Exam #4 Flashcards
Hemorrhage
Blood loss >500mL after vaginal birth or 1000mL after cesarean birth.
Early Postpartum Hemorrhage
Occurs within 24 hours of birth
Late Postpartum Hemorrhage
Occurs after 24 hours and within 6 wks after birth. Usually results from retention of placental fragments or subinvolution of the uterus.
Hypovolemic Shock
The major risk with hemorrhage, interrupts blood flow to body cells.
S/S of Hypovolemic Shock
Tachycardia, Narrow Pulse Pressure and BP continues falling and eventually cannot be detected. Pale, cold, clammy skin and mucous membranes, anxiety, confusion, restlessness, lethargy. Decreased urine output.
Managing Hypovolemic Shock resulting from Hemorrhage
Stop the blood loss. Give IV fluids. Give blood transfusions. Give oxygen. Place foley cath.
Methylergonovine
Increases BP and should not be given to a woman with hypertension
Lacerations
Bleeding can be profuse, and is usually brighter red than lochia and flows in a continuous trickle. Fundus is firm.
Hematomas of the Reproductive Tract
Usually on the vulva or inside the vagina. Seen as a bulging bluish/purplish mass. Usually severe, unrelenting pain that analgesics do not relieve. Pressure in the vulva, pelvis, or rectum. May be unable to urinate. PULSE AND RR RISE & BP FALLS.
Why does a poorly contracted uterus lead to hemorrhage?
Because there is no pressure where the placenta was
Bleeding associated with Uterine Atony
Heavy with clots
PP Infection
Characterized by T 100.4 after the first 24hrs after birth, occurring on at least 2 days during the first 10 days after birth.
Puerperal Sepsis
Infection or septicemia after childbirth
Mastitis
Infection of the breast, usually occuring 2-3 wks after giving birth. Breast engorgement and inadequate emptying of milk are associated with mastitis.
S/S of Mastitis
redness or heat in the breast, tenderness, edema and a heaviness in the breast, purulent drainage (may or may not be present). The woman usually has fever, chills, and other systemic S/S
Tx of Subinvolution
Methylergonovine to maintain firmness, antibiotics for infection, dilation of the cervix and currettage to remove fragments of the placenta from the uterine wall
Cardiovascular System
Develops between the 3rd and 8th week of gestation. First system to function in intrauterine life. When development is incomplete, heart defects occur.
S/S common to congenital cardiac problems
Failure to thrive/poor weight gain, cyanosis or pallor, visually observed pulsations in neck veins, tachypnea/dyspnea, irregular pulse rate, clubbing of fingers, fatigue during feeding/activity, excessive perspiration especially over the forehead
Acquired Heart Disease
Occurs AFTER birth
Defects that Increase Pulmonary Blood Flow
Atrial Septal Defect, Ventricular Septal Defect, Patent Ductus Arteriosus