Nursing Practice Experience Week 3

Lochia

vaginal discharge present during postpartum stage of labour.

500

Expected blood loss during a vaginal delivery is ____ mL

1000

Expected blood loss during a cesarean delivery is _____ mL

Tone

One of 4 Ts of bleeding - Uterine atony, or lack of uterine muscle tone, where the uterus fails to contract properly, leading to excessive postpartum bleeding.

Tissue

One of 4 Ts of bleeding - Retained placental fragments, where leftover tissue in the uterus prevents contraction and results in persistent postpartum bleeding

Trauma

One of 4 Ts of bleeding - Injury to the birth canal, including vaginal, cervical, or uterine lacerations, or uterine rupture, causing postpartum bleeding.

Thrombin

One of 4 Ts of bleeding - A blood clotting disorder or coagulopathy, such as in cases of preeclampsia or placental abruption, that interferes with clot formation and leads to postpartum hemorrhage.

Compensation

Degree of shock caused by 500-1000mL of blood loss. No blood pressure change, dizziness, palpitations, tachycardia. Mothers body makes extra blood to compensate.

Mild

Degree of shock caused by 1000-1500mL of blood loss. Slight fall in blood pressure, tachycardia, weakness, sweating.

Moderate

Degree of shock caused by 1500-2000mL of blood loss. Marked fall in blood pressure, restlessness, pallor, oliguria.

Severe

Degree of shock caused by 2000-3000mL of blood loss. Profound fall in blood pressure, collapse, air hunger, anuria.

Breasts

B in “BUBBLLEE” assessment - describes firmness of _____ and nipples

Uterine Fundus

U in “BUBBLLEE” assessment - describes the location and firmness of the _____ ______

Bladder

B in “BUBBLLEE” assessment - describes the ______ function; amount and frequency of urination

Bowel

B in “BUBBLLEE” assessment - describes the _____ function; passing of gas and bowel movements

Lochia

L in “BUBBLLEE” assessment - describes the amount and color of the _____

Legs

L in “BUBBLLEE” assessment - presence of peripheral edema

Episiotomy/Laceration

E in “BUBBLLEE” assessment - describes the perineum: discomfort, condition of repair if done.

Emotional Status

E in “BUBBLLEE” assessment - describes the mood of the mother, fatigue.

Involution

Return of the uterus to the nonpregnant condition.

6

The uterus size decreases by 1-2cm every 24 hours following birth. It will return to normal size by ____ weeks.

Uterine Atony

When the uterine muscles fail to contract around the endometrial arteries at the placental site, it is known as _____ _____ or “boggy fundus”. Causes hemorrhaging.

Fundal Massage

If uterine atony occurs, the nurse can perform a ___ ___ to stimulate the uterine muscles to contract.

Lochia Rubra

Red lochia present 1-3 days postpartum. Composed of blood, fragments of decidua, and mucus.

Lochia Serosa

Pink lochia present 3-10 days postpartum. Composed of blood, mucus, and invading leukocytes.

Lochia Alba

White lochia present 10-14 days postpartum and up to 6 weeks. Largely mucus, leukocyte count high.

1

Bowel habits should return to normal after _ week of delivery.

First

A _____ degree classification of perineal laceration would include: vaginal mucus membrane and skin of the perineum to fourchette.

Second

A _____ degree classification of perineal laceration would include: vagina, perineal skin, fascia, levator ani muscle, and perineal body

Third

A _____ degree classification of perineal laceration would include: the entire perineum and external sphincter of the rectum

Fourth

A _____ degree classification of perineal laceration would include: the entire perineum, rectal sphincter, and some of the mucous membrane of the rectum.

Vertical incision

Cut sometimes used in emergency C-sections - allows better access to the baby but eliminates the possibility of future vaginal delivery.

Horizonal

Cut most often used in C-sections that gives possibility of future vaginal delivery.