Maternity Nursing Chap 23 Flashcards
__________ is the loss of more than 500 mL of blood after vaginal birth and more than 1000 mL after cesarean birth. Additional criteria that might be used are decrease in hematocrit of 10% or more between admission for labor and postpartum or a need for erythrocyte infusion. The leading cause is uterine atony.
-postpartum hemorrhage (PPH)
___________ or _________ occurs more than 24 hours but less than 6 weeks postpartum.
- late PPH
- secondary PPH
__________, __________, or ________ occurs within 24 hours of birth.
- early PPH
- primary PPH
- acute PPH
Marked hypotonia of the uterus is called __________.
-uterine atony
A pelvic __________ is the collection of blood in vulvar, vaginal, or retroperitoneal tissue as a result of blood vessel damage. Vulvar hematomas are the most common. Vaginal hematomas are usually associated with a forceps assisted birth, performance of an episiotomy, or status as a primigravida. The woman often complains of persistent perineal or rectal pain or a feeling of pressure in the vagina.
-hematoma
_______________ refers to the turning of the uterus inside out. The primary presenting signs of its presence are hemorrhage, shock, and pain. Contributing factors include uterine malformations, fundal implantation of the placenta, manual extraction of the placenta, short umbilical cord, uterine atony, leiomyomas, and abnormally adherent placental tissue.
-inversion of the uterus
__________ is the delayed return of the enlarged puerperal corpus to normal size and function.
-subinvolution
___________ is an emergency situation in which profuse blood loss (hemorrhage) can result in severely compromised perfusion of body organs. Death can occur.
-hemorrhagic (hypovolemic) shock
A ___________ is suspected when bleeding is continuous and there is no identifiable cause. Idiopathy thrombocytopenia purpura is an autoimmune disorder in which antiplatelet antibodies decrease the life span of the platelets. Von Willebrand disease is a type of hemophilia and is probably the most common of all types of hereditary bleeding disorders.
- coagulopathy
- idiopathy thrombocytopenia purpura
- von Willebrand disease
A ___________ is the formation of a blood clot or clots inside a blood vessel and is caused by inflammation or partial obstruction of the vessel. Superficial venous thrombosis involves the superficial saphenous venous system. In deep vein thrombosis (DVT) involvement varies but can extend from the foot to the iliofemoral region. Pulmonary embolism occurs when part of a blood clot dislodges and is carried to the pulmonary artery, where it occludes the vessel and obstructs blood flow to the lungs.
-thrombosis
____________ or ___________ refers to any clinical infection of the genital canal that occurs within 28 days after miscarriage, induced abortion, or childbirth. The first symptoms is usually a fever of 38* C or higher on 2 successive days of the first 10 postpartum days (not counting the first 24 hours).
- postpartum
- puerperal infection
__________ is the most common cause of postpartum infection. It usually begins at the placental site.
- endometritis
- presents with fever, increased pulse, chills, anorexia, nausea, fatigue and lethargy, pelvic pain, uterine tenderness, or foul smelling profuse lochia
- lab findings leukocytosis and a markedly increased RBC sedimentation
- anemia may also be present
________ is an infection of the breast affecting approximately 1% to 10% of women soon after childbirth, most of whom are first time mothers who are breastfeeding. This infection is almost always unilateral and develops well after the flow of milk has been established.
-mastitis
_______ is a variation of the normal placement of the uterus, the most common type of which is posterior displacement or retroversion.
-uterine displacement
Downward displacement of the uterus is known as _________. This dropping down of the uterus can range from mild to complete.
-uterine prolapse
__________ is a protrusion of the bladder downward into the vagina. It develops when supporting structures in the vesicovaginal septum are injured.
-cystocele
___________ is the herination of the anterior rectal wall through the relaxed or ruptured vaginal fascia and rectovaginal septum.
-rectocele
Uncontrollable leakage of urine is known as __________. When it occurs as a result of sudden increases in intraabdominal pressure associated with sneezing, coughing, or laughing, it is called stress incontinence.
-urinary incontinence
A __________ is an abnormal communication (opening) between one hollow viscus (organ) and another or from one hollow viscus to the outside. A communication between the bladder and the genital tract is called a vesicovaginal fistula, and one between the rectum and the vaginal tract is call a rectovaginal fistula.
-fistula
A _________ is a device that can be placed in the vagina to support the uterus and hold it in the correct position.
-pessary
Surgical repair of a cystocele is called _____________, whereas posterior colporrhaphy is the surgical repair of a rectocele.
- anterior colporrhaphy
- posterior colporrhaphy
True or False: Early PPH usually occurs as a result of uterine atony.
True
- leading cause of PPH
- associated with high parity, hydramnios, a macrosomic fetus, and multifetal gestation
- uterus overstretched and contracts poorly after birth
- other causes traumatic birth, use of halogenated anesthesia or magnesium sulfate,rapid or prolonged labor, chorioamnionitis, and use of oxytocin
True or False: When a woman hemorrhages, changes in her baseline vital sign values might not be reliable indicators of shock in the immediate postpartum period because of the physiologic adaptations that occurred during pregnancy.
True
True or False: Dark red blood is a characteristic finding when deep lacerations of the cervix bleed.
False: shallow and bleeding is minimal.
True or False: Methergine is the oxytocic of choice for PPH if the woman is experiencing preeclampsia.
False: continuous IV infusion of 10 to 40 units of oxytocin added to 1000 mL of LR and Normal saline. Methergine is contraindicated if preeclampsia or hypertension is present.
True or False: Prostaglandin F2 (carboprost tromethamine, Hemabate) should be used with caution or not at all if the postpartum woman has asthma.
True (also cardiac problems)
True or False: Placental retention because of poor separation is very common in postdate pregnancies.
False: common in very preterm births (20-24 weeks of gestation)
True or False: Placenta percreta refers to a placenta that perforates the uterus.
True
