Postpartum Complications (Ch. 33 ATI 20-22) Flashcards
For DVT the patient should receive _____ until ambulation is reestablished
Sequential compression device
If bed rest is longer than 8 hours, use ____ and ____
Active and passive ROM to promote circulation
If a patient has DVT they should ____ extremity above the heart. They should apply intermittent or continuous ____
Elevate. Warm moist compress.
FOR A PATIENT WITH DVT DO NOT
MASSAGE
If providing heparin, monitor ____. If providing warfarin monitor ____
aPTT. INR
Big risk factors for DVT (3)
Obesity, immobility, cesarean birth.
Definition of postpartum hemorrhage
Cumulative blood loss of over 1000 mL with findings of hypovolemia within 24 hours of birth
Risk factors for PPH (lots)
Uterine atony, prolonged labor, high parity, ruptured uterus, placenta previa, abruptio placentae, subinvolution of uterus, retained placental fragments, lacerations and hematomas.
Two medications that increase risk of PPH
Oxytocin and Magnesium Sulfate
Interventions for PPH (lots)
Determine QBL immediately, massage fundus, monitor vitals, assess bleeding, assess lochia, assess bladder for distention, elevate legs to 20 or 30 degrees to increase circulation to organs.
4 medications used for postpartum hemorrhage
Oxytocin, methylergonovine, carboprost, tranexamic acid
What does oxytocin do for PPH and what do we assess
Increases uterine contractions. Assess uterine tone and vaginal bleeding
What does methylergonovine do for PPH and what do we assess
Controls hemorrhage. Assess uterine tone and vaginal bleeding
What does carboprost do for PPH and what do we assess
Controls hemorrhage. Assess uterine tone and vaginal bleeding
What does tranexamic acid do for PPH and what do we assess
Improves clotting. Assess uterine tone and vaginal bleeding
Indications and contraindications of methylergonovine
BP above 140/90 do NOT GIVE. Indicated for PPH
Definition of uterine atony
Inability of the uterus to contract adequately after birth
Causes of uterine atony (6)
Retained placental fragments, prolonged labor, oxytocin induced labor, magnesium sulfate, anesthesia, trauma during labor.
Signs of uterine prolapse
PAIN in lower abdomen. Vaginal bleeding (hemorrhage). Dizziness, hypotension, tachycardia, pallor.
Uterine prolapse has 3 stages. Describe them
Incomplete inversion - smooth mass dilated through cervix
Prolapsed inversion - large, red, rounded mass protruding
Complete inversion - fundus prevents as a mass in the vagina
