OB Exam 2 Study Guide 12/03/2016
Fundal Assessment
• Actions/Interventions
o Determine tone
▪ Firm=contracted
▪ Soft=boggy
Indicates uterus is not contracting and places the woman at an increased risk for excessive blood loss
Massage fundus w/palm of hand in a circular motion u...
OB Exam 2 Study Guide 12/03/2016
Fundal Assessment
•
Actions/Interventions
o
Determine tone
▪
Firm=contracted
▪
Soft=boggy
Indicates uterus is not contracting and places the woman at
an increased risk for excessive blood loss
Massage fundus w/palm of hand in a circular motion until firm
to stimulate contraction
•
Reevaluate w/in 30 mins
Give oxytocin to stimulate smooth muscle of uterus to
contract
Physiological changes in PP
•
Assessment & Care
o
Reproductive
▪
Assess uterus for location, position,
and tone of fundus
Potential complications that
may lead to postpartum
hemorrhage are greatest within
the first hour following delivery
▪
Measure the distance between the
fundus and umbilicus
Each finger breadth=1cm
▪
Determine position of uterus
Shifted to side may indicate distended bladder
If deviated, soft, or elevated above the umbilicus, have pt void
o
Endometrium
, ▪
Assess lochia to monitor blood loss
Scant (<1in), light (<4in), moderate (<6in), heavy (pad
saturated)
Measure clots—10g=10mL of blood loss
(Table 12-2 pg. 313)
o
Vaginal/perineum
▪
Assess perineum using
REEDA
Redness,
edema, ecchymosis,
discharge,
approximation of edges of episiotomy or laceration
▪
Position in side lying position for better visualization
▪
Apply ice or cold sitz baths for first 24 hours; warm sitz baths after
24 hours twice a day for 20 mins
▪
Give peri-bottle w/warm water to rinse area after elimination
▪
Tighten gluteal muscle as she sits down and to relax muscles
after she is seated
o
Cardiovascular
▪
Assess pulse & BP—every 15 mins for the first hour
▪
Assess for orthostatic hypotension
▪
Assess for venous thrombosis
Homan’s sign
Calf tenderness, edema, and sensation of warmth
Encourage early ambulation
▪
Assess for postpartum chills and give warm blanket
o
Breast
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller FLOYYD. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $13.99. You're not tied to anything after your purchase.
