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Natural Childbirth IV > Postpartum Complications > Flashcards

Postpartum Complications Flashcards

1
Q

what are afterpains? etiology?

A

cramping after birth
can be quite severe
etiology: rhythmic contractions PP in an attempt to involute the uterus

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2
Q

RFs for afterpains? (4)

A

prolonged labor
poor muscle tone
overdistension of uterus
multiparity (grandmultips, st find these pains greater than labor)

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3
Q

how to manage afterpains?

A

any pn after 3 days is considered abn

advise mom to keep uterus firm (empty bladder, massage uterus, nurse regularly)

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4
Q

ssxs of afterpains?

A

mild to severe cramping usu beginning in 4th stage
may last hrs to several days
comes and goes
often accompanied with latching and nursing

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5
Q

botanicals to prevent afterpains?

A 
medicago
rubus
urtica
caulophyllum
cimicifuga
senecio
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6
Q

pains dt debility, fullness and wt in pelvis, pains in legs

30 gtt q hr then PRN

A

caulophyllum

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7
Q

tense, aching pains

30 gtt 1hr then PRN

A

cimicifuga

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8
Q

do not give immediately PP
pains dt nervous exhaustion
10-20 gtt q 2 hrs PRN

A

gelsemium

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9
Q

gentle anti-spasmodic, uterine tonic, laxative

30 gtt q hr PRN

A

leonurus

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10
Q

severe, spasmodic pains

20 gtt q 15 min then PRN, up to 120 gtt x 4 d

A

viburnum op

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11
Q

achy, bruised pain w/shocky, dazed sensorium, does not want to be touched
200c, 3 pellets q 1 hr x 3 hrs

A

arnica

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12
Q

intense soreness, bruised feeling dt trauma, worse with cold drinks and cold drafts
200 c

A

bellis perennis

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13
Q

cramping, spasmodic pains, intense, can be sharp

30c, 200 c

A

mag phos

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14
Q

mineral great for relieving after pains?

A

cal/mag- 1000 mg q hr until resolved for 1-3 hrs

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15
Q

etiology of hemorrhoids?

A

increased venous stasis from progesterone
physical P of baby’s wt
valsalva P during 2nd stage

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16
Q

RFs for hemorrhoids?

A

existing hemorrhoids
prolonged 2nd stage
poor nutrition
obesity

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17
Q

ssxs of hemorrhoids?

A

pain
protruding, bulging veins
bleeding- blood on outside of stool, not mixed in

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18
Q

one way to prevent hemorrhoid formation during labor? management of hemorrhoids?

A

counterpressure during 2nd stage to prevent
afterwards: donut cushions, sitz baths, epsom salts, suppositories, keep stool soft, refer at 2 mos if still present for Kesey tx

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19
Q

etiology and predisposing factors of a hematoma?

A 
etiology: rupture of BV causing extravasation of blood into tissue
predisposing factors:
varicosities
prolonged 2nd stage
excessive use of perineal stretching
instrumentation
macrosomia
20
Q

hematoma ssxs?

A

swelling, bruising
pain
displacement of uterus (if internal, broad lig hematoma)
signs of shock: increased pulse, decreased BP)

21
Q

management of external hematoma?

A

apply pressure: ice pack, truss, wrung out sanitary pad
stop bleeding
prevent infxn via good hygiene, peri bottle, sitz baths, immune stimulating herbs
broad lig hematomas should be monitored and may require surgical drainage

22
Q

etiology of urinary incontinence? RFs? ssxs?

A

etiology: weakened pelvic structures
RFs: prolonged 2nd stage, poor nutrition, intrapartum or PP urinary retention, multiparity
ssxs: incontinence overt or dt stress, cystocele

23
Q

management of PP urinary incontinence?

A

pelvic floor exercises- kegels should be started immediately and increased if incontinence persists
can add pelvic wts after lochia stops

24
Q

incontinence dt bruising and trauma

5 gtt tid

A

arnica

25
Q

incontinence dt tissue laxity
astringent
30 gtt qid

A

achillea

26
Q

weakness of bladder
caution- TOXIC BOTANICAL
10 gtt tid

A

claviceps

27
Q

incontinence dt prolapse
tones pelvic tissue
30-60 gtt tid

A

helonias

28
Q

tones urinary apparatus
caution- SEDATIVE EFFECT ON NURSING NEWBORN
20 gtt tid

A

piper

29
Q

weak bladder sphincter, dribbling with cough

20 gtt qid

A

thuja

30
Q

stress incontinence dt prolapse, weak feeling in pelvis

A

helonias

31
Q

involuntary when walking, coughing

good after disappointing birth

A

nat mur

32
Q

involuntary urination worse with coughing and passing gas

worse at night

A

pulsatilla

33
Q

involuntary urination, esp during 1st sleep, pelvic weakness and uterine prolapse, slow sluggish urination

A

sepia

34
Q

incontinence dt cystocele, feeling a P on bladder

A

staphysagria

35
Q

whom is 5x more likely to experience a thrombosis? complication?

A

PG/PP women

complication is pulmonary embolism

36
Q

predisposing factors to a thrombus? (8)

A 
C-section
over 35 yo
high parity
obesity
suppression of lactation
smoking
immobility
trauma to legs
37
Q

ssxs of superficial thrombphlebitis? DVT?

A

superficial thrombophlebitis: tenderness, vein hard, red and warm
DVT: pain, (+) Homan’s sign, swelling in affected leg

38
Q

how to manage/tx a thrombosis?

A

prophylactic tx is via preventing trauma and partaking in exercise
afterwards: supportive hose or bandages, elevate legs, Vit E 400-1200 IU, bioflavinoids, immune stim herbs, bromelain 1000 mg qid, heparin/warfarin

39
Q

ssxs of PE?

A 
severe chest pn
dyspnea
shock 
slight hemoptysis
mb no sx if clot lg enough, death may occur w/o warning
collapse
cyanosis
hypotension
40
Q

amniotic fluid embolism accounts for what %age of maternal deaths?

A

4-10%

41
Q

definition of amniotic fluid emobolism

A

amniotic fluid entering maternal circulation, may cause obstruction of pulmonary vessel but seems to more often cause anaphylaxis

42
Q

predisposing factors to amniotic fluid embolism?

A

precipitous labor
multiparity
excessive use of oxytocic drugs or prostaglandins
uterine trauma- version, catheter, ruptured uterus, C-section

43
Q

ssxs of amniotic fluid embolism?

A 
sudden onset of dyspnea
rapid, shallow resps
pulmonary edema
tachycardia
hypotension out of proportion to blood loss
convulsions/seizures
hemorrhage dt DIC
pt often states she is going to die
44
Q

mortality associate with amniotic fluid embolism?

A

mortality is ~85%
25% of deaths occur in 1st hr
death dt: hypoxia, hypovolemic shock, cardiogenic shock, DIC

45
Q

how to manage an amniotic fluid embolism?

A

maintain airway
oxygen
CPR
TRANSPORT!!

Natural Childbirth IV (15 decks)

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