mat pt 3 workbook Flashcards
What factors predispose women to DVTs?
what about to thrombophelitis
- are inactive during labor and during early puerperium bc this inc risk of blood clot formation
- spent prolonged time in a birthing rool w legs in stirrus
- preexisting obesity and a preg weight gain greater than recommended weight gain- leading to inactivity and lack o exercise
- preexisting varicose veins
- develop a postpartal infection
- have a hx of previous thrombophlebitis
- older than 35 or have inc parity
- high incidence of thrombophlebitis in family
- smoke cigrettes bc nicotine causes vasoconstriction
• Inflm w formation of blood clots. When in postpartal period its gen extension of endometrial infect that occurs d/t
o Inc fibrinogen from preg
o Dilatation of lower extremitiy veins from P of fetal head
strategies to dec risk of DVTs
Ambulation, limiting time in stirrups or make sure they are well padded, support stockings for first 2 weeks after birth can help inc VR, instruct her to remove them twice daily to look at skin for mottling or inflm, ight be prescribed aspirin q4h
i imagine hydration
leg exercises
Why is it dangerous to massage the skin over a clotted area?
Because it can loosen the clot causing a pulmonary or cerebral embolism
what is mastitis
• Infect of breast that might occur between 7th day puerperium to when babe is several months old
how does the infection get in with mastitis
what are the different types and which is gen unilateral
gen gets in through cracked nipple
- Sometimes the infectious org comes from the infant-epidemic mastitis. & spreads to others
- Gen unilateral but epidemic mastitis is bilateral
how can you prevent mastitis
o Pos babe well on nipple so it has areola in mouth too
o Help babe release grasp on nipple before removing babe from breast
o Hygiene after touching peri pads or before touching breasts
o Expose nipples to air for part of day
o Vit E ointment
o Enc to begin breastfeeding (when babe sucks most forcefully) on unaffected nipple
what might need to be ruled out with mastitis
take sonogram to rule out breast abscess
What organisms are associated with nosocomial mastitis?
Infant usually acquired staphylococcus aureus, a methicillin resistant infection (MRSA) or candidiasis while in the hospital
Describe assessment findings associated with mastitis.
Usually unilateral, although epidemic mastitis bc originates from infant may be bilateral. Feels painful and appears swollen and red. Fever comes within first hours and breast milk becomes scant.
t or f since the woman has an infection it is a bad idea for her infant to drink her breastmilk and also causes an inc in amount of microorgs
• Keep breastfeeding as this empties them of milk to prevent growth of bact. Might prefer hand expressing
Describe medical and nursing interventions to treat mastitis.
Abx effective against penicillin resistant staph such as dicloxacillin or a cephalosporin. Usually outpatient treatment. Breastfeeding should be continued if possible bc keeping breast empty prevents growth of more bacteria. Sometimes hurts from sucking so wants to express milk until abx works (3 days or so). Cold or ice compresses and a supportive bra help with pain reflief. Warm, wet compresses dec inflm and edema
Why are women prone to UTIs after delivery
Because often woman are catheterized at the time of childbirth or during postpartal period and bacteria are introduced there.
o Pushing w labor also might let secretions enter the urethra
might also be d/t not getting peri care after delivery
maybe not using their squirt bottle every time after toileting
Describe the assessment findings and therapeutic management of a UTI after delivery.
Symptoms of burning on urination, possibly blood in the urine (hematuria) and a feeling of frequency or that she always has to void. Pain is so sharp she may resist voiding. May have low-gradefever and lower abdm pain. Obtain a urine specimen but use a sterile cotton swab to tuck into vagina to avoid lochial discharge. Therapeutic mgmt.: broad spectrum anx such as amoxicillin or ampicillin. Make sure it is safe for breast feeding. Encourage mom to drink lots of fluids to help flush the infection (a glass/hr) may need Tylenol for pain. Make sure she takes abx for full amount of time
If a child is born with an illness or physical challenge, when should the child be shown to the parents? Why at this time? What are some common responses to delivering a child with an illness or physical challenge? What are some helpful nursing interventions and responses for a family whose newborn has died?
Helpful nursing interventions: let mom see the baby and clean the bab and wrap it up in a blankey. Remain with them but give them time to handle and inspect the child as they wish. Parents may want photos or a lock of hair
Which babies are at risk for RDS?
what is the cause
Most often occuts in preterm infants!!!
infants of diabetic mothers,
infants born by c/s or those who have dec blood perfusion of the lungs for whatever reason (ie. meconium aspiration).
also low birth wt
gen d/t dec in surfactant
when does surfactant gen form
what is being deposited in RDS
Surfactant usually forms in the 34th week of gestation.
hyaline like deposition of hardened exudate in terminal bronchioles
when do these s/s of RDs often first appear?
often they have challenge initiating resps at birth BUT then after resuscitation they seem to have a period of hrs or a day when theyre free of symptoms d/t an initial release of surfactant..they might have subtle s/s at this time
S&S- difficult resps at birth. After resuscitation they have hours or days of no symptoms bc initial release of surfactant but will have subtle symp such as: low boy temp, nasal flaring, sternal and subcostal retractions, tachypnea (more than 60RR), cyanotic mucous membranes. Within hours, expiratoy grunting occurs caused by the closure of the glottis,aas it tries to inc the p in alveoli on expiration in order to keep them from collapsing. Infants become cyanotic and their po2 and o2 sat level fall on RA. Auscultation- fine rales and diminished breath sounds bc of poor air entry. As distress inc an infant may exhibit
- seesaw resps (inspiration- ant chest wall retracts and abdomen protrudes and expiration the sternum rises)
- Heart failure, evidenced by dec output and edema of the extremities
- Pale gray skin
- Periods of apnea
- Bradycardia
- Pneumo
what are mnfts of RDS for infant (initial and then later)
after a few hrs to days will have subtle symp such as: low body temp, nasal flaring, sternal and subcostal retractions, tachypnea (more than 60RR), cyanotic mucous membranes.
Within hours, expiratoy grunting occurs caused by the closure of the glottis,aas it tries to inc the p in alveoli on expiration in order to keep them from collapsing. Infants become cyanotic and their po2 and o2 sat level fall on RA. Auscultation- fine rales and diminished breath sounds bc of poor air entry. As distress inc an infant may exhibit
- seesaw resps (inspiration- ant chest wall retracts and abdomen protrudes and expiration the sternum rises)
- Heart failure, evidenced by dec output and edema of the extremities
- Pale gray skin
- Periods of apnea
- Bradycardia
- Pneumo
