Exam 2 Outline
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 2- Engorgement (edema)
3: 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 8-
during the first few 12 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, Subinvolution – failure
returning to of the uterus to return to
nonpregnant state nonpregnant state (due
(involution) to ineffective uterine
Fundus should be 1cm contractions/retained
above umbilicus in placental fragments)
12hrs after birth, at the Heavy/excessive
umbilicus within bleeding
24hrs, and descends Boggy uterus
1cm every 24hrs. 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
Urinary incontinence pt to bathroom to empty bladder
(if perineal trauma) if 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
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 2- Engorgement (edema)
3: 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 8-
during the first few 12 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, Subinvolution – failure
returning to of the uterus to return to
nonpregnant state nonpregnant state (due
(involution) to ineffective uterine
Fundus should be 1cm contractions/retained
above umbilicus in placental fragments)
12hrs after birth, at the Heavy/excessive
umbilicus within bleeding
24hrs, and descends Boggy uterus
1cm every 24hrs. 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
Urinary incontinence pt to bathroom to empty bladder
(if perineal trauma) if 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
