Chapter 33

Question 1

Differentiate the causes of postpartum infection

Answer 1

Entometritis (infection of the lining of the uterus, most common)

Wound infections (often develop after mothers are discharged)

Urinary tract infections

Question 2

Causes of Postpartum Hemorrhage

Answer 2

Uterine atony (associated with high parity, hydramnios, macrosomic fetus, multifetal gestation)

Retained placenta

Lacerations of the genital tract

Hematomas

Inversion of the uterus

Subinvolution of the uterus (late postpartum bleeding)

Question 3

Management of Postpartum Hemorrhage

Answer 3

Initial intervention is to massage uterine fundus

Express clots from the uterus

Eliminate bladder distension

Continuous IV infusion of 10-40 units of oxytocin or other uterotonic medications

Question 4

Summarize assessment and care of women with postpartum infections

Answer 4

Endometritis: S/S include fever, increased pulse, chills, pelvic pain, uterine tenderness; IV broad spectrum antibiotics

Wound Infections: S/S include fever, erythema, warmth, tenderness, pain; treat with antibiotic therapy and wound debridement

Urinary Tract Infections: S/S include dysuria, frequency and urgency, low grade fever, hematuria; treat with antibiotic therapy

Question 5

Incidence and Etiology of Thromboembolic Disorders

Answer 5

VTE occurs in pregnancy and postpartum period

DVT occurs most often during pregnancy

PE occurs postpartum

Primary causes include venous stasis and hypercoagulation

Question 6

Signs and Symptoms of Thromboembolic Disorders

Answer 6

Pain and tenderness, warmth, redness

Question 7

Management of Thromboembolic Disorders

Answer 7

Superficial treated with analgesia, elevation of affected leg, compression stockings

DVT treated with anticoagulant therapy, compression stockings