Skin Trimester Contraction & Lochia Growth

Skin Trimester Contraction & Lochia Growth

This chapter covers Skin Trimester Contraction & Lochia Growth.

Third trimester

Rapid fetal growth, breathing movements in uterine, oriented to light and refelxes

36 weeks

Return visits are every week after …


Normal BP for pregnant woman


Fetal heart rate

Vaginal bleeding

Warning sign in 3rd trimester

Elema in face hands legs and feet

Warning signs in 3rd trimester


Fetal descent , baby dropped down

Braxton hicks contractions

False labour , intermittent tightening

Cervical changes

Cervix becomes softer and spongier

Bloody show

Vaginal discharge, blood tinged mucous plug labour begins 24-48 hours after]

Rupture of membranes

SROM occurs naturally, gush of amniotic fluid out of the vagina, after labour has begun

GI disturbance

Indigestion nausea vomiting and diarrhea

Sudden burst of energy

Encourage mother to eat nutritious meals at this time , unknown reasoning

False labour

Irregular contractions, felt above umbilicus, discomfort in abdomen , no bloody show

True labour

Regular contractions, increase intensity and duration, discomfort in lumbar region, bloody show


Shortening and thinning of the cervix


Enlargement of cervical opening

Colour odour amount and time


Dilation of cervix, pressure on pelvis, stretching of vagina, uterine contractions

Causes of pain during labour

Uterine contractions

Smooth muscle of uterus contracts and relaxes


Contraction phase where strength increases


Contraction phase that is Period of greatest strength


Contraction phase where strength decreases


Time from beginning of one contraction to the beginning of the next


Resting period between contractions (should not be less than 60 seconds)


Length of one contraction (increment, peak, decrement) 90 seconds max

Uterine agony

Soft boggy uterus , post partum bleeding

1 and 5 minutes

When to apgar score after birth

Fluid and ice chips

Oral comfort measure


How to increase uterine activity


When should a pregnant client void

Decrease anxiety

Why use breathing techniques

Slow deep chest breathing

Inhale through nose and exhale through lips 6-9 breaths / minute

Shallow breathing

Inhale and exhale through mouth 2 breaths per second at peak of contraction

Pant-blow breathing

Used when contractions are intense, every three to four breaths is a forceful exhalation through lips

Systemic medication

Opioid analgesics reduce perception of pain

regional block

Epidural , during active labour

Pudenda block

Local analgesic 10-20 minutes before birth

General anesthesia

Given for a c section

Breasts uterus bladder bowel lochia episiotomy



Uterus should be …. After birth


Uterus should descent immediately after birth and … for 10 days

24 hours

How long to check urinary I/O for

Lochia rubra

Heaviest lochia discharge

Lochia serosa

Light blood discharge in lochia

Lochia alba

Yellow/ brown lochia discharge

Redness ecchymosis edema discharge approximation


Gestational diabetes

Why monitor blood glucose after birth


Suctioning of secretions from mouth and nose

Airway breathing and circulation



Infant dried to prevent heat loss by evaporation


APGAR score less than ____ is an indication that neonate is in distress


Newborn loses ___% of body weight in the first 3-4 days


Normal newborn temperature


Normal heart rate for a newborn


Normal respirations for a newborn


Normal BP for a newborn

Vernix caseosa

White creamy substance covering newborn body


Fine hair on body of newborn


Present for several hours after birth until cardio has stabilized , blue colour of hands and feet


Present around eyes, face, dorsa of hands and feet, Labia or scrotum


Yellow discolouration of skin, sclera and mucous membranes


Large irregular hemorrhagic area of skin (bruise)


Pearly white cysts of the face

Erythema toxicim neonatorum

Pink rash with yellow papules on newborn

Telagiectasia nevi

Birth marks of dilated capillaries (stork bites)

Nevus flammeus

Large red/purple birthmark on face or neck

Nevus vascularis

Enlarged superficial blood vessel birthmark

Mongolian spots

Large patches of bluish skin on buttocks of dark skinned babies

Epstein’s pealrs

Small epithelial cysts on hard palate


Soft spot on babies head

Anterior fontanelle

Closes by 18 months

Posterior fontanelle

Closes by 2 months

Caput succedaneum

Edema of newborn scalp at birth


Collection of blood between the periosteum and skull

3 months

Permanent eye colour by how many months


Chest circumference is how many cm smaller than head

Witch’s milk

Whitish fluid secreted by a newborns nipple


Black tarry BM


Infant scrotum is covered in


Blood tinged mucous discharge from a newborn caused by withdrawal of maternal hormones


Placement of urinary meatus on underside of penis


Condition where opening of foreskin is so small it can’t be pulled back


Failure of one or both testes to descend


Fluid around tested in the scrotum


Placement of urinary meatus on top of penis


Stroking skin at one corner of mouth and eliciting infant to turn head toward that side


Touching newborns lips eliciting what reflez


Tip of tongue is touched of depressed, infant forces tongue outward

Palmar grasp

Finger is placed across Palm, infants finger holds

Plantar grasp

Foot is touched below toes , when touched infant toes curl downward

Tonic neck

Placing infant supine and rotating head to one side, arm and leg will extend on that side

Startle reflex

Moro reflex, holding newborn in semi sitting and allowing head to fall


Elicited when infant lying prone with hands under abdomen, infants skin is stroked on one side of spine, infants pelvis and shoulders turn toward that side


Holding a baby over a flat surface infant will put feet on surface as if their walking


Plantar surface is stroked from heel to under toes, great toe should dorsiflex and other toes fan out

20-30 minutes after birth

Breastfeeding when to start


____causes posterior pituitary to secrete oxytocin

Cradle hold footba hold lying down and across lap

Types of positions to hold baby


Watery high in lactose and quenches thirst


High in fat leads to weight gain and more satisfying

30 minutes

Average breastfeeding session

2-3 hours

Breastfeeding frequency is every ___


How many diapers in 24 hours is necessary

Half way through feeding

When to burp baby


How many weeks should you wait before using a pacifier or bottle feeding

Oxygen in air


Oxygen therapy

Used for clients with impaired has exchange and or surgery

Nasal cannula

Most common , inexpensive low-flow device


DO NOT administer over

Simple face mask

Masks over clients nose and mouth

5L/min required to

Avoid rebreathing

Partial rebreather mask

Client rebreathes first third of exhaled air, do not allow deflation of bag

Non-rebreather mask

Highest oxygen concentration, client breathes only source of oxygen in the bag

Venturi mask

Precise oxygen concentration delivery

Face tent

When client can’t tolerate masks

Oxygen tent

Enclosed set up , tent with O2 at 15L/min for 15 minutes

Chemical restraint

Psychoactive medication, sedation ex: Ativan , Xanax, Thorazine

Physical restraint

A device that limits voluntary movement ie. Bed rail , table

Environmental restraint

Modulation of clients surroundings , to limit movement ie. Locks on a door, barriers, dead ends

Preventing fall

Cardiac status, lifestyle factors, mobility, emotional state, communication

Hypotension, medications, low vision, unsafe footwear

Older adults at risk for falls why ?

Bed or chair safety monitor

Position switch triggers an audio alarm

Magnetic box monitor

Mounted on a bed or chair , connects to clothing with a clip

Dual sensor

Pressure sensitive combined with beam detector

Restraint use reasons

Avoid harm to client or others around them , to do what is required to provide treatment

Causes of restraints

Increased agitation, increased behavioural problems, loss of dignity, social withdrawl

Least restraint approach

Preserves client dignity, enhances quality of life, CNO endorses this

Least restraint

All possible alternative interventions are exhausted before deciding to use a restraint


A mental state characterized by disorientation regarding time, place or person

Delirium idiopathic and dementia

3 major forms of confusion


Acute confusion, impaired cognitive functioning, symptoms are reversible


Severe symptoms throughout day, worse at night

Idiopathic confusion

No identifiable physiological basis, stressful disturbance in lifestyle, may or may not reverse


Chronic confusion, damage to cerebral cortex, irreversible


1. Cognitive impairment behaviour


2. Cognitive impairment behaviour


3. Cognitive impairment behaviour

Protective strike technique

Protecting from strikes, duck, move and shield yourself

Release technique

Protecting from grabs

Redirection technique

How to redirect someone

Stabilize ask and repete

step 1 to respond to a physical altercation

Call for help release technique

Step 2 to respond to a physical altercation

Back away open posture

Step 3 to respond to a physical altercation

First trimester

Major organs of the fetus form, uterus raises out of pelvis

Second trimester

Fetus grows size and complexity, uterus at level of umbilicus, fetal movement