Nursing 209

N209: Reproductive Health Study Guide

Promotes healing

Exercise •

• Depends upon medical history and delivery as well as fitness level • Usually no strenuous exercise for 4-6 weeks PP • Encourage Kegels: Contract pelvic muscles for 10 seconds then relax for 10 seconds; perform for 15 minutes four times per day • Helps reduce stress incontinence Contraception • Should be discussed as part of discharge planning • Most patients do not consider contraception immediately after delivery but often resume sexual intercourse prior to the sixth week postpartum visit • Ovulation can occur soon after delivery in non-lactating women • Breastfeeding should not be considered effective birth control (even though breastfeeding patients will have suppression of ovulation) • Postpartum sterilization should be discussed prior to labor • Most Medicaid plans require consent at least 30 days prior to delivery • No IUDs until six weeks PP • If noncompliance or health issues are a concern, a Depo-provera injection is considered at discharge; effective for three months 5.6 Neonatal Adaptation • Transition o Primary preparation for fetal transition is mediated by cortisol and catecholamine o Involves all organ systems o Immediate adaptations involve respiratory and cardiovascular systems • Essential components of transition o Fetal lung fluid clearance o Secretion of surfactant with initiation of breathing o Fetal to neonatal circulation o Decrease in vascular resistance with increase in pulmonary blood flow 5.7 Endocrine System Cortisol • Cortisol surge (levels increase at 36 weeks and peak several hours after birth)

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