the postpartum period is? - ANSWER the interval between brith and the
return of the reproductive organs to their normal non pregnant state this
period is sometimes referred to as the puerperium, or fourth trimester of
pregnancy
A nurse is assessing a postpartum client for fundal height, location, and
consistency. The fundus is noted to be displaced laterally to the right,
and there is uterine atony. The nurse should identify which of the
following conditions as a cause of uterine atony?
a. poor involution
b. urinary retention
c. hemorrhage
d. infection - ANSWER b
What happens when the uterus involutes? - ANSWER at the end of the
third stage of labor, the uterus is in the midline approximately 2cm below
the level of the umbilicus, with the fundus resting on the sacral
promontory.
Within 12 hours the fundus can rise to approximately 1cm above the
umbilicus
by 24 hours after birth the uterus is about the same size as it was at 20
weeks of gestation
involution progresses rapidly during the next few days
the fundus descends 1 to 2 cm every 24 hours
,by the sixth postpartum day the fundus is normally located halfway
between the umbilicus and the symphysis pubis
the uterus should not be palpable abdominally after 2 weeks and should
have returned to its non pregnant location by 6 weeks after birth
the return of the uterus to a non pregnant state after birth is called? -
ANSWER involution
when does involution take place? - ANSWER this process begins
immediately after expulsion of the placenta with contraction of the
uterine smooth muscle
the uterus which at full term weighs approximately 11 times its pre
pregnancy weight, involutes to approximately? - ANSWER 500g by 1
week after birth and to 300g by 2 weeks after brith
by 4 weeks postpartum it weights approximately 100g which is the non
pregnant size
increased estrogen and progesterone levels are responsible for
stimulating the massive growth of the uterus during pregnancy. Uterine
growth results from both hyperplasia (an increase in the number of
muscle cells) and hypertrophy (an enlargement of the existing cells).
After brith the decrease in these hormones causes? - ANSWER
autolysis which is the self destruction of excess hypertrophied tissue
sub involution is? - ANSWER the failure of the uterus to return to a non
pregnant state due to ineffective uterine contractions
the most common cause of sub involution is? - ANSWER retained
placental fragments and infection
The characteristics of post birth uterine discharge known as lochia,
correlate with? - ANSWER uterine involution and changes in the
endometrium
most women experience lochia for 4 to 6 weeks after brith
,for the first 2 hours after birth what are the characteristics of lochia? -
ANSWER the amount of uterine discharge should be about that of a
heavy menstrual period
after that time local flow will steadily decrease in amount and the
characteristics appearance of the lochia will change
describe the rubra lochia - ANSWER appearance: red
describe alba lochia - ANSWER appearance: whitish-yellow
time after birth: 10-14 days, can last 3-6 weeks
contents: WBCs, trophoblastic tissue debris
hemorrhoids (anal varicosities) are common and often develop during
pregnancy and internal hemorrhoids can evert while the woman is
pushing during birth. After birth what occurs to the hemorrhoids -
ANSWER women often experience associated symptoms such as
itching, discomfort, and bright red bleeding with defecation
hemorrhoids usually decrease in size within 6 weeks of brith and
eventually regress
, what changes occur in the breasts after birth? - ANSWER promptly after
brith, a decrease occurs in the cocnetraiton of hormones (estrogens,
progesterone, hCG, prolactin, cortisol, and insulin) that stimulated breast
development during pregnancy
the time required for these hormones to return to prepregnancy levels is
determine in part by whether or not the mother breast-fed her infant
during the first 24 hours after brith there is little if any change in the
breast tissue. ____ or early milk a clear yellow fluid can be expressed
from the breasts. - ANSWER colostrum
the breasts gradually become fuller and heavier as the colostrum
transitions to mature milk by about 72 to 96 hours after birth this is often
referred to as? - ANSWER "milk coming in" or lactogenesis 2
When lactogenesis 2 occurs what happens to the breasts? - ANSWER
the breasts can feel warm, firm and somewhat tender
bluish white milk with a skim milk appearance (true milk) can be
expressed from the nipples
as milk glands and milk ducts fill with milk, breast tissue can feel
somewhat nodular or lymph
engorgement - ANSWER as the milk glands and ducts fill with milk the
breast tissue can feel somewhat nodular or lymph some women
experience engorgement at this time due to an increase in blood and
lymphatic fluids as milk production increases
they are hard uncomfortable and mild temperature elevation can occur
the fullness of the nipple tissue can make it difficult for the infant to latch
on and feed
temporary lasts only 24 to 48 hours
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