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OB > high risk postpartum > Flashcards

high risk postpartum Flashcards

1
Q

s/sx of hemorrhage

A
  • decreased BP
  • increased pulse
  • restlessness, decrease LOC
  • decreased UOP
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2
Q

early (primary) postpartum hemorrhage

A

occurs within 24 hrs following delivery

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3
Q

what is primary PP hemorrhage r/t?

A
  • poor uterine tone (atony)
  • lacerations
  • episiotomy
  • retained placental fragments
  • hematoma
  • uterine rupture
  • problems w/ placental implantation
  • coag disorders
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4
Q

uterine atony can be r/t?

A
  • over distention (polyhydramnios, LGA, multiples)
  • prolonged labor (dystocia)
  • mag
  • > 30 min to deliver placenta
  • preeclampsia
  • forceps or vacuum use
  • retained placental fragments
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5
Q

management of atony r/t hemorrhage

A
  • massage
  • blood products
  • pitocin, methergine
  • D&C
  • hysterectomy if all fails
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6
Q

indications of risk for lacerations

A
  • nulliparity
  • epidural
  • precipitous delivery
  • macrosomia
  • operative delivery
  • pitocin
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7
Q

risks for a hematoma

A
  • preeclampsia
  • first full term delivery
  • precipitous labor
  • operative delivery
  • vulvar varicosities
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8
Q

management of hematomas

A
  • < 3 cm = ice packs and analgesia
  • > 3 cm = may consider I&D
  • antibiotics
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9
Q

risks for uterine rupture

A
  • prior c/s (scar makes muscle thinner)
  • fetal malpresentation
  • grandmultiparity
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10
Q

what would a patient report if she’s experiencing a uterine rupture?

A

intense abdominal pain, minimal/diffused bleeding

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11
Q

management of a uterine rupture

A

surgery, fluids, blood replacement

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12
Q

late (secondary) postpartum hemorrhage

A

occurs between 24 hours and 6 weeks PP
- less common

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13
Q

what is secondary postpartum hemorrhage r/t?

A
  • retained placenta
  • subinvolution
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14
Q

what would the PP OB assessment for a patient with subinvolution likely reveal?

A
  • fundal height would be greater than expected
  • rubra lochia may persist for longer than 2 weeks
  • brown lochia or heavy bleeding
  • backache
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15
Q

management of secondary postpartum hemorrhage

A
  • methergine
  • antibiotics
  • possible D&C
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16
Q

puerperal infection

A

infection of the reproductive tract occurring w/in 6 weeks following delivery

17
Q

puerperal morbidity

A

38C or > for any 2 of the first 10 days PP, exclusive of the first 24 hrs

18
Q

endometritis

A

inflammation of the endometrial lining

19
Q

how would a patient present with endometritis?

A
  • bloody vaginal discharge
  • foul smelling vaginal discharge
  • uterine tenderness
  • fever
  • tachy
20
Q

what are the causative agents of endometritis?

A

GBS, chlamydia, e.coli

21
Q

how do we treat endometritis?

A

broad spectrum antibiotics

22
Q

peritonitis

A

reproductive tract infection can spread to the entire peritoneal cavity; can be serious and life threatening

23
Q

peritonitis can get into…

A

blood, lymph, and spread

24
Q

cystitis

A

lower UTI (bladder)
- urgency, frequency, burning

25
Q

pylenephritis

A

upper UTI (kidney)
- flank pain

26
Q

how do we treat UTIs?

A
  • urine C&S
  • antibiotics
  • pyridium –> analgesic
27
Q

venous thrombosis

A

formation of a blood clot

28
Q

thrombophlebitis

A

inflammation, leading to formation of clot

29
Q

perinatal loss

A

death of fetus or infant from conception through 28 days following birth

30
Q

stillbirth/fetal demise

A
  • occurs after 20 weeks
  • not breathing or heart beating
30
Q

intrauterine fetal death (IUFD)

A

occurs while in utero

31
Q

neonatal death

A
  • when baby’s born, well or not well but dies prior to 28 days of life
32
Q

bereavement

A

to suffer loss

33
Q

grief

A

reaction to loss

34
Q

mourning

A

process of incorporating the loss

35
Q

dual process model

A
  • need to address loss
  • regain balance

OB (8 decks)

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