Breast engorgement is only an issue during the first week postpartum.

    False

    Name one management technique for treating spinal headaches.

    Reapplication of cerebrospinal fluid or hydration therapy.

    The inflammation and infection of the breast that occurs after the first week is known as ______.

    <p>mastitis</p> Signup and view all the answers

    What is the wavelength range utilized for wound healing?

    <p>600-750 nm</p> Signup and view all the answers

    Match the breast problems with their descriptions:

    <p>Breast engorgement = Uncomfortable swelling associated with milk secretion Mastitis = Inflammation and infection occurring after the first week Blocked ducts = Obstruction of milk flow in the ducts Cracked nipple = Tenderness due to incorrect positioning at the breast</p> Signup and view all the answers

    What is one method of managing cracked nipples?

    <p>I.R therapy for 10-15 minutes</p> Signup and view all the answers

    PEME is associated with increasing inflammation during treatment.

    <p>False</p> Signup and view all the answers

    What frequency is recommended for single head monopole treatment close to the perineum?

    <p>27 MHZ</p> Signup and view all the answers

    Blockages in milk ducts can lead to tenderness and erythema at any time during breastfeeding.

    <p>True</p> Signup and view all the answers

    During the early puerperium, how long does this stage last?

    <p>Up to the first week postpartum.</p> Signup and view all the answers

    Varicose veins are typically ___ and ___ veins that usually occur on the legs and feet.

    <p>swollen, enlarged</p> Signup and view all the answers

    Match the management strategies with their corresponding conditions:

    <p>Wear trochanteric belt = Symphysis Pubis Dysfunction Avoid prolonged sitting and standing = Varicose veins Ice treatment = Symphysis Pubis Dysfunction Bandaging = Varicose veins</p> Signup and view all the answers

    What is the primary effect of Buerger's exercises?

    <p>Improve leg and feet circulation</p> Signup and view all the answers

    Pregnancy does not affect the smooth muscle of the venous wall.

    <p>False</p> Signup and view all the answers

    What type of ultrasound is recommended for chronic perineal pain management?

    <p>3 MHz</p> Signup and view all the answers

    What is the recommended power and duration for laser therapy to improve protein and lactose content?

    <p>25mw, 10 min</p> Signup and view all the answers

    Diastasis of recti abdominis occurs only during pregnancy.

    <p>False</p> Signup and view all the answers

    What condition is characterized by a gap of more than 25mm between the recti abdominis muscles?

    <p>Diastasis of recti</p> Signup and view all the answers

    After pains are caused by intermittent contraction of the uterus as it shrinks back to its normal size during the ___ period.

    <p>puerperium</p> Signup and view all the answers

    Which management technique can help alleviate perineal pain?

    <p>Cold bath</p> Signup and view all the answers

    Match the management technique with its purpose for urinary retention:

    <p>Early ambulation = Assist bladder function Relieve perineal pain = Minimize discomfort Medication = Stimulate bladder contraction Fluid intake = Encourage urination</p> Signup and view all the answers

    TENS therapy can be applied in a V-shape on the lower abdomen.

    <p>True</p> Signup and view all the answers

    What should be maintained in order to enable the uterus to work efficiently during postpartum recovery?

    <p>Bladder empty</p> Signup and view all the answers

    Which condition is characterized by pain, numbness, and tingling in the hand due to pressure on the median nerve?

    <p>Carpal tunnel syndrome</p> Signup and view all the answers

    Increasing pain severity in carpal tunnel syndrome can occur with repetitive hand movements.

    <p>True</p> Signup and view all the answers

    What is the role of the transverse carpal ligament in the wrist?

    <p>It forms the roof of the carpal tunnel.</p> Signup and view all the answers

    The sciatic nerve travels from the lower back through the hips and buttocks and down to the ______.

    <p>leg</p> Signup and view all the answers

    Match the following management techniques with their corresponding conditions:

    <p>TENS = Carpal Tunnel Syndrome Resting the wrist = De Quervain Syndrome Relaxation training = Postpartum Maternal Fatigue Electrotherapy = Carpal Tunnel Syndrome</p> Signup and view all the answers

    What is a common symptom of De Quervain syndrome?

    <p>Pain around the base of the thumb</p> Signup and view all the answers

    Postpartum depression is only based on physical symptoms.

    <p>False</p> Signup and view all the answers

    Name one management strategy for postpartum maternal fatigue.

    <p>Social support</p> Signup and view all the answers

    Which symptom is NOT associated with DVT?

    <p>Numbness in the foot</p> Signup and view all the answers

    Prophylactic measures for DVT do not include circulation exercises.

    <p>False</p> Signup and view all the answers

    What is one common cause of hemorrhoids during pregnancy?

    <p>Pressure from carrying a baby</p> Signup and view all the answers

    Back pain is a common _____ complaint after pregnancy.

    <p>postnatal</p> Signup and view all the answers

    Match the following conditions with their respective symptoms or causes:

    <p>DVT = Swollen veins that are hard or sore Hemorrhoids = Pressure during childbirth Coccydynia = Pain in the coccyx area Back pain = Posterior pelvic and lumbar pain</p> Signup and view all the answers

    Which of the following is NOT a management strategy for coccydynia?

    <p>Using forceps during delivery</p> Signup and view all the answers

    Pain from sciatica is only felt in the lower back.

    <p>False</p> Signup and view all the answers

    What is one suggested management technique for back pain postnatally?

    <p>Gentle mobilization and paraspinal massage</p> Signup and view all the answers

    Study Notes

    Puerperium

    • Postpartum period where the body reverts to its pre-pregnant state
    • Stages:
      • Immediate Puerperium: first 24 hours post-delivery
      • Early Puerperium: first week post-partum
      • Remote Puerperium: up to 6 weeks post-partum for full organ involution

    Spinal Headache

    • Caused by cerebrospinal fluid leakage through a puncture hole in the dura mater
    • Decreased pressure on the brain and spinal cord results in headache

    Breast Problems

    Breast Engorgement

    • Uncomfortable breast swelling due to milk secretion, typically occurs 2-4 days postnatally
    • Caused by lymphatic and vascular congestion, interstitial edema, and milk stasis in ducts
    • Makes breastfeeding difficult

    Mastitis

    • Inflammation and infection of the breast characterized by pain, swelling, redness, and fever
    • Occurs typically after the first week, or at 5-6 weeks post-partum

    Blocked Ducts

    • Obstruction of milk flow in the breast, nipple, or ductal system
    • Tender lump and erythema in the breast due to finger compression or infrequent feeding

    Cracked Nipple

    • Caused by incorrect breastfeeding positioning and early nipple stretching
    • Nipple tenderness occurs in the first 2-4 days after birth

    Scanty Milk

    • Laser therapy can increase milk production
    • 6328 nm wavelength, 25mW power, 10 minutes application for 10 days
    • Stimulates mitochondrial cells and epithelial tissue, leading to increased protein and lactose content

    Diastasis Recti Abdominis

    • Gap between the rectus abdominis muscles in the linea alba ≥ 25mm (2.5 fingers)
    • It may occur during pregnancy or the expulsion stage of labor

    Afterpains

    • Intermittent uterine contractions as the uterus shrinks back to its normal size
    • Cramp-like pain in the lower abdomen, more intense in multiparous women
    • Strongest during the first 12 hours post-partum, decreasing as involution progresses

    Urinary Retention

    • Caused by sudden drop in intra-abdominal pressure, making the bladder less sensitive to stretching

    Perineal Pain

    • Can be acute or chronic, due to childbirth trauma or episiotomy
    • Management for acute pain includes:
      • Cold baths, pelvic floor exercises, defecation techniques, cushion use during sitting
      • Electrotherapy: Ice, pulsed ultrasound, infrared, low-level laser therapy, pulsed electromagnetic field therapy (PEME)

    Symphysis Pubis Dysfunction

    • Separation of the pubic symphysis joint, allowing excess lateral or anterior movement
    • Caused by pelvic loosening during pregnancy due to relaxin hormone
    • Management includes:
      • Trochanteric belt or full pelvic bender, static abdominal exercises, pillows between knees, ice, pulsed ultrasound

    Varicose Veins

    • Swollen, enlarged veins, usually occurring in the legs and feet
    • Causes:
      • Progesterone effect on venous smooth muscle causing hypotonia
      • Increased intra-abdominal pressure
      • Uterus pressing on pelvic veins and causing lower limb edema
    • Management includes:
      • Avoiding prolonged sitting and standing
      • Avoiding leg crossing
      • Wearing below knee support stocking
      • Leg elevation, bandaging, Buerger’s exercises, intermittent compression

    Deep Vein Thrombosis (DVT) or Superficial Vein Thrombosis (SVT)

    • Thrombosis occurs in superficial and deep veins of the lower extremities, primarily in the soleus muscle
    • Symptoms:
      • Tenderness, throbbing pain, heavy ache, red or darkened skin, warm skin, swollen veins
    • Prophylactic treatment includes:
      • Early ambulation, leg and breathing exercises, avoiding pressure on the thighs and calves

    Hemorrhoids

    • Varicose veins in and around the anus
    • Caused by the pressure of carrying a baby, straining during delivery, and constipation
    • Management includes:
      • Ice packs, PEME, preventing constipation with hydration, fiber, and ambulation

    Coccydynia

    • Pain in the coccyx and sacral area
    • Caused by trauma during delivery, laxity of pelvic ligaments, or forceps-assisted birth
    • Management includes:

    Back Pain

    • Common postnatal complaint, characterized by pain in the posterior pelvic and lumbar areas
    • Causes:
      • Physiological and biomechanical changes due to pregnancy
      • Labor and delivery trauma
      • Lack of postural control
      • Secondary to urinary tract infection or postpartum uterine contraction
    • Management includes:
      • Gentle mobilization, paraspinal massage, heat application, strengthening exercises, postural correction, TENS

    Low Back Pain (LBP) and Sciatica

    • Sciatica refers to pain along the sciatic nerve, which travels from the lower back through the hips, buttocks, and legs
    • Management includes:
      • Ultrasound, TENS

    Carpal Tunnel Syndrome

    • Narrow passageway in the wrist containing flexor tendons and the median nerve
    • Pressure on the median nerve caused by swelling or narrowing of the tunnel
    • Symptoms:
      • Pain, numbness, tingling, and weakness in the hand
    • Management includes:
      • Avoiding sleeping on the affected side
      • Wearing wrist splint
      • Exercise to improve circulation
      • Electrotherapy: TENS, ice, contrast bath, ultrasound

    De Quervain Syndrome

    • Inflammation of the tendons of the extensor pollicis brevis and abductor pollicis longus muscles in the wrist
    • Symptoms:
      • Pain and numbness around the base of the thumb
    • Management includes:
      • Resting the wrist, splinting, TENS, ultrasound, ice

    Maternal Fatigue

    • Multidimensional concept with physical, emotional, and cognitive aspects.
    • Physical → feelings of tiredness or exhaustion
    • Emotional → feelings of anxiousness or depression
    • Cognitive → feeling unfocused or unmotivated
    • Management includes:
      • Relaxation training, social support, massage

    Postpartum Depression

    • Type of depression occurring after childbirth
    • Symptoms:
      • Emotional highs and lows, frequent crying, fatigue, guilt, anxiety, difficulty caring for the baby
    • Management includes:
      • Seek professional help

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    Puerperium Lecture Notes 2024 PDF

    Description

    Explore key aspects of the puerperium phase, including immediate, early, and remote stages. Understand common breast issues such as engorgement, mastitis, and blocked ducts, along with causes and implications for breastfeeding. This quiz is essential for those studying postpartum care.

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