Exam 2 maternal
Unit 4 chapters 18,19,20,21,24 / Unit 5 chapters 22,23,25
Postpartum:
Characteristics/measurements of normal uterine involution patterns- INVOLUTION= Normal-
uterus returns to non-pregnancy state. SUBINVOLUTION= not Normal
oMeasurements: uterus is Midline @ umbilicus within first 12hrs.
o24hrs= uterus is the size it was in 20wks gestation
oInvolution occurs at a rate of 1-2cm a day
oAfter 2wks postpartum= uterus is felt externally.
oAfterpains resolve in 3-7 days, breastfeeding releases oxytocin which causes
contractions= decreases blood loss and hemorrhage.
oFirm? Massage it
oBoggy? Massage it
oDeviated? Void (pee)
oClots bigger than coins? Report it
oPooling? Assess and report
Lochia- 1 pad an hr. is normal, can occur for 4-8 weeks after birth.
oRubra- bright red (3-4 days duration)
oSerosa- pink brown after 3-4 days (4-10 days duration)
oAlba- yellow white, contain leukocytes, mucus, serum, bacteria (2-6wk duration)
o
oPersistent lochia rubra can be continued bleeding= retained fragments of placenta or
membranes.
oPersistent flow of serosa or alba= endometritis, s/s: fever, pain, ABD tenderness
oOffensive odor= infection
Anatomic & physiologic patterns during postpartum recovery and return to non-pregnant state
oHematological & Metabolic:
Decreased Blood volume
Estrogen, progesterone, and prolactin
Unit 4 chapters 18,19,20,21,24 / Unit 5 chapters 22,23,25
Postpartum:
Characteristics/measurements of normal uterine involution patterns- INVOLUTION= Normal-
uterus returns to non-pregnancy state. SUBINVOLUTION= not Normal
oMeasurements: uterus is Midline @ umbilicus within first 12hrs.
o24hrs= uterus is the size it was in 20wks gestation
oInvolution occurs at a rate of 1-2cm a day
oAfter 2wks postpartum= uterus is felt externally.
oAfterpains resolve in 3-7 days, breastfeeding releases oxytocin which causes
contractions= decreases blood loss and hemorrhage.
oFirm? Massage it
oBoggy? Massage it
oDeviated? Void (pee)
oClots bigger than coins? Report it
oPooling? Assess and report
Lochia- 1 pad an hr. is normal, can occur for 4-8 weeks after birth.
oRubra- bright red (3-4 days duration)
oSerosa- pink brown after 3-4 days (4-10 days duration)
oAlba- yellow white, contain leukocytes, mucus, serum, bacteria (2-6wk duration)
o
oPersistent lochia rubra can be continued bleeding= retained fragments of placenta or
membranes.
oPersistent flow of serosa or alba= endometritis, s/s: fever, pain, ABD tenderness
oOffensive odor= infection
Anatomic & physiologic patterns during postpartum recovery and return to non-pregnant state
oHematological & Metabolic:
Decreased Blood volume
Estrogen, progesterone, and prolactin
