HIGH RISK-POSTPARTUM Flashcards
Nursing actions to manage PPH
for “THROMBIN”
(3)
- Reverse
- Anticoagulation
- Replace Factors
inflammation of the wall of the uterus
METRITIS
Nursing actions to manage PPH
for “TISSUE”
(2)
- Manual Removal
- Curettage
TX OF MASTITIS
- Continue feeding on both sides
- 8 or more in 24
- begin breastfeeding on the unaffected side until let-down occurs and then switch to the affected side.
- adequate rest and fluids
- analgesics prn
- antiobiotics as ordered
Three (3) High Risk problems
*Postpartum Hemorrhage (PPH) *Infections *Thromboembolic condition
Most common cause of Post Partum Hemorrhage
UTERINE ATONY
Nursing actions to manage PPH
for “TONE”
(3)
- massage
- compress
- drugs
inflammation of the bladder
CYSTITIS
Normal Hematocrit levels
35-45%
Assessment findings of MASTITIS
- FEVER >100.4
- FATIGUE
- FLU LIKE SYMPTOMS
- PAIN OR SWELLING AT SITE
- RED, HOT, HARDENED AREA
(3) Three ways to manage PPH
- Uterotonic Drugs
- Uterine Balloon Tamponade/packing
- Hysterectomy
blood that collects within the tissue of the vagina or perineal area
HEMATOMA
CARE OF C-SECTION INCISION IN THE PPD PERIOD
KEEP DRY AND OPEN TO AIR
Endometrium vs Myometrium
Endo = inner wall of uterus
MyoMetrium= middle wall of ueterus
Estimated blood loss during emergency Hysterectomy
3,500 ml
infection of the breast tissue that results in breast pain, swelling, warmth and redness
MASTITIS
Perineal TX in PPD period
Frequent, warm baths
Good perineal hygiene
This uterotonic drug will increase blood pressure and nurse must not administer to patient that has High blood pressure
METHYLERGONOVINE (Methergine)
Uterotonic Drugs (5)
-Oxytocin (Pitocin)- IV or IM -Methylergonovine (Methergine)- IM injections ***SKIP IF PT HAS ELEVATED BP _Misoprostol (Cytotec)- Rectally _Carboprost (Hemabate)- IM -Lysteda (Teranexamic acid) - IV
PREVENTION OF THROMBOSIS
- SCD’S
- Encourage early ambulation
- Assess for s/s of thrombus formation
- antiembolism stockings for high risk mothers
Primary vs Secondary PPH
Primary occurs within 24 hrs of delivery
Secondary occurs after 24 hour and up until 6 weeks PPD
Normal HGB level
10-15
Uterotonic Drugs
(5)
-
OXYTOCIN (<u>IV or IM</u>)
- First medication usually given
-
METHYLERGONOVINE (methergine)(IM only)
- increases BP-skip in pt has high bp
- MISOPROSTOL (Cytotec) (rectally only)
-
CARBOPROST (Hemabate) <em>(IM)</em>
- causes extreme GI upset
- LYSTEDA (Transexamic acid) TXA (IV)
RISK FACTORS FOR PPH
- Multifetal gestation/over-distended uterus
- full bladder
- muscle fatigue
- medications
These medications help the uterus to “contract” and “clamp down”
Uterotonic Drugs
Nursing actions to manage PPH
for “TRAUMA”
(3)
- Correct Inversion
- Repair Laceration
- Identify Rupture
Nursing actions to manage PPH
Tone- Massage fundus uterotonic drugs Tissue- Manual removal Currettage Trauma- Correct inversion Repair laceration Identify the rupture Thrombin- Anticoagulation Replace the missing blood factors
Four (4) causes of PPH
T—Tone T—Tissue T—Trauma T- Thrombin
