Alterations Of Postpartum Flashcards

0
Q

What are the 4 postpartum complications

A

Hemorrhage
Infection
Thromboembolic disease
Postpartum affective disorder

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1
Q

Why is Depression screening hard to do on postpartum women

A

Most of the questions that are asked she will say yes to, not because of the depression but because the changes asked come with bringing a baby I to the world

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2
Q

What is classified as postpartum hemorrhage

A

Any amount of bleeding that places the mother in hemodynamic jeopardy

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3
Q

What are the signs and symptoms of <20% blood loss

A

Mild degree of shock

Diaphoresis, increased capillary refilling, cool extremities, maternal anxiety

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4
Q

What are signs and symptoms of 20-40% blood loss

A

Moderate degree of shock

Tachycardia, postural hypotension, oliguria

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5
Q

Signs and symptoms of >40% blood loss

A

Severe degree of shock

Hypotension, agitation/ confusion, hemodynamic instability

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6
Q

There are multiple causes to postpartum hemorrhage, what are they

A
Uterine atony
Lacerations/episiotomy
Retained placental fragments
Uterine inversion
Coagulation disorders
Hematomas
Hemorrhage history after delivery
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7
Q

During the birth of the placenta, should the doctor help by pulling or let it fall out naturally

A

Let it fall out naturally

Pulling on placenta could cause uterine inversion

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8
Q

5 T’s of postpartum hemorrhage

A
Tone: uterine atony; distended bladder
Tissue: retained placenta and clots
Trauma: vaginal, cervical, uterine injury
Thrombin: coagulopathy 
Traction: causing uterine inversion
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9
Q

When should you use Tylenol and when should you use Ibuprofen during/after pregnancy

A

During pregnancy only use Tylenol

After pregnancy use either but ibuprofen is reccomended because of its anti inflammatory properties

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10
Q

Management for postpartum hemorrhage

A
Focus on underlying cause 
Uterine massage 
Removal of retained placental fragments 
Antibiotics for infection 
Repair of lacerations
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11
Q

Postpartum hemorrhage is most commonly due to what

A

Uterine atony

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12
Q

What is subinvolution

A

The uterus not contracting the way it should

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13
Q

Causes of subinvolution

A

Retained placental fragments
Distended bladder
Uterine myoma
Infection

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14
Q

Complications of subinvolution

A

Hemorrhage
Pelvic peritonitis (inflammation of everything)
Salpingitis (inflammation of Fallopian tubes)
Abscess formation

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15
Q

Why is treatment of salpingitis so important

A

Your Fallopian tubes are as hollow as a single hair

In this infection if it is bit treated they could close up or scar tissue could build up causing future infertility

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16
Q

Thromboembolic conditions

A

Inflammation of blood vessel lining

17
Q

Two most common types of thromboembolic conditions

A

Superficial and deep vein

18
Q

What is different about superficial and deep vein thrombosis

A

Superficial you can see by looking at lower extremities

Deep vein you can only see with a Doppler ultrasound

19
Q

What should you be careful about when looking at thromboembolic conditions

A

Superficial and deep vein can occur at the same time. Always look for deep vein because although you can’t see it it can be there. Both can be very painful

20
Q

When testing for thromboembolic conditions do we worrying about unilateral pain or bilateral pain

A

Unilateral

21
Q

What drug would a nurse expect to administer to a postpartum woman with deep vein thrombosis

22
Q

What does a fever have to be over after first 24 hours to indicate a infection

A

100.4 degrees F

23
Q

What are the four postpartum infections

A

Metritis
Wound infections
UTI
Mastitis

24
What is metritis
Infection of endometrium, decidua, and adjacent myometrium
25
What is mastitis
Inflammation of the breast
26
Therapeutic management of metritis
Broad-spectrum antibiotics
27
Therapeutic management of wound infection
Recognition of infection and opening of wound to promote drainage, aseptic technique, analgesics if needed
28
Therapeutic management of UTI
Fluids and antibiotics
29
Therapeutic management of mastitis
Breast emptying and antibiotics
30
If a woman has mastitis how often should you try to get her to empty her breast?
Every 2 hours
31
Is vagina a sterile environment
No
32
Does tear or episiotomy heal better
Tear
33
What are ways to prevent postpartum infections
Aseptic technique, hand washing, perineal hygiene, screening of visitors
34
What does REEDA stand for? What is it used for?
``` Perineal healing assessment Redness Edema Ecchymosis Discharge Approximation ```
35
Do you see Lochia Rubra more in vaginal delivery or C/S? Why?
More in vaginal delivery because they vacuum the uterus out during C/S so you Exocet to see less blood
36
What is the most severe form of postpartum affective disorder?
Postpartum psychosis
37
What is the treatment of postpartum psychosis
Hospitalization
38
Signs of postpartum psychosis
Not knowing right from wrong, clear disconnect from reality, manic behaviors
39
Signs is postpartum depression
Major depressive episode associated with childbirth, symptoms lasting beyond 6 weeks and worsening
40
Signs of "Baby Blues"
Onset quicker but resolves, mood swings, irritability, insomnia, typically resolves within 2 weeks, usually self limiting