MCN Midterm Reviewer 2 Flashcards
- reproductive tract infection developing after delivery
* may spread to the peritoneum (peritonitis) or the circulation system (septicemia)
Post Partum Infection / Puerperal Infection
7 Risk Factors of Post Partum Infection / Puerperal
- Post Partual Hemorrhage
- Local Vaginal Infection
- Prolonged Rapture of membrane
- Retained Placental Fragment
- Preexisting anemia
- Frequent unsterile vaginal exam
- Prolonged and difficult labor
blood lost and eventually the immune system will be waken
Post Partual Hemorrhage
occurs after 24 hours / more than 24 hours before birth
Prolonged Rapture of membrane
anemia may cause the immune system lowered
Preexisting anemia
7 Manifestation or S/S of Puerperal infection / Post Partum Infection
- 4 cardinal signs of inflammation are included
1. Rubor- redness
2. Calor- Heat
3. Dolor-Pain
4. Tumor- swelling
5 burning in urination
- presence of fever
* temp of 38’C for 2 Days - wound discharges
4 Prevention of Puerperal Infection / Post Partum Infection
- Use Sterile Gloves and Instruments during labor, delivery and postpartum period
- Proper Perineal Care by the client
- Hand Washing
- Administer antibiotic as prescribed - broad
why no antibiotic during breast feeding
antibiotic passes into the breast milk and causes the development of fungal infection to the baby
*whitish build up on the mouth of the baby
5 Possible infections for Postpartum
- Endometritis
- Wound infection of the perineum
- UTI
- Perineal Hematoma
- Thromboembolic Disorder
Inflammation in the lining of the uterus
Endometritis
8 Manifestation of Endometritis
- fever - occurs day 2 or 3
- increase in WBC
- presence of chill
- lost of appetite
- general body “malaise”- painful muscle, flu like symptoms
- strong after pain
- uterus is not well contracted and painful to touch
- dark brown lochia and foul smelling odor
7 Management of Endometritis
- administer antibiotic
- administer oxytocic agent
- increase oral fluid intake
- administer analgesics as prescribe for strong after pain
- sitting in low fowlers position, or encourage the women to ambulate or walk
* for lochia drainage by gravity - wearing gloves when changing perineal pads
- early recognition of signs of endometritis
* presence of fever, swelling, pain, redness, inflammation
suture line from the laceration repair serves the portal entry for bacterial invasion
*when pain, heat, fever, open suture with drainage, what will you do
notify the physician at once
5 Manifestations S/S of UTI
- painful or burning sensation upon urination *dysuria
- presence of blood in the urine *hematuria
- feeling of frequent urination *polyuria
- presence of low grade fever
- presence of lower abdominal pain
Diagnostic test to confirm UTI
Urinalysis
3 Management
- administer of antibiotic
* 5-7 days * discontinue breast feeding - encourage the women to drink large amount of fluid
- administer analgesic if there’s a pain
- Collection of blood in the subcutaneous tissue in the perineum
- Cause by injury to the blood vessels in the perineum during birth
- It may occur at the side of the episiotomy or laceration
Perineal Hematoma
4 Manifestations or S/S or assessment finding of Perineal Hematoma
- severe pain the perineal are
- feeling of pressure between legs
- presence of hematoma
* purplish discoloration with 2cm to 8cm diameter swelling - presence of tenderness upon palpation
5 Nursing care management of Perineal Hematoma
- report hematoma immediately to the physician
- assess swelling
- administer analgesic
- apply cold compress to the hematoma with towel
- if hematoma is large or continuous to increase
* advice the women to go back to the delivery room
Bold clots are form when there is stasis when there is a repair of damage tissue
Thromboembolic Disorder
Thrombi / Thrombus
Clots and stationary
Embolus / Embolic
Dislodge and go with the circulation
8 Risk Factors of Thromboembolic Disorder
- History of varicosities in the legs
- Obesity
- Over 30 yrs. old
- Multi Parati
- Use of estrogen supplement
- History of thromboembolic disease
- Smoking
- Trauma to extremities with DM
3 Causes of Thromboembolic Disorder:
- Injury to blood vessels * occurs after and during delivery
- Increase clotting
* occurs after and during delivery - Blood Stasis
Diagnostic test for Thrombophlebitis
Ultra sound
Xray
Types of Thromboembolic disorder according to location
- Superficial thrombophlebitis
2. Deep Vein Thrombosis / Thrombophlebitis
Refers to the inflammation affecting the superficial veins of the extremities
Superficial Thrombophlebitis
Symptoms Superficial Thrombophlebitis
Tenderness and pain at the effected vein followed by edema
Inflammation of the vein within a muscle tissue
Deep Vein Thrombosis / Thrombophlebitis
Main danger is the presence of emboli which may reach the lungs and obstruct pulmonary blood flow
Pulmonary Embolism
Types of Thromboembolic Disorder according to types of veins affected
- Femoral Thrombophlebitis
- Superficial Venous Thrombosis / Theombophlebitis
- Deep Vein Thrombosis / Thrombophlebitis
Infections of the veins of the legs particularly the femoral and popliteal veins
Femoral Thrombophlebitis
Manifestation of Femoral Thrombophlebitis
- Homan’s Sign
- Phlegmasia Alba Dolens or Milk Leg
- Swelling, Pain and Stiffness of the affected leg
- Fever
- lower abdominal pain and flank pain
* additional manifestation If the uterine pelvic ovarian veins are affected
Calf pain upon Dorsi flexion of the foot
Homan’s Sign
The leg is shiny white appearance because of extreme swelling and lack of circulation
Phlegmasia Alba Dolens or Milk Leg
Management of Femoral Theombophlebitis
- Encourage early ambulation after delivery
- The use of support stocking in women with varicosities * promote circulation and prevent blood stasis * put the stocking before rising from bed in the morning
- Provide adequate hydration
- Avoid trauma to extremities particularly during delivery * to avoid pressures to the vein * to promote venous return
- Avoid activities that contribute venous stasis
Only involves the small veins
Superficial Venous Thrombosis / Theombophlebitis
Manifestation of Superficial Venous Thrombosis
- Pain in the area
2. Presence of clot
Management Superficial Venous Thrombosis / Theombophlebitis
- Administer analgesic
- Application of hot compress
- NSAID - Non Steroidal
- Instruct the client not to massage the area
Manifestation of DVT
- Fever, Swelling presents of veins
Management *it requires intensive management to prevent
- Administration of anti coagulant - warfarin ( Coumadin ) *Antidote- (Vit. K), Heparin- *Antidote-(Protamine Sulfate)
- Requires hospitalization during the acute phase
- Bed rest until sign and symptoms disappear * encourage gradual imbulation
- Encourage to elevate the legs
- Administration of analgesic, antibiotic and antipyretic
* Major Danger * presents of emboli and may lead to pulmonary embolism
Thrombosis
Clot
Thrombophlebitis
Clot and Inflammation
