Questions and Answers | A+ Score
Assured
Fourth stage of labor - 🧠ANSWER ✔✔-1-4hrs after delivery of placenta
- EBL not more than 500 mL
- bonding opportunity
Nursing Care Stage 4 - 🧠ANSWER ✔✔- Assess q15min for first hour
- Assess location and tone of fundus
- Lochia flow (amt and character)
- Perineum (edema, bruising, swelling)
- Bladder fullness
- Recovery from analgesia
- NUT for mom and baby
,Why do you need bladder empty after birth - 🧠ANSWER ✔✔it is hard for
the uterus to stay clamped down with a full bladder
What is the most severe and common side effect in the first hour after birth
- 🧠ANSWER ✔✔post-partum hemorrhage. Once placenta comes out,
uterus needs to clamp down/get hard
RN consideration for a mom that delivered with an epidural- 4th stage -
🧠ANSWER ✔✔Cannot walk right after an epidural, do not have pt go by
self the first time
The sensitive period - 🧠ANSWER ✔✔The time in the first hr after birth,
when hormonal changes and innate behaviors coincide to produce optimal
outcomes. Good opportunity for first feed and bond to occur because baby
will be wide awake and fully engaged.
Skin to skin - 🧠ANSWER ✔✔sooner and longer, increased ability to
maintain temp, higher blood glucose levels, less crying
--> mom bare chest, baby with a diaper and hat and a blanket over them
When does the postpartum period begin - 🧠ANSWER ✔✔after the delivery
of the placenta and lasts for 6wks. Marked by physiologic and
psychological changes
,Involution - 🧠ANSWER ✔✔refers to the changes to the reproductive organ,
particularly the uterus undergo after childbirth to return to their non-
pregnant size and contition
What helps to determine whether involution is progressing normally -
🧠ANSWER ✔✔the location of the fundus
Uterine involution immediately following birth - 🧠ANSWER ✔✔midway
between symphysis pubis and umbilicus
Uterine involution 6-12hrs after birth - 🧠ANSWER ✔✔even with umbilicus
Uterine involution 24hrs postpartum - 🧠ANSWER ✔✔1cm below
Uterine involution 3 days postpartum - 🧠ANSWER ✔✔3cm below
Uterine involution 6 days postpartum - 🧠ANSWER ✔✔6cm below
Uterine involution 14 days postpartum - 🧠ANSWER ✔✔non palpable
How to assess the fundus - 🧠ANSWER ✔✔squeeze hold/support uterine
segment. Use side of hand and palpate across abd down to where u expect
it to be
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, Afterpains - 🧠ANSWER ✔✔intermittent contractions that are expected.
Stronger during breastfeeding and more acute for multipara.
Self limiting and decrease after 48hrs
Afterpains tx - 🧠ANSWER ✔✔analgesics, heating pad prn to control
discomfort
Rubra lochia - 🧠ANSWER ✔✔deep, red mixture of mucus tissue and blood
that lasts 3-4days post birth
How do you know when bleeding after birth is from placenta site -
🧠ANSWER ✔✔wound that bleeds for 3wks until healed
serosa lochia - 🧠ANSWER ✔✔pink to brown in color lasting 3-10 days
alba lochia - 🧠ANSWER ✔✔white to light brown lasting 10-14 days. If alba
goes to serosa, placenta retained
Scant amount of lochia - 🧠ANSWER ✔✔<1 inch stain in one hour
Light amount of lochia - 🧠ANSWER ✔✔1-4inch stain in 1 hr
Moderate amount of lochia - 🧠ANSWER ✔✔4-6 inch stain in one hour;
expected for first two days