NUR 430 EXAM 2 REVIEW UNIT 4
Postpartum
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•Normal Postpartum vital signs
oHeart Rate – Slightly Altered
oPulse Pressure - elevated for 1st hour after birth then returns to normal.
oRespiratory Rate – Normally lowered, returns to non pregnant levels – usually 6-8 weeks
oBlood Pressure – slightly altered
oTemp – Birth temp usually around 100.4 for the 1st 24 hours then returns to normal after 24 hours
oHR/PP returns to nonpregnant levels within a few days
oPlatelet should be 150-400 thousand
oWhite Blood count will be elevated.
o If Temp is less than 100.4 usually sign of dehydration and greater then 100.4 indicates infection.
•Lochia – Can persist for up to 4-8 weeks postpartum
oRubra – Red, postpartum 1-3 days (3-4 days), made up of blood, decidua and mucus
oSerosa – Pink to brownish, postpartum 3-10 days (22 – 27 days), made up of blood, mucus and
invading leukocytes
oAlba – White in color, postpartum 10-14 days, last 6 weeks, mucus and leukocytes
•Postpartum hemorrhage – Elevated Hr/RR lowered temp, Blood pressure down – not an immediate response
to hemorrhage, body will try to compensate 1st.
oAlways check the bladder, if cannot void may need catheterization.
▪Full bladder displaces uterus making inability to contract.
oCauses maybe subinvolution of uterus, lead to pelvic infection, then leads to retained
placental fragments.
▪Endometrial regeneration – 16 days postpartum except the placental site, placental site takes 6
weeks after birth.
oUterus is about the size of grapefruit and at the level of umbilicus immediately following birth
▪Will start at level of umbilicus directly after birth and should be down in true pelvis by day 9
after delivery.
oMessage fundus – PRIORITY if it is boggy – Always stabilize bottom of uterus in place (sensitive pubis)
if you don’t could cause prolapsed uterus due to cervix still dilated.
oWater for saturating pad every hour of constant trickling of blood.
▪A pad or 2 every hour is too much.
▪Check under them for blood.
oAlways turn and check for blood under buttocks
o Looses about 500ML in normal delivery and about 1000lm in c section.
