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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
A placenta that fuses with the myometrium because of an abnormal decidua basalis layer
Placenta Accreta
26
It is performed to remove retained placental fragments
Dilatation & curettage (D & C)
27
Infection in the reproductive tract
Puerperal infection
28
Factors affecting puerperal infection:
- virulence of the invading microorganisms - the woman's general health - portal of entry - degree of uterine involution - presence of lacerations in the reproductive tract
29
Conditions that increase a woman's risk for postpartal infections:
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
30
Postpartal puerperal infections:
1. Endometritis 2. Wound infection 3. UTI
31
is an infection of the endometrium, the lining of the uterus
Endometritis
32
Endometritis is associated with:
chorioamnionitis and cesarean birth
33
When does the fever of endometritis usually occur?
3rd or 4th postpartal day
34
Antibiotic used in treating endometritis
Clindamycin (cleocin)
35
An oxytocic agent that may be prescribed to encourage uterine contraction
Methergine
36
Sitting in this position encourages lochia drainage by gravity and helps prevent pooling infected secretions
Fowler's position
37
Infection of the pueperium definitions:
- usually localized - s/s are pain, heat and feeling of pressure - purulent drainage is present
38
Blockage of inflamed intestines
Paralytic ileus
39
is often accompanied by paralytic ileus
Peritonitis
40
Three veins involved in femoral thrombophlebitis:
Femoral, saphenous, or popliteal veins
41
Milk leg or white inflammation
Phlegmasia alba dolens
42
s/s of peritonitis
- rigid abdomen - abdominal pain - high fever - rapid pulse - vomiting - the appearance of being acutely ill
43
After birth, when does a woman wear supprt stockings in order to increase venous circulation and prevent stasis?
in the first 2 weeks
44
How many times does a woman remove her support stockings to assess for her skin underneath for mottling that suggests inflammation of the veins?
Twice daily
45
inflammation of the lining of the blood vessel
Phlebitis
46
inflammation with the formation of blood clots
Thrombophlebitis
47
Veins involved in pelvic thrombophlebitis:
Ovarian, uterine and hypogastric veins
48
an infection in the peritoneal cavity
Peritonitis
49
usually an extension of endometritis
Peritonitis
50
This is where the abscess of peritonitis may form and also the lowest point of the peritoneal cavity
cul-de-sac of Douglas
51
an obstruction by the pulmonary artery by the blood clot
Pulmonary embolus
52
Signs of pulmonary embolus:
- sudden, sharp chest pain - tachypnea - tachycardia - orthopnea - cyanosis
53
inability to breath except in an upright position
Orthopnea
54
Infection of the breast
Mastitis
55
Vitamin ised to soften nipples
Vit. E
56
Occurs when the bladder is unable to empty completely
Urinary retention
57
Urinary retention is compounded during:
- prolonged labor - perineal lacerations - use of epidural anesthesia
58
Catheter used during urinary retention
Indwelling or Foley catheter
59
An infection in any part of your system
Urinary Tract Infection (UTI)
60
Kidney infection
Pyelonephritis
61
Bladder infection
Cystitis
62
Urethra infection
Urethritis
63
Prostate infection
Prostatitis
64
s/s of UTI
- 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
They are contraindicated for breastfeeding women because they cause neonatal jaundice.
Sulfa drugs
66
Prescribed to treat postpartal urinary infection
Amoxicillin or ampicillin
67
An oral analgesic used to reduce pain of urination for the next few times a woman voids
Acetaminophen (Tylenol)
68
Occur postpartally as a symptom of eclampsia that typically develops 6 to 24 hours after birth
Seizures
69
Immediate feeling of sadness that occurs 1 to 10 days postpartum
Postpartal blues
70
Overwhelming sadness beyond the immediate postpartal period possibly as long as 1 year
Postpartal depression
71
Psychosomatic symptoms of postpartal depression:
- nausea - vomiting - diarrhea - depressive or extreme mood fluctuation
72
Risk factors for postpartal depression:
- 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
Exists when a woman has lost contact with reality
Postpartal psychosis
74
When the illness coincides with the postpartal period or occurs during the following years
Postpartal psychosis

NuCM 109 - MCN (2 decks)

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