OB Test 2: High Risk Postpartum

Question 0

What is early postpartum hemorrhage and it’s causes

Answer 0

First 24 hours

Causes:
Uterine atony: not contracting
Lacerations: forces delivery
Retained tissue
Hematoma: blood goes in at hemorrhage rate in broad ligament
Coagulation: pt who has DIC

Question 1

What is a postpartum hemorrhage?

Answer 1

More then 500mL vaginal
More then 1000 mL Caesarian

10% drop in Hct

Question 2

What are implantation abnormalities?

Answer 2

Accrete: placenta grown to deep in endometrium and won’t let go
Increta: placental into muscle
Percreta: placenta into uterine wall

Question 3

What is uterine inversion?

Answer 3

Pull on cord does that with accreta

Question 4

What are the risk factors of early PP hemorrhage?

Answer 4

Over distention of the uterus
Hydraminos 
Prolonged labor
Grand multipara
Meds: mag sulfate, Asian/Hispanic/light skin redhead

Question 5

What are signs and symptoms of early Pp hemorrhage

Answer 5

Bleeding
-tremendous or continuous trickle
Hypocolemia

Question 6

Why is treatment of PPH?

Answer 6

Fundal massage
Bimanual compression
Increase fluid and blood
Uterine stimulants
Oxygen
Positioning
Arterial embolization
Surgical invention

Question 7

What are some uterine stimulants?

Answer 7

Oxytocin (Pitocin): causes phasic contraction
Methylergonovine maleate (Methergine): given to cause sustained uterine contraction
Prostaglandin F: last resort, cause hypertension and brnchospasm

Question 8

What are nursing assessment for uterine stimulants?

Answer 8

Monitor fundus and blood loss: for when drug wears off
Fundal massage
Vital signs
I&O : count and weigh peripads

Question 9

What are laceration risk factors?

Answer 9

Large baby

Forceps

Question 10

What are hematomas?
S&S?
Treatment?

Answer 10

Boot clot
S: pain, Hypovolemia
T: less then 5cm, ice pack, pain med
More then 5cm tie off bleeding vessel

Question 11

What are the causes, signs, and treatment of late Pp hemorrhage?

Answer 11

Cause: infection and subinvolution
Sign: after 24 hour - 6 week
         Increase fundal height
         Lochia Rubra, increased Lochia
Treat: rest if bleeding
          0.2 mg methrogen PO
          DNC
          Antibiotic

Question 12

What are the causes of thrombophlebitis?

Answer 12

Hypercoagubility
Venous stasis: blood sits there
Trauma: increa risk of clot formation

Question 13

What s thrombophlebitis

Answer 13

Irritation of inside vein related to clot

Question 14

What are the signs and treatment of thrombophlebitis

Answer 14

Signs: superficial vein thrombi
           Tender, warm, induration (firm), redness along vein
Treatment: elevation affected part
             Bed rest
             Moist heat
             Analgesic 
             TED hose

Question 15

What are the symptoms of DVt?

Answer 15

Pain
Edema
Fever with chills
Red or pale and cool

Question 16

Treatment of DVT?

Answer 16

IV Heprin 
Elevate leg
Bed rest
Analgesic 
Antibiotic
Comparison stocking
Coumadin

Question 17

Look over puerperal infection slide because I am lazy…..sorry

Answer 17

.

Question 18

What is mastitis symptoms and treatment?

Answer 18

Sign: sudden onset after 10 days, localized pain, redness, fever
Treat: analgesic, antibiotic, breast must be emptied, rest, hydration