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Nclex Review Notes > Maternal > Flashcards

Maternal Flashcards

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1
Q

Postpartum endometritis

Risk factors

A 
Cesarean birth
Intraamniotic infection
Group B Streptococcus colonization
Prolonged rupture of membranes
Operative vaginal delivery
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2
Q

Postpartum endometritis

Clinical
features

A

Fever >24 hr postpartum
Uterine fundal tenderness
Purulent lochia

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3
Q

Postpartum endometritis

Etiology

A

Polymicrobial infection

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4
Q

Postpartum endometritis

Priority Treatment

A

Clindamycin & gentamicin

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5
Q

Endometritis is characterized by

A

uterine tenderness and subinvolution, foul-smelling or purulent lochia
fever
tachycardia
chills.

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6
Q

Postpartum endometritis

comfort measures

A

repositioning, oral hydration, pain medication) can be

provided after antibiotic therapy is initiated.

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7
Q

Postpartum endometritis is

A

an infection of the endometrium (uterine lining) and is characterized

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8
Q

proper breastfeeding and latch technique include:

A

Breastfeed every 2-3 hours on average (8-12 times/day)
• Breastfeed “on demand” whenever the newborn exhibits hunger cues (eg, sucking, rooting reflex)
• Position the newborn “tummy to tummy” with mouth in front of nipple and head in alignment with body
• Ensure a proper latch (ie, grasps both nipple and part of areola)
• Feed for at least 15-20 minutes per breast or until the newborn appears satisfied
• Insert a clean finger beside the newborn’s gums to break suction before unlatching (Option 3)
• Alternate which breast is offered first at each feeding

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9
Q

Lactational mastitis

A

(infection and inflammation of breast tissue) result from inadequate milk duct drainage or poor breastfeeding technique.

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10
Q

Lactational mastitis

Manifestations

A

fever, muscle aches, and breast pain and

inflammation (eg, warmth, redness, edema)

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11
Q

lactational mastitis

Treatment

A

antibiotic therapy, continued breastfeeding, breastfeeding support (eg, proper latch technique), warm compresses, massage, adequate
nutrition and hydration, and appropriate analgesics (eg, ibuprofen, acetaminophen).

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12
Q

Postpartum vaginal bleeding

A

saturates a perineal pad in <1 hour is considered excessive.

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13
Q

Bladder distension

A

fundus is also elevated above

the umbilicus and deviated to the right

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14
Q

Bladder distention

Treatment

A

assisted to void then perform fundal massage

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15
Q

Oxytocin infusion should

be initiated

A

is a uterotonic

if initial attempts to control postpartum bleeding (relief of bladder distention and
fundal massage) have failed.

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16
Q

Pregnancy is a hypercoagulable state

A

increases risk for deep venous thrombosis and pulmonary embolism (PE).

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17
Q 
pulmonary embolism (PE)
Sign
A

anxiety/restlessness, pleuritic chest pain/tightness, shortness of breath, tachycardia, hypoxemia, and hemoptysis

18
Q

deep venous thrombosis (DVT)

Who at risk

A

cesarean section
obesity
smoking
genetic predisposition.

19
Q

DVT may progress to

A

pulmonary embolism (PE)

20
Q

deep venous thrombosis (DVT) /PE

nurse’s priority is rapidly step

A
  1. assessing respiratory status
  2. administering supplemental oxygen
  3. before administering requested pain medication
  4. notifying the health care provider (HCP)
21
Q

Postpartum depression (PPD)

Symptoms

A 
crying
irritability
difficulty sleeping (or sleeping more than usual)
anxiety
feelings of guilt.
22
Q

Postpartum depression (PPD)

Symptoms typically arise

A

4 weeks of delivery

feelings of inadequacy or guilt as they experience challenges in caring for their infant (eg, breastfeeding difficulties, infant colic).

23
Q 
Postpartum depression (PPD)
Questions to ask
A

specific questions about depression hopelessness to assess for PPD
thoughts of self-harm or harm to the
newborn.

24
Q

Postpartum hemorrhage (PPH)

A

uterine atony may require uterotonic drug administration to reverse excessive bleeding (may cause overdistension of the uterus)

25
Q

Methylergonovine causes

A

vasoconstriction and is contraindicated for clients with hypertension due to the risk of seizure or stroke

(eg, preeclampsia, preexisting hypertension)

26
Q

Postpartum hemorrhage (PPH)

interventions

A

If excessive bleeding persists after initial interventions
(eg, firm fundal massage, oxytocin bolus)

second-line uterotonic drugs (eg, carboprost, methylergonovine, misoprostol) may be
given.

27
Q

Misoprostol

A

> combats uterine atony by contracting the uterine muscle

> given per rectum for PPH to increase absorption

28
Q

Eclampsia
(severe preeclampsia + seizures)

Clinical features

A 
Hypertension
Proteinuria
Severe headaches
Visual disturbances
Right upper quadrant or epigastric pain
3-4 minutes of tonic-clonic seizure, usually self-limited
29
Q

postpartum preeclampsia

with signs and symptoms of preeclampsia

A 
edema
persistent headache
vision changes
elevated blood pressure
should be evaluated and treated
immediately.
30
Q

Postpartum blues

Symptoms

A

Emotional lability,
mild sadness,
irritability
insomnia

31
Q

Postpartum blues

Onset and duration

A

40%-80%

2-3 days postpartum; resolves within 2weeks

32
Q

Postpartum blues

(“baby blues”)

Treatment

A

Supportive care,
client & family education,
ongoing assessment for
worsening symptoms

33
Q

Postpartum depression

A

8%-15%

4-6 weeks postpartum; up to 12 months postpartum; gradual improvement
over first 6 months postpartum

34
Q

Postpartum depression

Symptoms

A

Extreme sadness,
irritability, emotional
outbursts, severe mood
swings; can present with postpartum anxiety

35
Q

Postpartum depression

Treatment

A

Supportive care plus

pharmacologic intervention &/or
psychotherapy

36
Q

Postpartum psychosis

A

0.1%-0.2%

2 weeks postpartum;
severity & duration can vary

37
Q

Postpartum psychosis

Symptoms

A

Hallucinations, delusions,
impulsivity, hyperactivity,
confusion, delirium; often
associated with bipolar disorder

38
Q

Postpartum psychosis

A

Emergency psychiatric
hospitalization,
pharmacologic
intervention

39
Q

Perinatal mood disorders may occur

A

sudden drop in estrogen and progesterone levels after birth

40
Q

endometrial infection

A

elevated temperature, chills, malaise, excessive pain, and foul-smelling lochia
foul odor of lochia

41
Q

During the first 24 hours postpartum

A

temperature and WBC count

are normally elevated

Nclex Review Notes (3 decks)

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