post partum women at risk - week 2

Question 1

postpartum hemorrhage

Answer 1

Traditional definitions:
* >500 mL following a vaginal birth
* >1,000 mL following a cesarean birth
* Care providers commonly underestimate blood loss
* Any amount of bleeding that places the mother in hemodynamic jeopardy

Question 2

the three causes of postpartum hemorrhage

Answer 2

Tone, Tissue
Retained placental fragments, Sub involution
Uterine inversion

Trauma
Lacerations of the genital tract
Episiotomy
Hematomas of the vulva, vagina or subperitoneal areas

Thrombosis
↓ Platelets

Question 3

what to do during a ton/tissue induced pph

Answer 3

Call for help EMERGENCY
Work as a team
Focus on underlying cause
Communicate with family and client

Tone, Tissue
Palpate the fundus—If boggy
Uterine massage
Removal of retained placental fragments,
Assist with uterine contraction Administration of Uterotonics and other Doctor’s orders -
oxytocin, ergometrine, hemabate, cytotec

Question 4

what to do during a trauma induced pph

Answer 4

Call for help EMERGENCY
Work as a team
Focus on underlying cause
Communicate with family and client

Trauma
Repair of lacerations, tie bleeding blood vessels
Start IV or second IV
Fluid administration - volume expanders,
Foley insertion-EMPTY BLADDER
Monitor vitals, other indicators of perfusion
Blood work
Measure vaginal blood loss -amount, pads, Maintain Intake output record
Document

Question 5

thromboemobolic conditions

Answer 5

Three most common types
Superficial thrombosis
Deep vein thrombosis
Pulmonary embolism

Pathophysiology
Venous stasis
Injury to innermost layer of blood vessel
Inflammation of blood vessel lining
Hypercoagulation

Question 6

nursing mangement of thromboemobolic conditions

Answer 6

Venous thromboembolism (VTE) is a condition that occurs when a blood clot forms in a vein
Prevention- fluids, ambulation
Adequate circulation: bed rest, antiembolism stockings,
anticoagulant therapy heparin/dalteparin / enoxaparin; emergency measures for pulmonary embolism
Education re prevention and detection

Question 7

baby blues

Answer 7

Emotional lability, irritability, and insomnia that typically resolves within 2 weeks (by postpartum day 10); usually self-limiting

Question 8

postpartum depression

Answer 8

Major depressive episode associated with childbirth; symptoms lasting beyond 6 weeks and worsening

Question 9

postpartum psychosis

Answer 9

Surfaces within 3 weeks of giving birth; sleep disturbances, fatigue, depression,

Question 10

nursing mangament of postpartm affective disorders

Answer 10

Assistance with coping and adjustment
Education-client and family
Referrals for support
Resources in the community