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Saunders Postpartum Period NCLEX 2024/2025 Updated
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Saunders Postpartum Period NCLEX 2024/2025 Updated
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2/21/24, 4:19 PM Saunders Postpartum Period NclexCH APT ER 2 5
Postpartum Period
http://evolve.elsevier.com/Silvestri/comprehensive
RN/
Priority Concepts
Health Promotion, Reproduction
I. Postpartum
A. Description: Period when the
reproductive tract returns to the
normal, nonpregnant state
B. The postpartum period starts
immediately after birth and is
usually completed by week 6
following birth.
II. Physiological Maternal Changes
B. Lochia
A. Involution
1. Descri
ption
2. Assess
ment
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c. The fundus steadily
descends into the
a. Involution is the rapid pelvis.
d. Fundal height
decrease in the size of
the uterus as it decreases about 1
returns to the cm/day (Fig. 25-
nonpregnant state. 1).
e. By 10 days
b. Clients who breast-feed
may experience postpartum, the
a more rapid uterus cannot be
involution because of palpated
the release of oxytocin abdominally.
f. A flaccid fundus
during breast-
feeding. indicates uterine atony,
and it should be
a. The weight of the massaged until firm; a
uterus decreases from tender fundus indicates
approximately 2 lb an infection.
g. Afterpains decrease in
(900 g) to 2 oz
(57 g) in 6 weeks. frequency after the
b. The endometrium
first few days.
regenerates.
774
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1. Description: Discharge from the
uterus that consists of blood
from the vessels of the placental
site and debris from the decidua
2. Assessment (Box 25-1)
a. Rubra is bright red
discharge that
occurs from day of
birth to day 3.
b. Serosa is brownish
pink discharge that
occurs from days 4 to
10.
c. Alba is white
discharge that
occurs from days 11
to 14.
d. Discharge should smell
like normal
menstrual flow.
e. Discharge decreases daily
in amount.
f. Discharge may
increase with
ambulation.
C. Cervix: Cervical involution occurs, and the
muscle begins to
regenerate after 1 week.
D. Vagina: Vaginal distention decreases,
although muscle tone is never
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restored completely to the pregravid
state.
E. Ovarian function and menstruation
1. Ovarian function depends on
the rapidity with which
pituitary function is restored.
2. Menstrual flow resumes within
1 to 2 months in non– breast-
feeding mothers.
3. Menstrual flow usually resumes
within 3 to 6 months in breast-
feeding mothers.
4. Breast-feeding mothers may
experience amenorrhea during
the entire period of lactation
so long as they are exclusively
breastfeeding.
Women may ovulate without
menstruating, so breast-feeding
should not be considered a form of
F. Breasts birth control.
1. Breasts continue to secrete
colostrum for the first 48 to 72
hours after birth.
2. A decrease in estrogen and
progesterone levels after birth
stimulates increased prolactin
levels, which promote breast
milk production.
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