NUR 230 Exam 2 Study Guide
Postpartum
Rhogam: It is a medication/injection that contains Rh immune globulin (RhIG). Stops the
producing of antibodies.
• What is it for? Prevents Rh incompatibility (isoimmunization) between Rh-negative
mother and Rh-positive baby.
• When do you give it? To be effective, Rh-negative mom must be given RhoGAM at
28wks of pregnancy and again within 72 hours after birth of Rh-positive fetus.
BUBBLEHE
Normal Abnormal
,Breasts Day 1-2: Soft, Day 23: • Engorgement (edema)
filling, Days 3-5: *Can be caused by
Fullness, soften with plugged/clogged milk ducts,
breastfeeding. tight clothing, or poorly fitting
Skin is intact underwire bra. To treat:warm
Mild nipple tenderness compresses, ensure feeding
during the first few 812 times in 24hrs, hand
days express/pump the other breast.
Other interventions: apply
cabbage leaves, ice packs (DO
NOT APPLY DIRECTLY TO
SKIN) and cold compresses.
Severe soreness
• Cracked nipples,
Fissures
• Bleeding nipples
• Localized heat
• Bruising, redness
• Abrasions
• Blisters
*Soreness can be due to poor
positioning, improper latching,
improper sucking, or infection.
*Nursing Interventions: mild
analgesics/anti-inflammatories
to reduce discomfort.
*Teaching: Information about
breastfeeding/support groups,
wear a supportive bra
*How to treat: Apply Lanolin
cream, with a nonstick gauze or
hydrogel pad during the day and
night or apply breastmilk; has
antibodies. Do not use a
soap/fragrance.
, Uterus Firm, midline, returning • Subinvolution – failure of
to nonpregnant state the uterus to return to
(involution) nonpregnant state (due
Fundus should be 1cm to ineffective uterine
above umbilicus in contractions/retained
12hrs after birth, at the placental fragments)
umbilicus within 24hrs, • Heavy/excessive
and descends 1cm bleeding
every 24hrs. • Boggy uterus
• Higher than expected
level: Uterine atony
*Nursing Interventions:
massage the fundus, IV fluids,
and oxytocin to stimulate
uterine contractions.
• Deviated uterus
*Nursing Interventions: empty
the bladder.
Bladder Increased bladder • Bladder distention
function/increased • Urinary retention
diuresis (begins 12hrs (output <30mL/hr)
after birth, • UTI (pain, burning,
3000mL/day) tenderness, hematuria,
2hrs after birth, mom frequency).
should be peeing
No dysuria *Nursing Interventions: Assist pt
Urinary incontinence to bathroom to empty bladder if
(if perineal trauma) unable to ambulate. Have pt
listen to running water or place
hands in water, pour water from
peri bottle over perineum to
stimulate voiding.
*Teach patient proper hygiene
(wipe front to back), urinate
q4hrs, report any symptoms of
UTI. Promote Kegel exercises.
Postpartum
Rhogam: It is a medication/injection that contains Rh immune globulin (RhIG). Stops the
producing of antibodies.
• What is it for? Prevents Rh incompatibility (isoimmunization) between Rh-negative
mother and Rh-positive baby.
• When do you give it? To be effective, Rh-negative mom must be given RhoGAM at
28wks of pregnancy and again within 72 hours after birth of Rh-positive fetus.
BUBBLEHE
Normal Abnormal
,Breasts Day 1-2: Soft, Day 23: • Engorgement (edema)
filling, Days 3-5: *Can be caused by
Fullness, soften with plugged/clogged milk ducts,
breastfeeding. tight clothing, or poorly fitting
Skin is intact underwire bra. To treat:warm
Mild nipple tenderness compresses, ensure feeding
during the first few 812 times in 24hrs, hand
days express/pump the other breast.
Other interventions: apply
cabbage leaves, ice packs (DO
NOT APPLY DIRECTLY TO
SKIN) and cold compresses.
Severe soreness
• Cracked nipples,
Fissures
• Bleeding nipples
• Localized heat
• Bruising, redness
• Abrasions
• Blisters
*Soreness can be due to poor
positioning, improper latching,
improper sucking, or infection.
*Nursing Interventions: mild
analgesics/anti-inflammatories
to reduce discomfort.
*Teaching: Information about
breastfeeding/support groups,
wear a supportive bra
*How to treat: Apply Lanolin
cream, with a nonstick gauze or
hydrogel pad during the day and
night or apply breastmilk; has
antibodies. Do not use a
soap/fragrance.
, Uterus Firm, midline, returning • Subinvolution – failure of
to nonpregnant state the uterus to return to
(involution) nonpregnant state (due
Fundus should be 1cm to ineffective uterine
above umbilicus in contractions/retained
12hrs after birth, at the placental fragments)
umbilicus within 24hrs, • Heavy/excessive
and descends 1cm bleeding
every 24hrs. • Boggy uterus
• Higher than expected
level: Uterine atony
*Nursing Interventions:
massage the fundus, IV fluids,
and oxytocin to stimulate
uterine contractions.
• Deviated uterus
*Nursing Interventions: empty
the bladder.
Bladder Increased bladder • Bladder distention
function/increased • Urinary retention
diuresis (begins 12hrs (output <30mL/hr)
after birth, • UTI (pain, burning,
3000mL/day) tenderness, hematuria,
2hrs after birth, mom frequency).
should be peeing
No dysuria *Nursing Interventions: Assist pt
Urinary incontinence to bathroom to empty bladder if
(if perineal trauma) unable to ambulate. Have pt
listen to running water or place
hands in water, pour water from
peri bottle over perineum to
stimulate voiding.
*Teach patient proper hygiene
(wipe front to back), urinate
q4hrs, report any symptoms of
UTI. Promote Kegel exercises.
