High Risk Postpartal Client Flashcards
Blood loss from the uterus greater than 500 mL within 24 hr period
Postpartal Hemorrhage
5 main causes for PH
Uterine atony
Laceration(vaginal and perineal)
Retained placental fragments
Uterine inversion
DIC
Relaxation of the uterus
Uterine Atony
If a uterus cannot remain contracted, IV infusion of …
Oxytocin (Pitocin)
What are the 3 other meds if uterus cannot remain contracted with oxytocin
Carboprost tromethamine (Hemabate)
Methylergonovine maleate (Methergine)
Rectl Misoprostol
May be repeated every 15 to 90 minutes up to 8 doses
Carbropost tromethamine (Hemabate)
May be repeated every 2 to 4 hours up to 5 doses
Methylergonovine maleate (Methergine)
A prostaglandin E1 analogue, may be administered rectally/ a last drug of choice
Rectal misoprostol
The usual dosage of oxytocin per 1000mL of a ringers lactate solution
10 to 40 U
Causes increased blood pressure
Methylergonovine
Management of Uterine Atony
Bimanual massage
Porstaglandin administration
Blood replacement
Hysterectomy
A placenta does not deliver in its entirety
Retained placental fragments
Retained placental fragments can be detected by?
Ultrasound
Having one or more accessory lobes of the placenta
Sucenturiateplacenta
Performed to remove the placenta fragment
Dilatation and Curettage
To destroy the retained placental tissue
Methotrexate
Incomplete return of the uterus to its prepregnant size and shape
Subinvolution
Infection of the reproductive tract
Puerperal infection
Conditions that increase a woman’s risk for Postpartal Infection (5)
Rupture of the membrane
Retained placental fragments
Postpartal hemorrhage
Dysfunctional labor
Uterus is explored after birth
Infections also are becoming more common
Escherichia coli. Staphylococcal
Infections are the cause of toxic shock syndrome
Staphylococcal
Infection of the endometrium, the lining of the uterus
Endometritis
WBC counts is…
20,000 to 30,000
Antibiotic in endometritis
Clindamycin