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Lactogenesis is the transition from pregnancy to |
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Stage 1 of lactogenesis begins mid-pregnancy until |
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Stage 1 of lactogenesis entails differentiation of cells and with prolactin which stimulates epithelial cells to |
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The second stage of lactogenesis occurs through PP days |
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Stage 2 is triggered by a rapid |
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with a drop in pregesterone there is an increase in |
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the maintenance of the established milk production is called |
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Lactation can be delayed if |
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retained placental fragments can delay the start of milk production because |
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progesterone levels will not decline |
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essential for initiating and maintaining milk production |
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Has a role during pregnancy of increasing breast mass and cell differentiation |
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Dopamine is prolactin inhibiting-- when the nipple is stimulated and milk is removed, |
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hypothalamus inhibits dopamine causing more milk production |
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Prolactin levels follow a circadian rhythmm thus levels are higher at_____ which causes more_____ |
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night and milk production |
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what drops with cigarette smoking? |
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drinking beer causes a rise in |
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depressed mothers have lower |
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The final differentiation of alveolar epithelial cells into mature milk cells takes place only after exposure to |
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TSH are normally elevated during which PP days? |
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mammory growth and lactation |
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Prolactin- Inhibiting factor- stimulates dopamine release and therefore |
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Definition
inhibits prolactin secretions |
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Nipple stimulation and milk removal suppress |
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Definition
Prolactin inhibiting factor and dopamine, causing prolactin levels to rise |
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Causes a contraction of the myoepithelial cells surrounding the alveoli necessary for the removal of milk from the breast (the “milk letdown”). |
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women who have C/S have less circulating |
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Avoid breastmilk for premature infants of mothers with acute |
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Breastfeeding permitted unless mother develops _______ several days before delivery or within 48 hours after birth. |
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Reconstitutes in the first few postpartum days. |
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the endometrium resembles a non-pregnant endometrium by |
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placental implantation site takes_____before returning to pre-pregnancy appearance |
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Vaginal rugae return at approximately |
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mammary involution can takes |
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Decreased GI motility can lead to |
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distention, constipation, and sometimes ileus. |
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Gastric tone and motility remain decreased for |
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Gradual return to nonpregnant values of GFR, renal plasma flow, plasma creatinine, BUN, and creatinine clearance by |
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The “taking-in” phase of postpartum adjustment involves reviewing |
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________ follows where the mother gradually assumes tasks of mothering, care of baby and self, along with attention to family and her support network. |
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ombined hormonal contraception is now classified as a category 4 (unacceptable health risk) for all postpartum women, regardless of breastfeeding status, for the first |
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Women who are between __________ and ___________ days PP should not use COCs if the risk outweigh the benefits/ |
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After 42 days PP, the risk for VTE is resolved and women may use ____ for birth control. |
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_____increases the risk of VTE in PP women. |
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consist primarily of blood is red to brownish color and last 3-5 days |
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contains some blood but primarily wound exudate and leukocytes is pinkish brown color. Median duration is 22 days |
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Some may experience a transient increase in bleeding 7-14 days postpartum secondary to sloughing of |
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- Composed predominantly of leukocytes and some decidual cells and is white or yellowish white in color |
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In women who do not breastfeed, ______ decreases within the first postpartum week |
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Women who do not breastfeed or who wean abruptly may have a increased risk of |
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LFTs_____during pregnancy/labor |
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The drop in estrogen leads to return to non-pregnant _____ levels |
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the incidence of _____________is more common in the postpartum than at any other time in a woman’s life. |
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medications need to bind to protein.. if it is highly protein bound then it is less likely to |
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lipid soluble durgs are more likely to pass through the cell membrabrane and get into the |
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low molecular weight medications readily c |
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cross the cell membrane; high contents in breastmilk |
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when is breastfeeding contraindicated in breastfeeding? |
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outbreak five days prior to birth or 48hrs after birth |
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can mother breastfeed with HINI? |
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yes...she needs to pump and feed her baby until she is better |
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can mothers breastfeed with active TB? |
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no...needs to wait until she is recovered |
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is CMV contraindicated in breastfeeding? |
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no, only with acute infection for premies |
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when should nbns receive HBIG and Hep B vaccine? |
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what are the medication properties that increase the chances of crossing into the breastmilk? |
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low molecular weight, low protein binding, and fat soluble medications |
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diaphragms should be refitted when what happens? |
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after childbirth and each time there is a 10lb weight change (plus or minus) |
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when are diaphragms contraindicated? |
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while the woman is still having lochia discharge |
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what is the risk of diaphragm use while lochia is still present? |
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when should diaphragms be refitted after childbirth? |
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contraceptive sponge is not as effective once |
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contraceptive sponge can be used |
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after childbirth; 6wks pp |
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IUD must be placed immediately PP, otherwise there is an |
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increased risk of expulsion |
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what is the time frame for IUD placement after childbirth? |
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with 10mins of placental expulsion or after 4-6wks |
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lactogenesis can be delayed in women who_____.______, or______, |
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Definition
had a c/s, had an epidural, or have diabetes |
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how long can a baby go without nursing and it still be okay? |
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one 5hr stretch is usu okay in babies who are breastfeeding well |
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how long should women delay breastfeeding with drinking alcohol? |
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how long should BFing be delayed when smoking marijuana? |
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how long should BFing be delayed with methadone use? |
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can mothers who smoke cigarettes breastfeed? |
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yes, benefits outweigh the risk |
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why are breastfed, late pretermers more likely to be readmitted to the hospital than formula fed late pretermers? |
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poor suck and milk exchange challenges related to the poor suck |
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