| The postpartum period is also called the _______. | Puerperium |
| How long does the immediate postpartum period last? | 6 hours |
| The later postpartum period lasts ___ weeks after delivery | 6 |
| The postpartum period is part of which stage of labor? | The fourth stage |
| The uterus contracts in response to which hormone? | Oxytocin |
| Oxytocin is produced by which gland? | Posterior pituitary gland |
| What is the position of the uterine fundus immediately after birth? | Midway between umbilicus and symphysis pubis |
| What is the position of the uterine fundus 12 hours after birth? | Level of umbilicus |
| After birth, what is the rate of descent of the fundus? | One fingerbreadth per day |
| The decrease in size of the uterus is called ________. | Involution |
| Autolysis is a result of sudden withdrawal of________ and _________ | Estrogen and progesterone |
| Lochia consists of which 3 components? | Blood
Tissue
Mucus |
| Discharge that becomes pink to brown is called _____ _______. | Lochia serosa |
| Describe the appearance of lochia rubra | Bright red drainage |
| What is yellow to white discharge called? | Lochia alba |
| When should hemorrhage related to lacerations be suspected ? | If bleeding continues despite a firm, contracted uterine fundus |
| When should an episiotimy be healed? | 2-3 weeks |
| List the factors leading to obstetric lacerations of the lower genital tract? | Operative birth
Precipitous birth
Congenital abnormalities
Contracted pelvis |
| What type of lacerations are the most common in the lower genital tract? | Perineal |
| Describe a first-degree perineal laceration? | Extends through skin and structures superficial to muscle |
| A laceration extending through the muscles of the perineal body is what degree laceration? | Second-degree |
| What kind of laceration continues through the sphincter muscle? | Third-degree |
| Describe a fourth degree perineal laceration | Involves anterior rectal wall |
| Estrogen stimulates the growth of the milk ducts to prepare for _________. | Lactation |
| The production of colostrum continues for how long? | 2 days after delivery |
| Colostrum is rich in: | Protein
Calories
Antibodies
Lymphocytes |
| Prolactin is secreted by which gland? | Posterior pituitary |
| What is prolactin responsible for? | Stimulating milk production |
| What causes the release of oxytocin? | Stimulation of the nipples |
| What stimulates the contraction of mammary ducts, ejecting the milk from the breasts? | Oxytocin |
| How much blood is lost during delivery? | 300mL - 500mL |
| What accounts for the most fluid loss after delivery? | Diuresis and diaphoresis |
| Why is the mother at risk for thrombus in the early postpartum period? | Due to elevation of platelets |
| After childbirth, women have a _______ urge to void | Decreased |
| Bladder tone is normally restored within how many days of birth? | 5 to 7 days |
| After bladder tone is restored, what is the normal daily output of urine? | 3 L |
| Postpartum headaches may be caused by: | Hypertension
Stress
Leakage of cerebrospinal fluid |
| When do estrogen and progesterone reach their lowest levels after delivery? | 1 week into the postpartum period |
| The estrogen levels in nonlactating women are higher by postpartum day ____ than in women who breastfeed | day 17 |
| The anterior pituitary gland secretes _________ ONLY in response to nipple stimulation | Prolactin |
| If the woman is not found to be sensitized and gives birth to an Rh positive infant, they must receive RhoGAM within how many hours of delivery? | 72 hours |
| List 5 postpartum maternal danger signs: | Fever
Maloderous discharge
Excessive vaginal discharge
Bright red vaginal bleeding
Edema |
| If the mother has been under general anesthesia, what must be assessed prior to offering solid foods? | Presence of bowel sounds |
| The breast feeding mother should increase their caloric intake by how much? | 300 to 500 kcal/day |
| Why might the postpartum woman experience vertigo while showering? | Due to vascular shifts related to heat of the shower |
| Why should the nurse encourage voiding after birth? | A full bladder interferes with the complete contraction of the uterus |
| When should initial voiding occur after childbirth? | 4 to 6 hours |
| How often should perineal pads be changed? | After each urination or defecation |
| Enemas and suppositories are contraindicated in women who experience which degree lacerations? | Third and fourth-degree |
| During the recovery stage, what is key in prevention of complications? | Early ambulation |
| Chilling is a normal reaction to the stress of _______. | Labor |
| When is bradycardia not considered abnormal? | If other vital signs are within normal limits |
| What contributes to orthostatic hypotension in the postpartum woman? | Pooling of blood in the viscera |
| What should be kept on hand to revive the patient who is ambulating for the first time? | Ammonia ampules |
| Vital signs usually stabilize within the first __ hours of delivery | 2 hours |
| What is considered indicative of puerperal infection? | Temperature of 100.4 or higher on 2 consecutive days during the first 10 days after delivery |
| Inactivity predisposes the patient to the development of _________ | Thrombophlebitis |
| What kind of exercises tone without causing undue exertion? | Isometric exercises |
| The patient should void before checking the _______ | Fundus |
| The new breast feeding mother feeds her baby at ___ to ___ hour intervals through the night | 2 to 3 hour intervals |
| How often should the lochia and fundus be checked after birth? | Every 15 minutes for the first 1-2 hours |
| Which oxytocic medications are prescribed to to induce uterine contractions? | Oxytocin (Pitocin)
Maleate (Methergine) |
| Hematomas ae most common after deliveries in which what instrument is used? | Forceps |
| What are afterbirth pains? | Cramping sensations that result from the contraction of the uterus |
| Ibuprofen are used cautiously in people with which 3 conditions | Kidney disease
Heart disease
Taking diuretics |
| After delivery, the mother is instructed to make a follow-up appointment within how many weeks? | 6 weeks |
| When are healthy babies seen by a physician after birth? | At 2 weeks of age |
| Babies who are discharged before 48 hours of age are seen by the health care provider within how many days? | 2 to 5 days of discharge |
| Well baby visits continue until what age? | 18 months |
| Well baby visits are scheduled every __ to __ months | 2 to 3 months |
| The baby's first doctors appointment after birth is aimed at reviewing which factors? | Nutritional status
Elimination
Presence of jaundice |
| What is the respiratory rate of the newborn? | 30 to 60 breaths per min |
| What is the pulse rate of the newborn? | 120 - 160 |
| How much does the average newborn weigh? | 7 lbs 8 oz |
| The head circumference of the newborn is how much larger than the circumference of the chest? | 1 inch |
| What is the head circumference of the average newborn? | 13 to 14 in |
| When should the apical pulse of the newborn be auscultated? | While the infant is asleep |
| What kind of heart sounds are common in the newborn? | Murmurs |
| When half of the baby's body appears deep red and the other half appears pale as a result of vasomotor disturbance, this is known as __________ sign. | Harlequin |
| Jaundice that occurs sooner than 48 hours after birth is called _______ jaundice | Pathologic jaundice |
| What might pathologic jaundice be the result of | Maternal-fetal blood incompatibility |
| At birth, the skin is covered in a yellowish white, cream cheese-like substance. What is this substance called? | Vernix caseosa |
| What is the purpose of vernix caseosa? | Protects the infants skin from amniotic fluid |
| When does the anterior fontanelle close? | 18 months |
| At what age does the posterior fontanelle close? | 2 months |
| What are Epstein pearls? | White nodules on the hard palate |
| A two vessel cord may indicate: | Congenital abnormalities |
| Infection of the newborn's eyes, usually resulting from gonorrheal other infection contracted from the birth canal is called ________ __________. | Opthalmia neonatrum |
| At what distance can newborns see best? | 8 to 10 inches |
| When does the umbilical cord usually fall off? | 10 to 14 days |
| When soiled, the cord should be cleaned with ________ | Water |
| What is the term for undescended testes in the neonate? | Cryptochidism |
| What should the newborn's spine look like? | Straight without curves |
| What is the term for extra digits? | Polydactyl |
| The malformation of digits is called _______. | Syndactyly |
| Newborns have low _______ levels and are at risk for hemorrhage | prothrombin |
| Where should intramuscular injections be administered in the newborn? | Vastus lateralis |
| How much weight does the newborn lose in the first week of life? | 10% |
| How many kcals per day does the healthy newborn need? | 120kcal |
| How much fluid is intake is necessary for the newborn? | 140-160 mL/kg/day |
| Colostrum is rich in: | Protein
Calories
Antibodies
Lymphocytes
Immunoglobins |
| When does the pregnant mother begin producing colostrum? | Last trimester |
| How long is transitional milk produced? | For 1 week |
| How long is colostrum produced after delivery? | 2 to 4 days |
| What is the newborn's first feeding if bottle fed? | 15 to 30mL of sterile water |
| What is the newborn's normal hematocrit level? | 14-24 g/dL |
| What is the newborn's normal glucose level? | 40 - 60 mg/dL |
| What is the newborn's normal bilirubin level? | 0-1 mg/dL |
| Normal hemoglobin levels for the newborn are: | 14-24 g/dL |
| What is the basis of most formulas? | Bovine milk |
| The newborn loses heat through: | Radiation
Evaporation
Conduction
Convection |
| What kind of soap should be used for the initial bath? | Nonmedicated mild soap |
| What should be used to clean the ears and nostrils? | Cotton balls |
| The newborn's temperature should be reassessed ___ minutes after the bath | 30 minutes |
| The bathing room should be set at ___ degrees | 75 degrees |
| The newborn's bath water should be set to ___ degrees | 100 degrees |
| The newborn should void within how many hours of delivery? | 24 hours |
| Small pink or brown discharge from the urethra is the result of: | Uric acid crystals |
| What substances make up meconium? | Vernix
Lanugo
Mucus
Other substances from amniotic fluid |
| The newborn's first stool is odorless, black-green and sticky. What is this stool called? | Meconium |
| How many hours per day does the newborn spend sleeping? | 16 - 20 hrs |
| What can a high-pitched cry indicate? | Neurological problems |
| Newborns prefer to look at ______ over _______. | Faces over patterns |
| List 5 postpartum danger signs for parent-newborn relationships | 1. Passive reaction
2. Hostile reaction
3. Disappointment over gender
4. Lack of eye contact
5. Nonsupportive interaction between parents |
| What kind of lochia immediately follows delivery? | Lochia rubra |
| Where is breast engorgement usually observed first? | Axillary region |
| On which postpartum day does breast engorgement usually occur? | Third postpartum day |
