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NuCM 109 - MCN > Nursing Care Of The Postpartum Client: For A Woman Experiencing Postpartum Complication > Flashcards

Nursing Care Of The Postpartum Client: For A Woman Experiencing Postpartum Complication Flashcards

1
Q

Assessment findings associated with a postpartum complication may be subtle, such as:

A
  • Tenderness in the calf of a leg
  • Increase in uterine perineal pain
  • Slight elevation in temperature
  • Small increase in the amount of lochia flow
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2
Q

Complications when assessing postpartal women:

A
  • elevated temperature
  • pallor
  • pain & swelling
  • relaxed uterus
  • perineal pain
  • abdominal pain
  • pain & tenderness in calf of leg
  • feeling of extreme sadness or unreality
  • thready, rapid, weak pulse
  • decreased blood pressure
  • uterine hemorrhage
  • pain of symphysis pubis on walking
  • lochia with foul odor
  • positive Homan’s sign
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3
Q

Normal urine output

A

30 ml/hr

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4
Q

Amt of blood loss of postpartum hemorrhage at vaginal birth

A

500 ml or more

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5
Q

Percentage of occurrence of postpartum hemorrhage

A

5-15%

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6
Q

Blood loss of postpartum hemorrhage at cesarean birth

A

1000 ml

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7
Q

Percentage of decrease in hematocrit level at cesarean birth during postpartum hemorrhage

A

10%

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8
Q

Occur early within the first 24 hours following birth

A

Early postpartal hemorrhage

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9
Q
  • occur from 24 hrs to 6 weeks after birth
  • the greatest danger is in the first 24 hrs because of the grossly denuded and unprotected uterine area left after detachment of the placenta
A

Late postpartal hemorrhage

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10
Q

Main reasons for postpartum hemorrhage:

A
  1. Uterine atony
  2. Trauma or lacerations
  3. Retained placental fragments
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11
Q

Can be prescribed to help the uterus maintain tone

A
  • oxytocin (pitocin)
  • carboprost tromethamine (hermabate)
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12
Q

Given intramuscularly, may be repeated every 2 to 4 hrs up to 5 doses

A

Methelergononvine maleate (methergine)

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13
Q

Ca prostaglandin E analogue may also be administered rectally to decrease postpartum hemorrhage

A

Carboprost tromethamine (hermabate)

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14
Q

How many hours does the woman need to deadpan or go to the bathroom when she has uterine atony?

A

Every 4 hrs

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15
Q

What is the rate of administering oxygen by face mask if the woman is experiencing respiratory distress from decreasing blood volume?

A

10 to 12 L/min

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16
Q

If fundal massage and administration of uterotonics are not effective at stopping uterine bleeding, this may be done to detect possible retained placental fragments

A

Sonogram

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17
Q

Inserting one hand into a woman’s vagina while pushing against the fundus through the abdominal wall with the other hand

A

Bimanual compression

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18
Q

Trauma or lacerations may occur most often in the following circumstances:

A
  • with difficult or precipitate births
  • primigravidas
  • birth of a large infant (more than 9 lb.)
  • use of lithotomy position and instruments
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19
Q

Types of trauma or lacerations:

A
  1. Cervical lacerations
  2. Vaginal lacerations
  3. Perineal lacerations
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20
Q

This laceration is usually found on the sides of the cervix

A

Cervical laceration

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21
Q

Therapeutic management of cervical lacerations:

A
  • Must have adequate space to work
  • Adequate sponges and sutures supplies
  • Good light source
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22
Q

Lacerations that occur in the vagina. They are easier to assess because they are easier to view

A

Vaginal lacerations

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23
Q

They usually occur when a woman is placed on lithotomy position for birth, because this position increases tension on the perineum

A

Perineal lacerations

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24
Q

A placenta with an accessory lobe

A

Succenturiate placenta

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25
Q

A placenta that fuses with the myometrium because of an abnormal decidua basalis layer

A

Placenta Accreta

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26
Q

It is performed to remove retained placental fragments

A

Dilatation & curettage (D & C)

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27
Q

Infection in the reproductive tract

A

Puerperal infection

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28
Q

Factors affecting puerperal infection:

A
  • virulence of the invading microorganisms
  • the woman’s general health
  • portal of entry
  • degree of uterine involution
  • presence of lacerations in the reproductive tract
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29
Q

Conditions that increase a woman’s risk for postpartal infections:

A
  1. Rupture of the membranes more than 24 hrs before birth
  2. Placental fragments retained within the uterus
  3. Postpartal hemorrhage
  4. Preexisting anemia
  5. Prolonged and difficult labor, particularly instrument births
  6. Internal fetal heart monitoring
  7. Local vaginal infection was present at the time of birth
  8. The uterus was explored after birth for a retained placenta or abnormal bleeding site
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30
Q

Postpartal puerperal infections:

A
  1. Endometritis
  2. Wound infection
  3. UTI
31
Q

is an infection of the endometrium, the lining of the uterus

A

Endometritis

32
Q

Endometritis is associated with:

A

chorioamnionitis and cesarean birth

33
Q

When does the fever of endometritis usually occur?

A

3rd or 4th postpartal day

34
Q

Antibiotic used in treating endometritis

A

Clindamycin (cleocin)

35
Q

An oxytocic agent that may be prescribed to encourage uterine contraction

A

Methergine

36
Q

Sitting in this position encourages lochia drainage by gravity and helps prevent pooling infected secretions

A

Fowler’s position

37
Q

Infection of the pueperium definitions:

A
  • usually localized
  • s/s are pain, heat and feeling of pressure
  • purulent drainage is present
38
Q

Blockage of inflamed intestines

A

Paralytic ileus

39
Q

is often accompanied by paralytic ileus

A

Peritonitis

40
Q

Three veins involved in femoral thrombophlebitis:

A

Femoral, saphenous, or popliteal veins

41
Q

Milk leg or white inflammation

A

Phlegmasia alba dolens

42
Q

s/s of peritonitis

A
  • rigid abdomen
  • abdominal pain
  • high fever
  • rapid pulse
  • vomiting
  • the appearance of being acutely ill
43
Q

After birth, when does a woman wear supprt stockings in order to increase venous circulation and prevent stasis?

A

in the first 2 weeks

44
Q

How many times does a woman remove her support stockings to assess for her skin underneath for mottling that suggests inflammation of the veins?

A

Twice daily

45
Q

inflammation of the lining of the blood vessel

A

Phlebitis

46
Q

inflammation with the formation of blood clots

A

Thrombophlebitis

47
Q

Veins involved in pelvic thrombophlebitis:

A

Ovarian, uterine and hypogastric veins

48
Q

an infection in the peritoneal cavity

A

Peritonitis

49
Q

usually an extension of endometritis

A

Peritonitis

50
Q

This is where the abscess of peritonitis may form and also the lowest point of the peritoneal cavity

A

cul-de-sac of Douglas

51
Q

an obstruction by the pulmonary artery by the blood clot

A

Pulmonary embolus

52
Q

Signs of pulmonary embolus:

A
  • sudden, sharp chest pain
  • tachypnea
  • tachycardia
  • orthopnea
  • cyanosis
53
Q

inability to breath except in an upright position

A

Orthopnea

54
Q

Infection of the breast

A

Mastitis

55
Q

Vitamin ised to soften nipples

A

Vit. E

56
Q

Occurs when the bladder is unable to empty completely

A

Urinary retention

57
Q

Urinary retention is compounded during:

A
  • prolonged labor
  • perineal lacerations
  • use of epidural anesthesia
58
Q

Catheter used during urinary retention

A

Indwelling or Foley catheter

59
Q

An infection in any part of your system

A

Urinary Tract Infection (UTI)

60
Q

Kidney infection

A

Pyelonephritis

61
Q

Bladder infection

A

Cystitis

62
Q

Urethra infection

A

Urethritis

63
Q

Prostate infection

A

Prostatitis

64
Q

s/s of UTI

A
  • burning on urination
  • hematuria (blood in urine)
  • a feeling of frequency or that she always has to void
  • a sharp pain in voiding
  • a low grade fever or discomfort from lower abdominal pain
65
Q

They are contraindicated for breastfeeding women because they cause neonatal jaundice.

A

Sulfa drugs

66
Q

Prescribed to treat postpartal urinary infection

A

Amoxicillin or ampicillin

67
Q

An oral analgesic used to reduce pain of urination for the next few times a woman voids

A

Acetaminophen (Tylenol)

68
Q

Occur postpartally as a symptom of eclampsia that typically develops 6 to 24 hours after birth

A

Seizures

69
Q

Immediate feeling of sadness that occurs 1 to 10 days postpartum

A

Postpartal blues

70
Q

Overwhelming sadness beyond the immediate postpartal period possibly as long as 1 year

A

Postpartal depression

71
Q

Psychosomatic symptoms of postpartal depression:

A
  • nausea
  • vomiting
  • diarrhea
  • depressive or extreme mood fluctuation
72
Q

Risk factors for postpartal depression:

A
  • history of depression
  • troubled childhood
  • low self-esteem
  • stress in the home or at work
  • lack of effective support
  • different expectations between partners
  • disappointment in the child
73
Q

Exists when a woman has lost contact with reality

A

Postpartal psychosis

74
Q

When the illness coincides with the postpartal period or occurs during the following years

A

Postpartal psychosis

NuCM 109 - MCN (2 decks)

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