Postpartem risk Flashcards
postpartum hemorrhage is defined as
500mL of blood loss after a vaginal birth or 1000mL of blood loss after a C-section or a 10% change in Hct between labor and postpartum
what is the leading cause of maternal mortality and morbidity
post partum hemorrhage
when does early PPH occur
within 24 hours of the birth
when does late or secondary PPH occur
more than 24 hours but less than 6 weeks after birth
what are the risk factors for PPH
precipitous labor, multifetal gestation, macrosomia, high parity, genital tract trauma, coagulation defects, operative vaginal delivery, sepsis, retained placenta.
what are the five Ts of PPH
Tone: uterine atony, distended bladder
Tissue: retained placenta and clots
Trauma: vaginal, cervical, or uterine injury
Thrombin: coagulopathy (preexisting or acquired)
Traction: causing uterine inversion
what are the interventions for PPH
form massage fo the uterine funds, expression of any clots in the uterus, elimination of bladder distention, continuous IV infusion of 10-40 U of oxytocin in 1000mL, additional uterotonic medications.
what is subinvolution, causes, and complications
incomplete involution of uterus after birth, retained placental fragments, distended bladder, uterine myopia, infection
complications include hemorrhage, pelvic peritonitis, salpingitis, abbess formation
what is another name for postpartum infection, what is the definition, and what are some symptoms
puerperal infection
Any clinical infection of the genital tract that occurs within 28 days after miscarriage, induced abortion, or birth
Defined as presence of a fever of 38_ C (100.4_ F) or more on 2 successive days of the first 10 postpartum days (not counting the first 24 hours after birth)
what is metritis
infection of the endometrium, decide, and adjacent myometrium
what are the nursing interventions for postpartum infections
Broad-spectrum antibiotics for metritis
Wound care for wound infections
Fluids and antibiotics for UTIs
Breast emptying and antibiotics for mastitis
what are the differences between baby blues and post part depression
baby blues are normal and include crying, mood swings, sadness, difficulty sleeping, irritability, appetite changes, and concentration problems which show within a few days and last a few weeks
postpartum depressions is serious and can look like BB in the beginning but includes suicidal thoughts, inability to care for newborn, and symptoms last beyond 6 weeks
