Alterations Of Postpartum

Question 0

What are the 4 postpartum complications

Answer 0

Hemorrhage
Infection
Thromboembolic disease
Postpartum affective disorder

Question 1

Why is Depression screening hard to do on postpartum women

Answer 1

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

Question 2

What is classified as postpartum hemorrhage

Answer 2

Any amount of bleeding that places the mother in hemodynamic jeopardy

Question 3

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

Answer 3

Mild degree of shock

Diaphoresis, increased capillary refilling, cool extremities, maternal anxiety

Question 4

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

Answer 4

Moderate degree of shock

Tachycardia, postural hypotension, oliguria

Question 5

Signs and symptoms of >40% blood loss

Answer 5

Severe degree of shock

Hypotension, agitation/ confusion, hemodynamic instability

Question 6

There are multiple causes to postpartum hemorrhage, what are they

Answer 6

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

Question 7

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

Answer 7

Let it fall out naturally

Pulling on placenta could cause uterine inversion

Question 8

5 T’s of postpartum hemorrhage

Answer 8

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

Question 9

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

Answer 9

During pregnancy only use Tylenol

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

Question 10

Management for postpartum hemorrhage

Answer 10

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

Question 11

Postpartum hemorrhage is most commonly due to what

Answer 11

Uterine atony

Question 12

What is subinvolution

Answer 12

The uterus not contracting the way it should

Question 13

Causes of subinvolution

Answer 13

Retained placental fragments
Distended bladder
Uterine myoma
Infection

Question 14

Complications of subinvolution

Answer 14

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

Question 15

Why is treatment of salpingitis so important

Answer 15

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

Question 16

Thromboembolic conditions

Answer 16

Inflammation of blood vessel lining

Question 17

Two most common types of thromboembolic conditions

Answer 17

Superficial and deep vein

Question 18

What is different about superficial and deep vein thrombosis

Answer 18

Superficial you can see by looking at lower extremities

Deep vein you can only see with a Doppler ultrasound

Question 19

What should you be careful about when looking at thromboembolic conditions

Answer 19

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

Question 20

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

Answer 20

Unilateral

Question 21

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

Answer 21

Heparin

Question 22

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

Answer 22

100.4 degrees F

Question 23

What are the four postpartum infections

Answer 23

Metritis
Wound infections
UTI
Mastitis

Question 24

What is metritis

Answer 24

Infection of endometrium, decidua, and adjacent myometrium

Question 25

What is mastitis

Answer 25

Inflammation of the breast

Question 26

Therapeutic management of metritis

Answer 26

Broad-spectrum antibiotics

Question 27

Therapeutic management of wound infection

Answer 27

Recognition of infection and opening of wound to promote drainage, aseptic technique, analgesics if needed

Question 28

Therapeutic management of UTI

Answer 28

Fluids and antibiotics

Question 29

Therapeutic management of mastitis

Answer 29

Breast emptying and antibiotics

Question 30

If a woman has mastitis how often should you try to get her to empty her breast?

Answer 30

Every 2 hours

Question 31

Is vagina a sterile environment

Answer 31

No

Question 32

Does tear or episiotomy heal better

Answer 32

Tear

Question 33

What are ways to prevent postpartum infections

Answer 33

Aseptic technique, hand washing, perineal hygiene, screening of visitors

Question 34

What does REEDA stand for? What is it used for?

Answer 34

Perineal healing assessment
Redness
Edema
Ecchymosis
Discharge
Approximation

Question 35

Do you see Lochia Rubra more in vaginal delivery or C/S? Why?

Answer 35

More in vaginal delivery because they vacuum the uterus out during C/S so you Exocet to see less blood

Question 36

What is the most severe form of postpartum affective disorder?

Answer 36

Postpartum psychosis

Question 37

What is the treatment of postpartum psychosis

Answer 37

Hospitalization

Question 38

Signs of postpartum psychosis

Answer 38

Not knowing right from wrong, clear disconnect from reality, manic behaviors

Question 39

Signs is postpartum depression

Answer 39

Major depressive episode associated with childbirth, symptoms lasting beyond 6 weeks and worsening

Question 40

Signs of “Baby Blues”

Answer 40

Onset quicker but resolves, mood swings, irritability, insomnia, typically resolves within 2 weeks, usually self limiting