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RNSG 1251 UNIT 3 > ch. 33: postpartum complications > Flashcards

ch. 33: postpartum complications Flashcards

1
Q

What is UTERINE ATONY?

A

inadequate uterine ctx, uterus is flaccid & rapid blood loss can follow

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2
Q

What is the treatment for UTERINE ATONY?

A

-massage fundus until firm
-empty bladder
-IV oxytocic meds

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3
Q

What are PLACENTAL COMPLICATIONS?

A

-retained placenta: placenta NOT expelled within 30 mins after birth
-fragments of placenta remain in uterus

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4
Q

What is the treatment of PLACENTAL COMPLICATIONS?

A

manual separation and removal by nurse-midwife or physician

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5
Q

What are LACERATIONS?

A

-tear that causes bleeding despite contracted fundus: slow trickle, oozing, hemorrhage
-can also cause hematomas

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6
Q

What is the treatment of LACERATIONS?

A

-usually Id and sutured immediately: position changes, warm/cold application, increase fiber and fluid, stool softener
-hematomas are surgically evacuated

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7
Q

What is INVERSION OF THE UTERUS?

A

uterus turns inside out
-s/s: hemorrhage, shock, pain

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8
Q

What is the treatment of INVERSION OF THE UTERUS?

A

-maternal fluid resuscitation
-replacement fo uterus within pelvic cavity
-correction of associated clinical conditions

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9
Q

What is SUBINVOLUTION OF THE UTERUS?

A

delayed return of enlarged uterus to non-pregnant size and function
-s/s: prolonged lochia, irregular excessive bleeding

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10
Q

What is the treatment of SUBINVOLUTION OF THE UTERUS?

A

-depends on cause
-Ergonovine or Methylergonovine (methergine) 0.2 mg every 3-4 hr for 24-48 hr

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11
Q

What are the side effects of OXYTOCIN?

A

-water intoxication
-n/v

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12
Q

What are the contraindications for OXYTOCIN?

A

none for PPH

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13
Q

What is the dosage/route of OXYTOCIN?

A

10-20 units/L up to 80 units/L diluted in LR or NS at 125-200 microunits/min
OR
10-20 units IM

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14
Q

What are nursing considerations for OXYTOCIN, MISOPROSTOL, CARBOPROST, & DINOPROSTONE?

A

continue to monitor bleeding and uterine tone

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15
Q

What are the side effects of MISOPROSTOL?

A

-HA
-n/v
-diarrhea
-fever
-chills

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16
Q

What are the contraindications for MISOPROSTOL?

A

none

17
Q

What is the dosage/route of MISOPROSTOL?

A

600-1000 mcg rectally ONCE
OR
400 mcg SL or PO ONCE

18
Q

What are the side effects of METHYLERONOVINE?

A

-HTN
-hypotension
-n/v
-HA

19
Q

What are the contraindications for METHYLERONOVINE?

A

-HTN
-PREECLAMPSIA
-CARDIAC DISEASE

20
Q

What is the dosage/route of METHYLERONOVINE?

A

0.2 mg IM q 2-4 hr up to 5 DOSES
-can also be given intrauterine or orally

21
Q

What are the nursing considerations for METHYLERONOVINE?

A

-check BP before admin
-DO NOT GIVE if BP > 140/90
-continue monitoring vag bleeding and uterine tone

22
Q

What are the side effects of CARBOPROST?

A

-HA
-n/v
-diarrhea
-fever
-chills
-TACHYCARDIA
-HTN

23
Q

What are the contraindications for CARBOPROST?

A

AVOID giving to pts w/ ASTHMA or HTN

24
Q

What is the dosage/route of CARBOPROST?

A

250 mcg IM
OR
intrauterine inj q 15-90 min UP TO 8 DOSES

25
Q

What are the side effects of DINOPROSTONE?

A

-HA
-n/v
-diarrhea
-fever
-chills

26
Q

What are the contraindications for DINOPROSTONE?

A

use w/ caution on pts w/ hx of ASTHMA, HTN, HYPOTENSION

27
Q

What is the dosage/route of DINOPROSTONE?

A

20 mg vaginal or rectal suppository q 2 hr

28
Q

What are risk factors for developing a DVT/PE?

A

-obesity
-immobility
-malignancy
-chronic medical condition
-smoking
-multiparity

29
Q

What are clinical manifestations of DVT?

A

-unilateral extremity edema, erythema, warmth, pain, + Homan’s sign

30
Q

What are clinical manifestations of PE?

A

-chest pain
-coughing
-dyspnea
-tahcypnea
-crackles

31
Q

What teaching would you provide to pts discharged home after a DVT/PE?

A

-explain treatment schedule and possible SE of oral anticoagulants
-pts on anticoagulants should AVOID BREASTFEEDING or use alternative (warfarin)

32
Q

What is the management/nursing interventions for puerperal infection?

A

-IV broad spectrum axb (cephalosporins, penicillins, clindamycin, gentamycin)
-supportive care: hydration, rest pain relief

RNSG 1251 UNIT 3 (4 decks)

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