The Post-Natal Period!

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  • Created by: Izzy2807
  • Created on: 06-12-19 11:53
When does the post-natal period straight?
Straight after the placenta (3rd stage of labor) has been delivered. It initiates the reversal process of pregnancy.
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What are some temporary changes that will be reversed?
Hormones, weight and circulation
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What kind of things are permanent changes in pregnancy?
Stretch marks (striae gravidarum), hair changes, skin pigmentation
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How many weeks of post-partum care does a woman receive?
8 weeks (NICE), but it depends on the pathway they're on
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What alters the pathway for care in the post-partum period?
The level of risk antenatally, intra-partum and post. Standard pathway, intermediate and high risk (complex).
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In a top-to-toe examination of a mother, what things to do with the HEAD are we looking for?
Headaches, visual distrubances and migraines (preeclampsia) and MENTAL HEALTH
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What are the endocrine changes after pregnancy? (after day 3)
HPL levels decrease (modifies metabolism so fetus can get energy), HCG decreases (modifies placenta), Oest & Progest decreases (TEARFUL: usually resolves after 14 days, referral if not)
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How does the anatomy of the breast change?
Milk ducts open, milk produced (oxytocin and prolactin acts on acini cells), pain, tingling, ENGORGMENT, itching, MASTITIS (infected blocked milk duct)
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How does menstruation and ovulation change?
If you're exclusively breastfeeding, you're RELATIVELY infertile (lactational ammenorrhea)
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How does the respiratory system change?
Full inflation of the lungs and O2 capacity at its highest again. Respiratory rate back to normal again (no hyperventilation)
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How does the cardiovascular system change?
Lower Oest. therefore diuresis, plasma volume reduces (less swelling), cardiac output, BP and vascular tone returns to normal
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What general observations are taken on the mother?
Temperature, BP, Pulse and Respiration (indicates which pathway they should be on)
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What is the LOCHIA?
The vaginal colour. Consists of blood, leucocytes, shreds of deciduas and organisms
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What is lochia rubra?
Bright red colour (1-3 days)
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What is lochia serosa?
Pink colour (4-10 days)
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What is lochia alba?
Sticky, discharged lochia (11-21 days)
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What are the signs of vaginal spesis?
Offensive smell, painful, feeling unwell, excessive bleeding, passed any clots?
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What is recommended for good vaginal hygiene?
Sanitary towels regularly changes, good hygiene and call midwife if problems persist
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What are the 4 main issues we look for post-partum?
Deep Vein Thrombosis, Pre-Eclampsia, Infection (sepsis) and Post-Partum Hemorrhage
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What are the signs of DVT?
Pains in the calve, redness or swelling, shortness of breath/chest pain
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What are the signs of pre-eclampsia?
Headaches, visual disturbances, nausea and vommiting.
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What are the signs of sepsis?
Fever, shivering, abdominal pain and/or offensive vaginal loss
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What are the signs of post-partum haemorrhage?
Sudden and profuse blood loss or persistent increased blood loss. Faintness, dizziness or palpitations/tachycardia
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What is Involution of the Uterus?
When the uterus/myometrium returns to its non-pregnant state
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What is ischaemia?
Contraction of the muscles of the uterus (at 3rd stage). The blood vessels at the placenta constrict (so no blood loss)
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What changes happen to the urinary tract?
In labour, the bladder is displaced into the abdomen and the urethra is stretched. Duiresis may lead to bladder retention. Renal system reforms to normal parameters (due to red. in progest.)
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What happens to excess uterine tissue?
Autolysis (self-destruction by proteolytic enzymes), detritus is destructed by phagocytosis (macrophages)
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How does the uterus regenerate?
Posterior spongy endometrium is sloughed off with placenta, BASAL LAYER of placenta becomes new endometrium.
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What happens to the superficial layer of the uterus?
It provides a barrier for infection and is then is degraded and sloughed off in the lochia
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What should midwives consider in relation to uterus involution?
Fuller bladders will raise the uterus, infections, retained products and blood clots!
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What happens in the genital tract?
The cervix becomes softer and less vascular (usually remains slightly open), ovaries/uterine tubes return to pelvic cavity, vagina/***** usually recovers, pelvic floor recovers in 6 weeks (PFE'S!!)
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How does the perineum/any wounds heal?
Inflammatory response - macrophages digest dead tissue, migratory phase: mesenchymal cells form fibroblasts (new tissue), proliferate phase: new cells!
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Other cards in this set

Card 2

Front

What are some temporary changes that will be reversed?

Back

Hormones, weight and circulation

Card 3

Front

What kind of things are permanent changes in pregnancy?

Back

Preview of the front of card 3

Card 4

Front

How many weeks of post-partum care does a woman receive?

Back

Preview of the front of card 4

Card 5

Front

What alters the pathway for care in the post-partum period?

Back

Preview of the front of card 5
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