HIGH RISK-POSTPARTUM

Question 2

Nursing actions to manage PPH

for “THROMBIN”

(3)

Answer 2

• Reverse
• Anticoagulation
• Replace Factors

Question 4

inflammation of the wall of the uterus

Answer 4

METRITIS

Question 5

Nursing actions to manage PPH

for “TISSUE”

(2)

Answer 5

• Manual Removal
• Curettage

Question 6

TX OF MASTITIS

Answer 6

• 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

Question 7

Three (3) High Risk problems

Answer 7

*Postpartum Hemorrhage (PPH) *Infections *Thromboembolic condition

Question 8

Most common cause of Post Partum Hemorrhage

Answer 8

UTERINE ATONY

Question 9

Nursing actions to manage PPH

for “TONE”

(3)

Answer 9

• massage
• compress
• drugs

Question 10

inflammation of the bladder

Answer 10

CYSTITIS

Question 11

Normal Hematocrit levels

Answer 11

35-45%

Question 12

Assessment findings of MASTITIS

Answer 12

• FEVER >100.4
• FATIGUE
• FLU LIKE SYMPTOMS
• PAIN OR SWELLING AT SITE
• RED, HOT, HARDENED AREA

Question 13

(3) Three ways to manage PPH

Answer 13

1. Uterotonic Drugs
2. Uterine Balloon Tamponade/packing
3. Hysterectomy

Question 15

blood that collects within the tissue of the vagina or perineal area

Answer 15

HEMATOMA

Question 16

CARE OF C-SECTION INCISION IN THE PPD PERIOD

Answer 16

KEEP DRY AND OPEN TO AIR

Question 17

Endometrium vs Myometrium

Answer 17

Endo = inner wall of uterus

MyoMetrium= middle wall of ueterus

Question 18

Estimated blood loss during emergency Hysterectomy

Answer 18

3,500 ml

Question 19

infection of the breast tissue that results in breast pain, swelling, warmth and redness

Answer 19

MASTITIS

Question 20

Perineal TX in PPD period

Answer 20

Frequent, warm baths

Good perineal hygiene

Question 21

This uterotonic drug will increase blood pressure and nurse must not administer to patient that has High blood pressure

Answer 21

METHYLERGONOVINE (Methergine)

Question 22

Uterotonic Drugs (5)

Answer 22

-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

Question 23

PREVENTION OF THROMBOSIS

Answer 23

• SCD’S
• Encourage early ambulation
• Assess for s/s of thrombus formation
• antiembolism stockings for high risk mothers

Question 24

Primary vs Secondary PPH

Answer 24

Primary occurs within 24 hrs of delivery

Secondary occurs after 24 hour and up until 6 weeks PPD

Question 25

Normal HGB level

Answer 25

10-15

Question 26

Uterotonic Drugs

(5)

Answer 26

• 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)

Question 27

RISK FACTORS FOR PPH

Answer 27

1. Multifetal gestation/over-distended uterus
2. full bladder
3. muscle fatigue
4. medications

Question 28

These medications help the uterus to “contract” and “clamp down”

Answer 28

Uterotonic Drugs

Question 29

Nursing actions to manage PPH

for “TRAUMA”

(3)

Answer 29

• Correct Inversion
• Repair Laceration
• Identify Rupture

Question 30

Nursing actions to manage PPH

Answer 30

Tone- Massage fundus uterotonic drugs Tissue- Manual removal Currettage Trauma- Correct inversion Repair laceration Identify the rupture Thrombin- Anticoagulation Replace the missing blood factors

Question 31

Four (4) causes of PPH

Answer 31

T—Tone T—Tissue T—Trauma T- Thrombin