Postpartum Period
http://evolve.elsevier.com/Silvestri/compreh
ensiveRN/
Priority Concepts
Health Promotion, Reproduction
I. Postpartum
A. Description: Period when the
reproductive tract returns to
the normal, nonpregnant state
B. The postpartum period starts
immediately after birth and is
usually completed by week 6
following birth.
II. Physiological Maternal Changes
B. Lochia
A. Involution
1. Descr
iption
2. Asses
smen
t
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c. The fundus steadily
descends into the
a. Involution is the pelvis.
d. Fundal height
rapid decrease in
the size of the decreases
uterus as it about 1
returns to the cm/day (Fig.
nonpregnant 25-1).
e. By 10 days
state.
b. Clients who breast-
postpartum, the
feed may experience uterus cannot be
a more rapid palpated
involution because abdominally.
f. A flaccid fundus
of the release of
oxytocin during indicates uterine
breast- feeding. atony, and it should
be massaged until
a. The weight of the firm; a tender
uterus decreases fundus indicates an
from approximately infection.
g. Afterpains
2 lb (900 g) to 2 oz
(57 g) in 6 weeks. decrease in
b. The endometrium
frequency after the
regenerates. first few days.
774
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1. Description: Discharge from
the uterus that consists of
blood from the vessels of
the placental site and
debris from the decidua
2. Assessment (Box 25-1)
a. Rubra is bright
red discharge
that occurs from
day of birth to
day 3.
b. Serosa is brownish
pink discharge that
occurs from days 4
to 10.
c. Alba is white
discharge that
occurs from days
11 to 14.
d. Discharge should
smell like normal
menstrual flow.
e. Discharge decreases
daily in amount.
f. Discharge may
increase with
ambulation.
C. Cervix: Cervical involution occurs,
and the muscle begins to
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regenerate after 1 week.
D. Vagina: Vaginal distention
decreases, although muscle
tone is never restored
completely to the pregravid
state.
E. Ovarian function and menstruation
1. Ovarian function depends
on the rapidity with which
pituitary function is
restored.
2. Menstrual flow resumes
within 1 to 2 months in
non– breast-feeding
mothers.
3. Menstrual flow usually
resumes within 3 to 6
months in breast-feeding
mothers.
4. Breast-feeding mothers
may experience
amenorrhea during the
entire period of lactation
so long as they are
exclusively breastfeeding.
Women may ovulate without
menstruating, so breast-
feeding
should not be considered a form
F. Breasts of birth control.
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