Maternity 3 Flashcards
What factors predispose women to DVTs?
What are the S and S, Dx, Tx
stasis of blood in lower extremities from uterine pressure and hypercoagulability (d/t elevated estrogen). Damage can occur to walls of veins from pressure of baby’s head. Creates virchow’s triad: stasis, vessel damage and hypercoagulability). Key risk is pull embolism
S&S: pain, redness in calf (usually)
Diagnosis: Doppler ultrasonography and Hx.
Tx: bed rest, IV heparin 24-48h. Followed by subq heparin for 12-24 hr for duration of pregnancy (inject in arms/thighs instead of belly).
what is Thrombophlebitis and what are risks associated with pregnancy
inflammation with the formation of blood clots
postpartal risks: cigarette smoking, obesity from inc pregnancy wt gain leading to inactivity, dilatation of lower extremity veins, inactivity in delivery room, inc fibrinogen level
What are some strategies to avoid DVT post part
Prevention: don’t sit with crossed legs at knees, high knee stockings, avoid standing in 1 position for long periods.
Support stockings help for first 2wks post birth, but put on before getting out of bed.
Start walking early and get into an exercise program to lose pregnancy weight
Measures to avoid mastitis
Organism causing mastitis usually enter through crack & fissured nipples… so it is important to prevent nipples from cracking:
baby is positioned correctly & grasps nipple properly (inclu nipple & areola)
helping a baby release a grasp on nipple before removing from breast
washing hands btwn handling perineal pads & touching breasts (duh!!!)
exposing nipples to air for at least part of every day
possibly using vit E ointment daily to soften nipples
encouraging women to begin breastfeeding (when infants sucks more forcefully) on unaffected nipple
Whats responsible for nosocomial mastitis
usually from naso-oral cavity from infant
Staphylococcus aureus, methicillin-resistant Staphylocuccus aureus (MRSA), candidiasis
S and S of Mastitis
(usually) unilateral may be bilateral if epidemic mastitis breast painful, swollen, reddened fever scant breast milk
Tx of Mastitis
abx effective against penicillin-resistant staphylococci
dicloxacillin or cephalosporin
breastfeeding continued if possible → breast emptied of milk helps prevent bact growth
cold or ice compresses & supportive bra → pain relief
warm, wet compresses → reduce inflm & edema
drink at least 8 glasses of fluid (imp for milk formation & prev dehydration from fever)
if left untreated: could lead to localized abscess
if abscess forms, breastfeeding is discontinued; but encourage pumping
Why are women prone to UTIs after delivery?
may have been catheterized
pushing with labour may have allowed some secretions to enter the urinary urethra
