what physical changes happen to postpartum pt (6)
-physical change (uterine involution, lochia flow, cervical involution, ↓ in
vaginal distention, alteration in ovarian function, menstruation, cardiovascular,
urinary tract, breast, GI changes
-greatest risk (shock, haemorrhage, infection)
-oxytocin (the hormone from the pituitary gland) strengthens uterine
contractions, and breastfeeding stimulates the release
-after delivery of the placenta, estrogen, progesterone, and placental enzyme
insulinase ↓, result in ↓BG, breast engorgement, diaphoresis, diuresis, diminish
vaginal lub, ↑ muscle tone, reversal of diabetogenic effect, hCG disappears from
the blood
-lactating pt, ovulation return affected by breastfeeding freq, length, use of
supplementation, approx 6mons
-nonlactating pt, prolactin decline, reach prepreg lvl by 3wk postpartum,
ovulation start 7-9wks after birth, menses resume after 12wks
what to assess for in physical changes to postpartum pt (14)
-monitor VS
-BP, HR check every 15 mins for 2hr
-temp check every 4hr for 8hr
-fundus
-amt of vaginal bleeding
-B: breast
-U: uterus (fundal height, uterine placement, consistency) always midline
-B: bowel and GI function
-B: bladder function
-L: lochia (color, odor, consistency, amt)
, -E: episiotomy (edema, ecchymosis, approximation)
-reinforcement of teaching needs
-urinalysis, CBC for Hgb, Hct, WBC, platelet
-rubella, Rh
what changes occur to uterus during postpartum pt (7)
-involution of uterus (contraction of uterine smooth muscles, uterus return to
prepreg site)
-↓ in size
-stat are delivery, fundus (top portion of uterus) palpable, firm at midline and
2cm below umbilicus
-1hr after delivery, fundus rise to umbilicus
-12hr after delivery, fundus palpated ay 1cm above umbilicus
-every 24hr, fundus descend 1-2cm
-after 2wks, uterus lie within pelvis
-if boggy, risk postpartum hemorrhage
-tx: abdominal massage in circles
-if toward side, ask to empty bladder
what to assess for uterus changes in postpartum pt (3)
-assist with fundal height, uterine placement, uterine consistency
-fundus either midline, if laterally due to full bladder
-position pt supine with knees slightly flexed
what is nursing action for changes to uterus in postpartum pt (4)
-monitor for oxytocin and misoprostol cause hypotension
-monitor for Methylergonovine, ergonovine, and carboprost cause hypertension
-encourage early breastfeeding (help produce oxytocin, prevent hemorrhage)
-encourage empty bladder every 2-3hr
what changes occur to lochia in postpartum pt and abnormal (5)
-physical change (uterine involution, lochia flow, cervical involution, ↓ in
vaginal distention, alteration in ovarian function, menstruation, cardiovascular,
urinary tract, breast, GI changes
-greatest risk (shock, haemorrhage, infection)
-oxytocin (the hormone from the pituitary gland) strengthens uterine
contractions, and breastfeeding stimulates the release
-after delivery of the placenta, estrogen, progesterone, and placental enzyme
insulinase ↓, result in ↓BG, breast engorgement, diaphoresis, diuresis, diminish
vaginal lub, ↑ muscle tone, reversal of diabetogenic effect, hCG disappears from
the blood
-lactating pt, ovulation return affected by breastfeeding freq, length, use of
supplementation, approx 6mons
-nonlactating pt, prolactin decline, reach prepreg lvl by 3wk postpartum,
ovulation start 7-9wks after birth, menses resume after 12wks
what to assess for in physical changes to postpartum pt (14)
-monitor VS
-BP, HR check every 15 mins for 2hr
-temp check every 4hr for 8hr
-fundus
-amt of vaginal bleeding
-B: breast
-U: uterus (fundal height, uterine placement, consistency) always midline
-B: bowel and GI function
-B: bladder function
-L: lochia (color, odor, consistency, amt)
, -E: episiotomy (edema, ecchymosis, approximation)
-reinforcement of teaching needs
-urinalysis, CBC for Hgb, Hct, WBC, platelet
-rubella, Rh
what changes occur to uterus during postpartum pt (7)
-involution of uterus (contraction of uterine smooth muscles, uterus return to
prepreg site)
-↓ in size
-stat are delivery, fundus (top portion of uterus) palpable, firm at midline and
2cm below umbilicus
-1hr after delivery, fundus rise to umbilicus
-12hr after delivery, fundus palpated ay 1cm above umbilicus
-every 24hr, fundus descend 1-2cm
-after 2wks, uterus lie within pelvis
-if boggy, risk postpartum hemorrhage
-tx: abdominal massage in circles
-if toward side, ask to empty bladder
what to assess for uterus changes in postpartum pt (3)
-assist with fundal height, uterine placement, uterine consistency
-fundus either midline, if laterally due to full bladder
-position pt supine with knees slightly flexed
what is nursing action for changes to uterus in postpartum pt (4)
-monitor for oxytocin and misoprostol cause hypotension
-monitor for Methylergonovine, ergonovine, and carboprost cause hypertension
-encourage early breastfeeding (help produce oxytocin, prevent hemorrhage)
-encourage empty bladder every 2-3hr
what changes occur to lochia in postpartum pt and abnormal (5)
