NUR2633 Exam 2
ANYTHING ON EXAM 1 IS FAIR GAME
Risk factors for postpartum hemorrhage
Mom that has had many babies (anything that tires or stretches out the uterus---lg babies, twins,
prolonged labor, mag sulfate, fibroids)
Management for postpartum hemorrhage—priority assessment and intervention; uterotonics
Massage the fundus, check the uterus, fundal assessment----most common cause is due to uterus not
having a good tone (uterine atony) 4 P’s ----look for tone, tissue, trauma, thrombus
Uterontonics- PITOSIN, given in 3rd stage of labor MISOPROSTOL, part of the MnM cocktail in
abortion but can also be given to induce labor and for postpartum labor
Breastfeeding/formula feeding—care of breasts, complications, education
Still educate mom even if she does not plan on breast feeding, breast milk is made based on supply and
demand. If a women is not going to breastfeed they can wear a tight fitting bra and use ice to relieve any
discomfort. Breastfeeding moms should wear a slightly looser bra and can use a warm compress or
warm shower to help with discomfort
THRUSH can show up on the babies tongue, it is common with newborns, however baby can then
transfer this yeast infection to moms breast causing sore and cracked nipples. Treat both mom and baby
for thrust. ENGORGEMENT is normal (like depended edema in people but in moms breast), the more
mom breast feeds the more milk mom will make, cabbage leaves are good for mom. If mom has a fever
of 100.4 this is a sign of infection---will be given antibiotics---mom should tell doc she is still breast
feeding so meds do not affect baby
LET DOWN REFLUX tingling type feeling in the breast, and then milk ejection from breast, mom can wear
a breast pad to protect from leaking however mom needs to clean and change these often
6-8 wet diapers and 1 bowel movement a day from baby to know baby is eating the correct amount of
food (moms milk should come in day 4-5 after birth) baby should have 8-12 feedings in a day
Postpartum focused assessment
BUBBLE HE
B-breast
U-uterus (do after you listen to bowel sounds and evaluate the fundus---is it firm or boggy, midline or
displaced, fundus should move down 1cm a day)
B-bowel (listen to bowel sounds)
B-bladder (have mom empty bladder often)
L-lochia (vaginal drainage) (rubra—dark red color for 1 st few days, cerosa- pink color, alba-white/clear
color-----the more mom does the more she will bleed)
E-episiotomy (focus on peri care and ice area for the first 24hrs)
H-homan’s sign (are there any S/S for a DVT)
E- emotional status (bonding with baby, S/S of postpartum depression
Postpartum care and education—self-care and care of newborn
Educate on breastfeeding and what mom should expect (see above and read ATI)
Newborn—normal newborn transition and assessment
Give newborn sponge bath appox. every 2 days until the cord falls off, have baby follow up with doctor
Check child’s ABC’s and use ABC’s to determine priority issues in a baby---check respiratory issues 1 st
Normal for baby to have a pink core and cyanotic hands and feet after birth (acrocyanosis)
ANYTHING ON EXAM 1 IS FAIR GAME
Risk factors for postpartum hemorrhage
Mom that has had many babies (anything that tires or stretches out the uterus---lg babies, twins,
prolonged labor, mag sulfate, fibroids)
Management for postpartum hemorrhage—priority assessment and intervention; uterotonics
Massage the fundus, check the uterus, fundal assessment----most common cause is due to uterus not
having a good tone (uterine atony) 4 P’s ----look for tone, tissue, trauma, thrombus
Uterontonics- PITOSIN, given in 3rd stage of labor MISOPROSTOL, part of the MnM cocktail in
abortion but can also be given to induce labor and for postpartum labor
Breastfeeding/formula feeding—care of breasts, complications, education
Still educate mom even if she does not plan on breast feeding, breast milk is made based on supply and
demand. If a women is not going to breastfeed they can wear a tight fitting bra and use ice to relieve any
discomfort. Breastfeeding moms should wear a slightly looser bra and can use a warm compress or
warm shower to help with discomfort
THRUSH can show up on the babies tongue, it is common with newborns, however baby can then
transfer this yeast infection to moms breast causing sore and cracked nipples. Treat both mom and baby
for thrust. ENGORGEMENT is normal (like depended edema in people but in moms breast), the more
mom breast feeds the more milk mom will make, cabbage leaves are good for mom. If mom has a fever
of 100.4 this is a sign of infection---will be given antibiotics---mom should tell doc she is still breast
feeding so meds do not affect baby
LET DOWN REFLUX tingling type feeling in the breast, and then milk ejection from breast, mom can wear
a breast pad to protect from leaking however mom needs to clean and change these often
6-8 wet diapers and 1 bowel movement a day from baby to know baby is eating the correct amount of
food (moms milk should come in day 4-5 after birth) baby should have 8-12 feedings in a day
Postpartum focused assessment
BUBBLE HE
B-breast
U-uterus (do after you listen to bowel sounds and evaluate the fundus---is it firm or boggy, midline or
displaced, fundus should move down 1cm a day)
B-bowel (listen to bowel sounds)
B-bladder (have mom empty bladder often)
L-lochia (vaginal drainage) (rubra—dark red color for 1 st few days, cerosa- pink color, alba-white/clear
color-----the more mom does the more she will bleed)
E-episiotomy (focus on peri care and ice area for the first 24hrs)
H-homan’s sign (are there any S/S for a DVT)
E- emotional status (bonding with baby, S/S of postpartum depression
Postpartum care and education—self-care and care of newborn
Educate on breastfeeding and what mom should expect (see above and read ATI)
Newborn—normal newborn transition and assessment
Give newborn sponge bath appox. every 2 days until the cord falls off, have baby follow up with doctor
Check child’s ABC’s and use ABC’s to determine priority issues in a baby---check respiratory issues 1 st
Normal for baby to have a pink core and cyanotic hands and feet after birth (acrocyanosis)
