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EOR - Women's Health > Postpartum Care > Flashcards

Postpartum Care Flashcards

1
Q

mc cause of infxn after childbirth

A

endometritis

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2
Q

mc source of bacteria that cause endometritis

A

endogenous

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3
Q

3 external sources of bacteria responsible for endometritis

A

during childbirth
gynecologic procedures
IUD
STI

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4
Q

2 STI mc responsible for endometritis

A

chlamydia
gonorrhea

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5
Q

2 types of endometreitis

A

acute
chronic

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6
Q

which type of endometritis is more likely to be symptomatic

A

acute

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7
Q

4 sx of endometreitis

A

fever
low abd pain
abd bleeding
d.c

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8
Q

5 rf for endometreitis

A

c section
PROM
vaginal delivery
D&C
pelvic exam

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9
Q

complications of endometreitis

A

-infxn spread:
myometreitis
parametreitis
salpingitis
oophritis
-asherman syndrome

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10
Q

what is asherman syndrome

A

intrauterine adhesions

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11
Q

dx for endometreitis

A

clinical
bx (not necessary/commonly done)

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12
Q

histological findings of acute vs chronic endometreitis

A

acute: neutrophils in endometrium
chronic: plasma cells in endometrium

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13
Q

PE findings of endometreitis

A

-fever
-tachycardia
-vaginal bleed
-foul smell
abd pain/uterine tenderness

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14
Q

2 post birth pt’s esp at risk for endometreitis

A

2-3 days post c section
postabortal

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15
Q

tx for endometreitis based on cause

A

-childbirth: clinda PLUS gentamicin
-remaining placental/fetal tissues: D&C
-STI: doxy PLUS ceftriaxone
-TB: RIPE

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16
Q

postpartum (puerperium) period lasts _ weeks

A

6

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17
Q

what happens in puerperium period

A

anatomic/physiologic changes of pregnancy are reversed - body returns to nonpregnant state

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18
Q

3 stages of puerperium

A

immediate: first 24 hr
early: through first week
remote: ~ 6 weeks

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19
Q

period when acute post anesthetic/post delivery complications may occur

A

immediate puerperium

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20
Q

what changes occur during normal puerperium

A

-uterine involution (shrinkage)
-immediate placental contraction -> hemostasis
-postpartum d.c
-cervix closes
-vagina returns to antepartum size
-ovulation
-widening of pubic symphysis/SIJ
-increased bladder capacity
-mild proteinuria

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21
Q

normal postpartum d/c begins as _

A

lochia rubra

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22
Q

postpartum d.c is usually gone by _ weeks postpartum

A

5-6

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23
Q

normal size of the cervix by the end of the first week postpartum

A

~1 cm

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24
Q

the vagina normally turns to antepartum size by _ weeks postpartum

A

3

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25
ovulation usually returns by _ weeks in non bf'ing women and _ weeks in bf'ing women
non bf'ing: as early as 27 days, mean 70-75 days bf'ing: 6 months
26
anovulation during pregnancy is due to elevated _ levels
prolactin
27
tearing or overstretching of musculature/fascia during delivery predisposes pt to (3)
genital prolapse genital hernias cystocele/rectocele/enterocele
28
involution of abd musculature to pre pregnancy state may require _ weeks post partum
6-7
29
pt education until abd musculature is back to normal
no vigorous exercise
30
2 common postpartum bladder issues
incomplete emptying residual urine
31
when does bladder usually return to normal postpartum
by 6 weeks
32
risk of postpartum UTI is higher in women with
persistent dilation
33
when does postpartum proteinuria normally resolve
1-2 days postpartum
34
when does CrCl return to normal postpartum
by 8 weeks
35
t/f: most patients should be hospitalized for 2-4 days postpartum
t!
36
4 common postpartum complaints
painful perineum bf'ing difficulty UTI urinary/fecal incontinence
37
most women can return home _ days after vaginal delivery
2
38
when can pt get out of bed postpartum
as soon as tolerated
39
t/f: in uncomplicated delivery, you can start exercising vigorously without delay
t! just don't if any rips/tear to abd musculature
40
bf'ing moms require _ more kcal/day
500
41
when can postpartum mom get down and dirty again
perineum is comfortable no bleeding
42
normal time for sexy time to occur after delivery
-6 weeks
43
mc form of obstetric injury
perineal laceration
44
t/f: episiotomies are commonly done
f! it likely increases tears
45
4 classes of perineal tears
1st degree: perineal skin and vaginal mucosa 2nd degree: injury to perineal body 3rd degree: through external anal sphincter 4th degree: thru rectal mucosa
46
tx for perineal tear
-natural healing -surgical repair
47
which types of perineal tear usually require surgical repair
3rd 4th
48
when are episiotomies mc performed
2nd stage of labor
49
indication for episiotomy
fetal distress
50
complications of episiotomy
bleeding pain infxn unsatisfactory anatomic results sexual dysfxn
51
types of episiotomy
midline mediolateral (mc) lateral j shaped
52
mc cause of maternal morbidity/death around the world
postpartum hemorrhage
53
definition of postpartum hemorrhage
-loss of > 500 mL blood w.in first 24 hr after vaginal delivery -loss of 1,000 mL blood after c section
54
signs of significant blood loss in mom
decrease of 10% Hct changes in HR, BP, SpO2
55
4 mc causes of postpartum hemorrhage
tone trauma tissue thrombin
56
mc cause (90%) of postpartum hemorrhage
uterine anatomy/atony: boggy/enlarged uterus
57
anatomical rf for potpartum hemorrhage
genital tract trauma retained placental tissue coagulation d.o's
58
what clotting d.o is associated. w sevrve preeclampsia, amniotic fluid embolism, and placental abruption
DIC
59
tx for postpartum hemorrhage due to atony
-fundal massage -oxytocin/misoprostol -hysterectomy
60
tx of postpartum hemorrhage due to genital tract trauma
sutures if > 2 cm

EOR - Women's Health (15 decks)

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