Chapter 2: Tatiana Bennett (Later Postpartum Hemorrhage) Flashcards
criteria for PCOS
need 2 out of 3
* irregular period or lack of period (amenorrhea)
* high testosterone levels (hirsutism, deeper voice)
* polycystic ovaries seen in ultrasound
problems associated with PCOS diagnosis?
- increased diabetes risk
- difficulty getting pregnant
What laboratory tests are expected in a woman diagnosed with PCOS?
- free and total testosterone
- cortisol
- TSH
- prolactin
- IGF-I
- fasting lipids
- two-hour OGTT
- fasting glucose or hemoglobin A1c
what to do if you miss 1 oral contraceptive pill?
take 1 pill as soon as remembered
what to do if you miss 2 oral contraceptive pills?
- take 2 when remembered
- take 2 next day
- use protection
what to do if you miss 3 oral contraceptive pills, or miss 2 pills in week 3?
- take 1 pill daily until sunday
- start new pack
- use protection
- may miss period
when do pap tests start and frequency?
- age 21 regardless of sexual history
- every 3 years until 29
when is hpv tested with pap tests?
- age 30-64
- every 5 years
- no more screening after 65+
autosomal recessive inheritance pattern
- Need 2 copies of the mutation, one from each parent
- Ex) cystic fibrosis
Autosomal dominant inheritance pattern
- Need one copy of the mutation
- Ex) Huntington’s and Rh factor
what are braxton hicks contractions?
- False labor, uterine contractions that do not cause cervical effacement and dilation
- Relieved by drinking water or resting
True labor characteristics
- 411 rule: contractions that are 4 minutes apart, last at least a minute for at least an hour
- Location: back and front
- Contractions regular
- Not relieved by drinking water, resting
Potential side effects of epidural & spinal anesthesia
- hypotension
- pruritis
- urinary retention or bladder distention
- spinal headaches relieved when lying down
- resp depression
group b strep treatment
- penicillin G
- IV infuse over 15-30 minutes
postpartum assessment frequency
- first hr: every 15 min
- second hr: every 30 min
- hours 3-24: every 4 hours
- after 24 hours: every 8-12 hours
what to check in postpartum assessment?
- uterus
- lochia (bleeding)
- perineum
- pain
- IV site
- urinary output
- maternal affect
- Abd incision if c-section
- ambulation, mobility, sensation
cause of later postpartum hemorrhage
endometritis
inflammation of uterine lining
endometritis treatment
gentamycin and clindamycin
postpartum hemorrhage treatment
Methylergonovine maleate
risk factors for PPH
- multiple pregnancies
- advanced maternal age
- bleeding or coagulation disorders
- history or family history
- uterine atony
- retained placenta
- hypertensive disorders
- asian or hispanic ethnicity
- maternal obesity
- multiple previous births
breastfeeding colostrum composition
- first milk
- immunologic components
breastfeeding transitional milk composition
fats, calories, and lactulose increase
breastfeeding mature milk composition
almost complete nutrition for infant (carbs, fats, protein, vitamins, minerals, digestive enzymes)
breastfeeding latch
- lips flanged out over the breast and not tucked in
- areola fully in mouth
- try to get in first hr of birth
frequency of breastfeeding
- hourly
- week old: 8-12 times a day for 5-20 minutes
- infants will cry if hungry
- need vit D supplementation for breastfeeding