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Maternity > Module 6 > Flashcards

Module 6 Flashcards

1
Q

First Degree Perineal Laceration

A
  • Superficial vaginal mucosa or perineal skin
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2
Q

Second Degree Perineal Laceration

A
  • Involves vaginal mucosa, perineal skin and deeper tissues of the perineum
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3
Q

Third Degree Perineal Laceration

A
  • Same as second degree but involves the sphincter
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4
Q

Fourth Degree Perineal Laceration

A
  • Extends through the anal sphincter into the rectal mucosa.
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5
Q

Treatment for Perineal Lacerations

A

-Usually suturing

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6
Q

Episiotomy

A

-Controlled surgical enlargement of the vaginal opening during birth

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7
Q

Indications for an Episiotomy

A
  • Control over how much and where the vaginal opening is enlarged
  • Clean edged opening
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8
Q

What is an alternative to an episiotomy ?

A

Perineal massage and stretching before labor

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9
Q

Midline Episiotomy

A

Directly down to the sphincter

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10
Q

Mediolateral Episiotomy

A

Directly down and then to the side of the sphincter

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11
Q

Nursing Care after episiotomy

A
  • Cold packs for first 12 hours
  • Hot packs sitze baths after 12-24 hours
  • Oral analgesics as ordered
  • No suppositories or enemas for 3-4 degree tears
  • High fibre diets and fluids
  • Stool softeners
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12
Q

4 types of Shock

A
  • Hypovolemic
  • Septic
  • Cardiogenic
  • Anaphylactic
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13
Q

HypoVolemic Shock

A
  • Volume of blood is depleted and cannot fill circulatory system
  • Caused by Postpartum Hemorrhage or blood clotting disorders
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14
Q

Body Response to Hypovolemia

A
  • Increased heart and respiratory rate
  • Increase o2 content of red blood cells
  • speed up circulation of blood in system
  • BP shows narrow pulse pressure
  • Blood flow to nonessential organs gradually stops
  • Skin and mucosa membranes become pale, cold and clammy
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15
Q

Narrow pulse pressure

A

Falling systolic

Rising Diastolic readings

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16
Q

Immediate Medical and Nursing interventions to Correct HypoVolemia

A
  • Give IV fluids to maintain circulating volume and replace fluids
  • Blood Transfusions to replace lost erythrocytes
  • Give O2 to increase saturation in blood cells
  • Indwelling foley catheter to assess urine output
17
Q

Medication intervention to correct hypovolemia

A
  • Oxytocin
  • Ergot Alkaloids
  • Misoprostol
18
Q

Nursing Care for Hypovolemia

A
  • VS often
  • O2 saturations
  • Assess Lochia ( for clots )
  • Assess Fundus
  • Measurements of intake and output
  • Monitor for signs of Anemia
  • Emotional support to woman
19
Q

Postpartum Hemorrhage

A
  • Blood loss greater then 500mL for vaginal birth or 1000mL for section.
20
Q

Postpartum hemorrhage early and late

A

Early within 24 hrs postpartum

Late between 24 hrs- 6 weeks postpartum

21
Q

What is the major risk of Hemorrhage

A

Hypovolemic shock

22
Q

Signs and Symptoms of a hemorrhage

A
  • Tachycardia
  • Active bleeding
  • Narrow pulse pressure
  • Pale, Cold, Clammy Skine
  • Mental status changes
  • Decreased urinary output.
23
Q

Causes of Early(Primary) Postpartum hemorrage

A
  • Uterine atony
  • lacerations or tears of the reproductive tract
  • Retained products
24
Q

Uterine Atony

A
  • Collection of blood in Uterus
25
Q

Medications used to Treat PPH

A
  • Oxytocin : stimulate upper muscles of uterus
  • Carbetocin ( long acting oxytocin)
  • Ergonovine ( Ergot Alkaloids): Stimulates the myometrium and upper/lower uterine segments
  • Misoprstol: Vasoconstrict and enhance contractility.
26
Q

Late PPH causes

A
  • Retention of placenta
  • Subinvolution
  • Preparation for IV medication
  • Prepare for possible surgical intervention
27
Q

Nursing care for late PPH

A
  • Teach to report persistent bright red bleeding

- return of red bleeding after it has changed to pink or white

28
Q

Puerperal Sepsis

A

Infection after child birth
fever 38 after first 24hr
lasts 2days for first 10 dats postpartum

29
Q

Risks of Puerperal Sepsis

A
  • Cracked Nipples
  • Surgical incision
  • tissue trauma during labor
  • Open wound at placental insertion site
  • retained placenta or blood clots
  • increased pH of the vagina after birth
  • Endometritis ( inflammation of the uterus lining)
30
Q

Nursing care for Infection

A
  • teach hygienic measures
  • promote adeqüei rest and nutrition
  • teach and observe for signs of infection
  • teach how to correctly apply perineal pads
  • teach the woman to take all antimicrobial medications as prescribed.
31
Q

Thromboembolic Disorders

A
  • Venous thrombosis blood clots
32
Q

Types of thromboembolic Disorders

A

Superficial Vein Thrombosis
- Deep Vein thrombosis
Pulmonary embolism

33
Q

Anticoagulant teachings

A
  • Prolonged bleeding from minor injuries
  • Nosebleeds
  • Unexplained bruising
  • stress importance of completing follow up blood tests
34
Q

Rh incompatability medication

A
  • Rh0 immunoglobulin is administered at 28 weeks and within 72 hours after delivery
35
Q

ABO blood incompatibility

A

Mothers blood type is O and babies is A or B this is life threatening

Maternity (6 decks)

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