Hesi Ob Exam Guide And Notes- Green Book Exam Notes

HESI OB EXAM GUIDE AND NOTES- GREEN BOOK EXAM NOTES Normal Puerperium (Postpartum): Period after pregnancy and delivery (usually 6 weeks) then the body return to the nonpregnant state. -Myometrial contractions occur for 12-24 hours postdelivery due to high oxytocin levels -Involution occurs (1-2 cm/day) First day: at or 1-2cm above umbilicus 7-10 days: decreases to 12 week size, slides back under symphysis pubis -Cervix heals within 6 weeks -Rugae in the vagina reappear within 3 weeks -Vaginal walls are thin and dry until ovulation returns -Engorgement of breasts may occur 2-3 days PP. At Delivery: -Maternal vascular bed is reduced by 15% -Pulse may decrease to 50 (normal puerperal bradycardia) -These changes are hypothesized to result in shivering -BP and pulse should quickly return to prepregnant levels First 72 Hours: -24-48 hours pp, cardiac output remains elevated, will return to nonpregnant levels in 2-3 weeks. -Diaphoresis (especially at night) helps restore normal plasma volume -Hct rises, WBC count is elevated (12k-25k), diff to use WBC level for determining infection -Blood clotting factors are elevated; increased risk for thromboembolism -Diuresis occurs; up to 3000 mL/day of urine -Bladder distention and incomplete emptying are common -Increase risk for UTI -Urine glucose,