postpartum

Question 1

grading perineal lacerations

Answer 1

• 1st-degree: tear in surface of skin
• 2nd-degree: deeper, but not into muscle
• 3rd-degree: all the way through muscle and up to anal sphincter
• 4th-degree: through anal sphincter (can lead to fistula)

Question 2

blood loss during delivery

Answer 2

• vaginal: 500 mL
• C/S: 1 L

Question 3

postpartum fluid loss

Answer 3

• losing extra volume gained during PG
• diaphoresis
• diuresis (3000cc/day)
• blood loss during delivery
• don’t usually develop shock because 500-750 mL diverted back into system from placenta

Question 4

diastasis recti

Answer 4

• separation of the two halves of the rectus abdominis muscles in the midline at the linea alba
• may require surgical repair depending on severity
• benign in pregnant women

Question 5

REEDA

Answer 5

• assessment for episiotomy, laceration, or C/S incision
• redness
• edema
• ecchymosis
• discharge
• approximation

Question 6

EBL

Answer 6

estimated blood loss

Question 7

SVD

Answer 7

spontaneous vaginal delivery

Question 8

QBL

Answer 8

• quantitative blood loss
• zero scale with clean item, then weigh saturated item
• 1 g = 1 mL

Question 9

PPH

Answer 9

postpartum hemorrhage

Question 10

D&C

Answer 10

dilation and curettage

Question 11

hypovolemic shock Tx

Answer 11

• EARLY ID AND RAPID RESPONSE
• frequent assess: continuous VS, palpate fundus, check skin color, RR, etc.
• additional large-bore IV access
• bolus crystalloid fluid
• volume expanders
• blood product transfusion
• Trendelenberg position: helps perfuse brain, heart

Question 12

I&D

Answer 12

incision and drainage