Maternal/Newborn ATI Final REVIEW

What is the fourth stage of labor and when does it start? - Postpartum period- starts after the delivery of the placenta What are the greatest risks during the postpartum period? - Hemorrhage Shock Infection When is RH immune globulin (RhoGAM) administered to post partum women? - Administered 72 hours for women who are Rh-negative and gave birth to infants who are Rh-positive This prevents sensitization to Rh in future pregnancies What is included in the postpartum nursing assessment? - Monitoring vital signs Assessing uterine firmness & location in relation to umbilicus Uterine position in relation to midline (if deviated, assist mom in emptying bladder) Amount of vaginal bleeding (lochia) How often should vitals be monitored after delivery? - Every 15 min for the first hour Every 30 minutes for second hour Every 4-8 hr depending on remaining medication regimen This occurs with contractions of the uterine smooth muscle, whereby the uterus returns to its prepregnant state - Involution Defined as blood flow from the uterus during postpartum period - Lochia This type of lochia is bright red in color, bloody consistency, fleshy odor, may contain small clots - Lochia rubraThis type of lochia is pinkish brown in color & serosanguineous consistency - Lochia serosa This type of lochia is yellowish, white creamy color, fleshy odor - Lochia alba When is colostrum present in the new mother's breasts? - During pregnancy and 2-3 days immediately after birth Defined as an infection in a milk duct of the breast with concurrent flulike symptoms - Mastitis What are therapeutic and approved holding positions when breast feeding? - Cradle hold Side-lying hold Football hold What does breast feeding cause the release of? What does this prevent? - Breast feeding causes the release of oxytocin which stimulates uterine contractions (will prevent hemorrhage) What are normal lab values in the post partum period? - Increased Hct & Hgb up to 72 hours Leukocytosis (WBC count up to 20,000-25,000 for the first 10-14 days, without presence of infection) Increased coagulation factors Increased fibrinogen A medical condition during pregnancy defined as excessive nausea and vomiting that is prolonged past 12 weeks of gestation. Results in weight loss & electrolyte imbalance - Hyperemesis gravidarum What are nursing responsibilities when caring for a patient diagnosed with hyperemesis gravidarum? - Monitor client's I&O Assess client's skin turgor/mucous membranes Monitor vital signs