1. Uterine involution
2. Cervical involution
3. Lochia Flow
4. Decrease in vaginal distention
What are the expected physiological changes in the
5. Alteration ibn ovarian function and menstruation
post-partum period? 6. CV, urinary tract, breast, and GI tract changes
Greatest risks during the post-partum period Hemorrhage, shock, and infection
Estrogen, progesterone, placental enzyme insulinase
What hormones are affected after the delivery of the decrease.
placenta?
-breast engorgement
-diaphoresis
Decreased estrogen results in -diuresis
-diminished vaginal lubrication
Decreased progesterone can result in Muscle tone increase throughout the body
1.breastfeeding frequency
2.length of each feeding
The return of ovulation is influenced by: 3.the use of supplementation
And the length of time to the postpartum ovulation is? Approximately 6 months
In non-lactating clients, ovulation occurs_____ and 7-9 weeks after birth; Menes resume by 12 weeks
menses resumes_______ postpartum
B: Breasts
U: Uterus (fundal height, uterine placement,
consistency)
A focused post-partum physical assessment should B: Bowel and GI function
include assessing what? B: Bladder function
L: Lochia (Color, odor, consistency, amount [[COCA]]
E: Episiotomy (edema, ecchymosis, approximation
BP and pulse q 15 hours for the first 2 hours after birth
Temp: q4 hours for the first 8 hours after birth, then q 8
hour
Uterus returns to its prepregnant state through
contractions of the smooth muscle
Involution of the uterus
, How many cm should the fundus descend q24 hours?
1-2 cm
Where should the fundus be by the 6th post-partum Halfway between the symphysis pubis and the
day? umbilicus
Where should the uterus be 2 weeks post-partum?
Uterus should lie within the true pelvis and should not
be palpable.
At the end of the third stage of labor, the uterus should
be palpable at______ and ____cm below the ____ Midline; 2cm below the umbilicus
-Client positioned in supine w/slightly flexed knees
-cup one hand above the symphysis pubis to support
How is a fundal assessment performed? the lower segment of the uterus; other hand should
palpate the abdomen to locate the fundus
Determine fundal height; measure how many
fingerbreadths fit b/w the fundus and the umbilicus
above, below, or at the umbilical level
Fundal location: midline or lateral
Uterine consistency: firm or boggy
What oxytocics can be given to promote uterine Oxytocin
contractions and prevent hemorrhage? Methylergonovine
Caboprost
When should this be administered? Misoprostol
What is the route of administration?
After the delivery of the placenta; IM or IV
What adverse effects should the nurse monitor for
when giving oxytocin and misoprostol? HYPOTENSION
What adverse effects should the nurse monitor for
when giving Methylergonovine, ergonovine, and Hypertension
carboprost?
2. Cervical involution
3. Lochia Flow
4. Decrease in vaginal distention
What are the expected physiological changes in the
5. Alteration ibn ovarian function and menstruation
post-partum period? 6. CV, urinary tract, breast, and GI tract changes
Greatest risks during the post-partum period Hemorrhage, shock, and infection
Estrogen, progesterone, placental enzyme insulinase
What hormones are affected after the delivery of the decrease.
placenta?
-breast engorgement
-diaphoresis
Decreased estrogen results in -diuresis
-diminished vaginal lubrication
Decreased progesterone can result in Muscle tone increase throughout the body
1.breastfeeding frequency
2.length of each feeding
The return of ovulation is influenced by: 3.the use of supplementation
And the length of time to the postpartum ovulation is? Approximately 6 months
In non-lactating clients, ovulation occurs_____ and 7-9 weeks after birth; Menes resume by 12 weeks
menses resumes_______ postpartum
B: Breasts
U: Uterus (fundal height, uterine placement,
consistency)
A focused post-partum physical assessment should B: Bowel and GI function
include assessing what? B: Bladder function
L: Lochia (Color, odor, consistency, amount [[COCA]]
E: Episiotomy (edema, ecchymosis, approximation
BP and pulse q 15 hours for the first 2 hours after birth
Temp: q4 hours for the first 8 hours after birth, then q 8
hour
Uterus returns to its prepregnant state through
contractions of the smooth muscle
Involution of the uterus
, How many cm should the fundus descend q24 hours?
1-2 cm
Where should the fundus be by the 6th post-partum Halfway between the symphysis pubis and the
day? umbilicus
Where should the uterus be 2 weeks post-partum?
Uterus should lie within the true pelvis and should not
be palpable.
At the end of the third stage of labor, the uterus should
be palpable at______ and ____cm below the ____ Midline; 2cm below the umbilicus
-Client positioned in supine w/slightly flexed knees
-cup one hand above the symphysis pubis to support
How is a fundal assessment performed? the lower segment of the uterus; other hand should
palpate the abdomen to locate the fundus
Determine fundal height; measure how many
fingerbreadths fit b/w the fundus and the umbilicus
above, below, or at the umbilical level
Fundal location: midline or lateral
Uterine consistency: firm or boggy
What oxytocics can be given to promote uterine Oxytocin
contractions and prevent hemorrhage? Methylergonovine
Caboprost
When should this be administered? Misoprostol
What is the route of administration?
After the delivery of the placenta; IM or IV
What adverse effects should the nurse monitor for
when giving oxytocin and misoprostol? HYPOTENSION
What adverse effects should the nurse monitor for
when giving Methylergonovine, ergonovine, and Hypertension
carboprost?
