Postpartum Adaptations and Nursing Care

A set of vocabulary flashcards covering postpartum physiological adaptations, psychological phases, nursing assessments, and patient care for both vaginal and cesarean deliveries.

Attachment

Process by which an enduring bond between a parent and child is developed through pleasurable, satisfying interactions.

Bonding

Initial, rapid attraction felt by parents for their infants; it is a one-way process from the parent to the infant.

Catabolism

Conversion of living cellular substances to simpler compounds; in postpartum, it allows uterine muscle cells to decrease in size.

En face

Position that facilitates eye-to-eye contact between the parent and newborn.

Engrossment

Intense fascination between the father and newborn.

Entrainment

Movement of the newborn in rhythm with the parent’s voice.

Fingertipping

Initial touch characteristics between the mother and newborn.

Fundus

Part of the uterus above the openings of the fallopian tubes.

Involution

Retrogressive changes that return the reproductive organs to their prepregnancy states.

Kegel exercises

Method to increase the tone of muscles in the vaginal and urinary meatal area.

Puerperium

Period from childbirth until the return of the reproductive organs to their prepregnancy states.

REEDA

Acronym that helps assess wound healing including redness, edema, ecchymosis, discharge, and approximation.

Taking-in phase

The first phase of maternal adaptation, often characterized by passivity and the mother's need to talk about her birth experience.

Uterine lining adaptation

The outer area of the decidua is expelled with the placenta; the superficial layer is shed in lochia, while the basal layer regenerates new endothelium.

Lochia rubra

Red discharge containing blood, mucus, and decidua with a duration of approximately $3$ days.

Lochia serosa

Pinkish discharge containing serous exudate, erythrocytes, leukocytes, and cervical mucus; duration is from the $4th$ to the $10th$ day.

Lochia alba

White or colorless discharge containing leukocytes, decidual cells, epithelial cells, fat, cervical mucus, and bacteria; duration varies from the $11th$ day until the $3rd$ to $6th$ week.

Postpartum Bradycardia

A decrease in pulse occurring as stroke volume increases because blood from the uteroplacental unit returns to central circulation.

Venous thrombosis risk factors

High fibrinogen levels, decreased clot-lysing factors, varicose veins, history of thrombophlebitis, or cesarean birth.

Postpartum Hemorrhage (Bladder impact)

A full bladder interferes with the ability of the uterus to firmly contract and can occlude open vessels at the placental site, allowing free bleeding.

Prolactin

Hormone that initiates milk production in the alveoli.

Oxytocin

Hormone that causes milk ejection from the alveoli into the lactiferous ducts.

Rho(D) immune globulin indication

Administered if the mother is $Rh-$ and the newborn is $Rh+$.

Rubella vaccine indication

Administered if prenatal rubella antibody screening shows the mother is nonimmune.

Proper funduss massage technique

One hand is placed just above the symphysis pubis to support the lower uterine segment while the other massages the fundus in a circular motion.

Uterine Inversion risk

Pushing on a uterus that is not contracted firmly when attempting to express clots can invert the uterus, causing massive hemorrhage and shock.

Perineal cold packs

Most effective if applied soon after birth for the first $24$ hours to prevent edema and numb the perineum.

Perineal care (Peri-bottle)

Squirt warm water over the perineum after each void or bowel movement; the bottle should not touch the perineum.

Sitz baths

Cleansing and comfort measure using cool water during the first $24$ hours for edema, and warm water after $24$ hours to increase circulation and healing.

Cesarean respiratory assessment

Frequent assessment required due to narcotic use which depresses the respiratory center; includes using pulse oximetry for $18-24$ hours post-op.

Constipation prevention

Includes increasing activity, drinking at least $8$ glasses of water daily, and adding dietary fiber from fruits, vegetables, and whole-grains.

Postpartum Blues

Mild, transient depression affecting more than $70\%$ of women, characterized by fatigue, weeping, and mood instability within the first week.

Breast engorgement prevention (Non-breastfeeding)

Constantly wear a well-fitting bra or breast binder; avoid pumping or stimulating the breasts.