EXAM 3 Flashcards
Define Croup
inflammation of the larynx, trachea, and major bronchi. Occurs in children 6m-3yrs
Define Bronchiolitis
Inflammation and edema of the fine bronchioles and small bronchi due to a viral illness. Most common cause is RSV. Common in children younger than 2yrs, peaking at ages 3-6months.
Define iron-deficiency anemia
common anemia of infancy and childhood. The diet of the child should be altered to be high in iron and Vitamin C.
What is a big concern of vomiting and diarrhea?
fluid and electrolyte loss
isotonic dehydration
water and salt are lost in proportion to eachother
hypertonic dehydration
body looses more water then electrolytes
hypotonic dehydration
body looses more electrolytes than water
range for pH of blood
7.35-7.45
range for dissolved carbon dioxide in blood (PCO2)
35-45 mm Hg
range for bicarbonate (HCO3) in blood
22-26mEq/L
Describe postpartal blues
feeling overwhelming sadness after birth
define involution
the reproductive organs return to their non pregnant state. Danger of hemorrhage if this does not happen
2 steps of involution of the uterus
- area where placenta was implanted is sealed off to prevent bleeding
- uterus is reduced to approximate pre-gestational size
uterine atony
relaxed uterus postpartum… BAD!!! ( risk of hemorrhage)
What is the normal urine output for for postpartum patients?
3,000mL per day during 2-5th day postpartum
What is lactogenesis
human milk production
define a hematoma
collection of blood in the subcutaneous space from bleeding from the episiotomy incision that can become so extensive it causes intense pain and disrupts suture line
define postpartum hemorrhage
bloodloss of 1,000mL+ after vaginal birth or C-Section.
when is the greatest danger for PP hemmhorage?
first 24 hrs PP
what are the 4 main reasons for PP hemorrhage?
uterine atony, trauma, retained placental fragments, DIC
also known as “The 4 T’s of pp hemorrhage”
-Tone
-Trauma
-Tissue
-Thrombin
describe bimanual compression
Provider inserts 1 hand into vagina while pushing against fundus through the abdominal wall with other hand
define lacerations regarding PP
small tears of the birth canal are common. large tears however can be sources of infection or hemorrhage.
RF:
-difficult births
-primigravidas
-birth of large infant
-use of instruments
what commonly happens if patient is placed in a lithotomy position for birth instead of supine?
perineal lacerations. Why? Bc this position puts more pressure on on perineum
Perineal lacerations first degree
Vaginal mucous membrane and skin of the perineum to the fourchette
Perineal lacerations second degree
Vagina, perineal skin, fascia, levator ani muscle, and perineal body
Perineal lacerations third degree
Entire perineum, extending to reach the external sphincter of the rectum
Perineal lacerations fourth degree
Entire perineum, rectal sphincter, and some of the mucous membrane of the rectum
Should a pt with a 3rd or 4th degree laceration ever have an enema or rectal suppository?
NO. Why? The hard tips of equipment could open sutures near area
define a succenturiate placenta
placenta with an accessory lobe. This puts patient at high risk for PP hemorrhage
Uterine inversion
prolapse of the fundus of the uterus through the cervix causing the uterus to turn inside out. Occurs immediately after birth
DIC
deficiency in clotting ability due to vascular injury
subinvolution
the incomplete return of the uterus to its pre-pregnant size and shape. With sub-involution, at a 4- o4 6- week PP visit, the uterus is still enlarged and soft.
vulvar hematomas
a collection of blood below the epidermis of the vulva
what does a hematoma look like?
area of purplish discoloration with obvious swelling
puerperal infection
infection of the reproductive tract in the postpartum period
endometritis
infection of the endometrium (the lining of the uterus). Bacteria enters through vagina
Are WBC an accurate way to identify infection in a PP patient?
No. during PP period patients commonly have increased WBC of 20,000-30,000 due to stress of labor. Instead look for temp above 100.4F 2x within 24hrs
thrombophlebitis
inflammation with the formation of blood clots
phlebitis
inflammation of the lining of a blood vessel
S&S of pt with femoral thrombophlebitis
unilateral localized symptoms: redness, swelling, warmth, hard inflamed vessel in affected leg
Mastitis
infection of breast. May occur as early as 7th day PP- or as late as when baby is months old
Postpartum psychosis
response to crisis of childbearing. Majority of these pts have symptoms of mental illness before pregnancy.
