Chapter 25

Question 1

One of the primaey causes of mortality associated with childbearing.

Answer 1

Hemorrhage

Question 2

Is defined as bloos loss of 1000mL or more following a vaginal birth or cesarean birth

Answer 2

Postpartum Hemorrhage

Question 3

The four main reasons for postpartum hemorrhage

Answer 3

*uterine atony
*trauma
*retained placental fragments
*disseminated intravascular coagulation

Question 4

Four Ts of postpartum hemorrhage

Answer 4

*tone
*trauma
*tissue
*thrombin

Question 5

Is the most frequent cause of postpartum hemorrhage, tends to occur in asian hispanic and black patients

Answer 5

Uterine atony

Question 6

Are easier to locate and assess than cervical lacerations

Answer 6

Vaginal Lacerations

Question 7

Placenta fuses with the myometrium because of an abnormal decidua basalis layer

Answer 7

Placenta Accreta

Question 8

Is a prolapse of the fundus of the uterus through the cervix so that the uterus turns inside out

Answer 8

Uterine inversion

Question 9

Is a deficiency in clotting ability caused by vascular injury

Answer 9

Disseminated Intravascular Coagulation

Question 10

Is the incomplete return of the uterus to its prepregnant size and shape.

Answer 10

Subinvolution

Question 11

Is a collection of blood below the epidermis of the vulva.

Answer 11

Vulvar Hematomas

Question 12

Organisms commonly cultured in the postpartum period include

Answer 12

Group B streptococci, staphylococci, and aerobic gram negative bacilli such as escherichia coli

Question 13

When is early hemorrhage

Answer 13

Within the first 24 hours following birth

Question 14

When is late hemorrhage

Answer 14

From 24 hours to 6 weeks after birth

Question 15

Uterine atony tends to occur most often in

Answer 15

Asian, Hispanic, and Black patients

Question 16

In uterine atony, first step in controlling hemorrhage is

Answer 16

To drain the bladder and attempt fundal massage to encourage contraction

Question 17

Inserts one hand into the vagina while pushing against the fundus through the abdominal wall with the other hand.

Answer 17

Bimanual Compression

Question 18

Removal of the uterus

Answer 18

Hysterectomy

Question 19

Lacerations occur most often:

Answer 19

*with difficult or precipitate births
*in primigravidas
*with the birth of a large infant
*with the use of lithotomy position and instruments

Question 20

Lacerations of the cervix are usually found on

Answer 20

The sides of cervix, near the branches of the uterine artery.

Question 21

First degree perineal lacerations

Answer 21

Vaginal mucous membrane and skin of the perineum to the fourchette

Question 22

Second degree

Answer 22

Vagina, perineal skin, fascia, levator ani muscle, and perineal body.

Question 23

Third degree

Answer 23

Entire perineum, extending to reach the external sphincter of the rectum

Question 24

Fourth degree

Answer 24

Entire perineum, rectal sphincter, and some of the mucous membrane of the rectum

Question 25

A placenta with an accessory lobe.

Answer 25

Succenturiate placenta

Question 26

A blood serum sample of this also reveals that part of a placenta is still present.

Answer 26

human chorionic gonadotropin

Question 27

Removal of the retained placenta can usually be accomplished by

Answer 27

Dilatation and Curettage (D&C)

Question 28

Disseminated Intravascular Coagulation is usually associated with

Answer 28

*premature separation of the placenta
*missed early miscarriage
*fetal death in utero

Question 29

Is the usual prescription to improve uterine tone and complete involution

Answer 29

Oral administration of Methylergonovine 0.2 mg four times daily

Question 30

Management for vulvar hematomas

Answer 30

Administer an analgesic as prescribed for pain relief. Applying an ice pack may prevent further bleeding.

Question 31

Is an infection of the endometrium, the lining of the uterus.

Answer 31

Endometritis

Question 32

Is one of the first symptoms of peritonitis

Answer 32

Rigid abdomen (guarding)

Question 33

Is inflammation of the lining of a blood vessel

Answer 33

Phlebitis

Question 34

Is inflammation with the formation of blood clots.

Answer 34

Thrombophlebitis

Question 35

Thrombophlebitis tends to occur because:

Answer 35

*smoke cigarettes
*have preexisting varicose veins
*develop a postpartum infection
*have increased parity
*have a history of a previous thrombophlebitis

Question 36

This decreased circulation, along with edema gives the leg a white or drained appearance.

Answer 36

Femoral Thrombophlebitis

Question 37

Femoral thrombophlebitis was formerly called

Answer 37

Milk leg or phlegmasia alba dolens (white inflammation)

Question 38

Patients who are at high risk for thrombophlebitis may be prescribed ________ daily as a preventive measure.

Answer 38

Aspirin

Question 39

If a pelvic thrombophlebitis develops, a patient will generally have

Answer 39

Elevated temperature, systemic fever, chills, and pain.

Question 40

Management for thrombophlebitis

Answer 40

*Ambulation
*Well-padded stirups
*support stocking
*heparin therapy