Common Problems and Complications PP

Question 1

why is bladder retention common PP? and how to monitor PP

Answer 1

periutethral edema; mother should be encouraged to void in the first hour post delivery, drink plenty of fluids, and void q4-6hrs; if voiding scant amounts, bladder scan to encourage that bladder is empty complete; repeat catherization is avoid; if indwelling catheter is placed prophylactic ampicillin should be concider

Question 2

how to deal with constipation PP?

Answer 2

stool softeners (not laxatives or enemas); adequate fluid and fiber intake; if mother is reluctant to bear down due to lac/epis, have mother hold a clean pad against the site and apply firm pressure while bearing down, may help with discomfort

Question 3

hemorrhoid management PP

Answer 3

sitz baths, witch hazel pads, anesthetic ointment, manual replacement of hemorrhoids (?) and side lying position

Question 4

afterpain management

Answer 4

apap or motrin an hour before nursing (breastfeeding stimulates oxytocin which can cause cramping)

Question 5

perineal edema and pain management PP

Answer 5

monitor for hematoma, if hematoma large it may need to be drained; monitor for any warmth, redness or indurated areas, may need antibiotics; ice packs and sitz baths

Question 6

how to prevent and treat spinal headaches

Answer 6

keeping the woman flat in supine for several hours and increasing hydration; caffeine or vasoconstrictor medication. if pain is severe or persistent an epidural blood patch is done

Question 7

why does a spinal block cause a headache for some woman?

Answer 7

cerebrospinal fluid (CSF) leaking from the meninges (3 layered membrane that protects the brain). sitting and standing results in pain from the reduced CSF creating traction on the pain sensitive CNS structures

Question 8

what is a epidural blood patch?

Answer 8

a small volume of blood is taken via venipuncture (it can not coagulate) and then injected into the same site as the spinal or epidural. used to treat severe or persistent headache after spinal block

Question 9

chills post delivery

Answer 9

common; caused by neurological and vasomotor changes; usually subsides in an hour or two; cover mom in warm blanket and offer warm liquids

Question 10

diphoresis PP

Answer 10

perspiration increases PP to help elevate excess fluid and waste products, night sweats are common

Question 11

when does PP blues start and how long does it last?

Answer 11

affects 50-80% of women; onset is usually less then 5 days PP and lasts usually 2-3 days but may persist up to 10 days

Question 12

signs of PP blues

Answer 12

mild insomnia, anger, mood swings, fatigue, irritability, impaired concentration, depressed affect, and frequent tearful episodes

Question 13

what are HIV/AIDS + mothers at risk for PP?

Answer 13

PPH, urinary and endometrial/pelvic infections, and poor wound healing

Question 14

average human breast milk calories per oz

Answer 14

20 - full term infant will need 6oz/kg/day to equal 120 cal/kg/day

Question 15

full term infant calories needs

Answer 15

100-120cal/kg/day

Question 16

premature infants calorie needs per day

Answer 16

110-160cal/kg/day

Question 17

infants recovering from surgery or have chronic illness calorie needs per day

Answer 17

less then or equal to 180 cal/kg/day

Question 18

how much protein does full term infants need

Answer 18

2.0-2.5 g/kg/day

Question 19

how much protein does perterm infants need per day? and how do they get that increased amount?

Answer 19

3.5-4.0 g/kg/day - special formulas are designed with increased protein needs; human breast milk automatically adjusts to preterm infants needs but there are fortifiers PRN

Question 20

primary source of carbs in breast milk

Answer 20

lactose

Question 21

how many g of carbs do full term infants need

Answer 21

60 g of carbs daily for the first 6 months of life