Module 6 - Complications after birth Flashcards
where can Lacerations of the Reproductive Tract occur? tx?
perineum, vagina, or cervix or around the urethra
Treatment is usually suturing
Keep woman NPO until further assessment can be made by health care
provider.
Describe first degree uncontrolled tearing of perineal tissue
superficial vaginal mucosa or perineal skin
Describe 2nd degree perineal lacerations
involves vaginal mucosa, perineal skin, and deeper tissues of the perineum
Describe 3rd degree perineal lacerations
same as second degree, plus involves anal sphincter
Describe 4th degree perineal lacerations
extends through the anal sphincter into the rectal mucosa
S& S of hemorrhage
increase RR & heart rate
- tachycardia
- 1st BP change Falling systolic & rising diastolic, then BP continues to fall.
- skin andmucous membranes pale, cold &clammy
- Anxiety, confusion, restlessness, lethargy
- decrease urine output
Describe the 3 causes of postpartum hemorrhage
> Uterine atony – Atony describes a lack of normal muscle tone.
Lacerations - Uncontrolled tearing of perineal tissue
Hematomas - Collection of blood within tissue
S and Symptoms of Pulmonary Embolism (PE)
sudden chest px, cough, dyspnea, decreased level of consciousness & signs of heart failure
Teachings for Thromboembolic
Disorders
- Teach woman not to cross legs because it impedes blood flow.
- Avoid pressure in the popliteal space behind the knee.
- Early ambulation and range-of-motion exercises.
- If antiembolic stockings are prescribed, the nurse should teach the woman the correct method of putting on the stockings.
Puerperal Sepsis is an infection or septicemia after childbirth, with a fever of 38°C after the first __ hours and for at least __ days during the first 10 days postpartum
First 24 hours; at least 2 days
What are risks for puerperal infection?
- Cracks in the nipples of the breasts
- Surgical incision
- Tissue trauma during labor
- Open wound at the placental insertion site
- Retained placenta or blood clots
- Increased pH of the vagina after birth
- Endometritis (inflammation of the lining of the uterus)
The object of nursing care for puerperal infection is preventative. To achieve this, the nurse should…
- Use and teach hygienic measures.
- Promote adequate rest and nutrition for healing.
- Teach and observe for signs of infection.
- Teach the woman how to correctly apply perineal pads (front to back).
- Teach the woman to take all antimicrobial medications as prescribed.
what are Signs and Symptoms of Postpartum Depression
- Lack of enjoyment in life
- Lack of interest in others
- Intense feeling of inadequacy, unworthiness, or guilt
- Inability to cope
- Loss of mental concentration or inability to make decisions
- Disturbed sleep or appetite
- Constant fatigue and feelings of ill health
what are the 2 main types of episiotomys?
Midline - incision is made in the middle of the vaginal opening, straight down toward the anus.
Mediolateral - incision begins in the middle of the vaginal opening and extends down toward the buttocks at a 45-degree angle.
Nursing care for episiotomy
•Apply cold packs for at least the first 12 hours to reduce pain, bruising and edema
• After 12-24hrs, apply warm packs, provide sitz baths to increase blood circulation
• Administer oral analgesics as ordered
• Encourage high fiber diets and fluids
• Administer stool softeners to ease passage of stools
(No suppositories or enemas for 3rd and 4th degree tears)
