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OB > Postpartum High Risk > Flashcards

Postpartum High Risk Flashcards

1
Q

readiness for hemorrhage

A

hemorrhage cart, meds, response team, transfusion protocol

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2
Q

recognition/prevention of hemorrhage

A

assess risk pre and post delivery, assess blood loss

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3
Q

response of hemorrhage

A

emergency plan and support

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4
Q

PPH

A

more than 500ml vag and 1000ml c/s w 10% drop in hematocrit/hemoglobin

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5
Q

low risk for PPH

A

no incisions, single preg, less than 4 vag births, no bleeding disorder/hx of PPH

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6
Q

med risk for PPH

A

induction/ripening, more than 4 vag births, incision, hx of PPH, multi gestation, chorioamnionitis, fetal demise, fibroids

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7
Q

high risk of PPH

A

2 or more of med w active bleeding, accrete/precreta, placenta previa

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8
Q

PPH greatest risk

A

1st hr after delivery but can also up to 6 wks post

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9
Q

causes of PPH

A

tone, tissue, trauma, thrombin

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10
Q

risk factors of PPH

A

macrosomia, precipitous, multiple gestation, prior PPH, uterine surgery, placenta abnl, high parity

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11
Q

tone medical factors

A

macrosomia, high parity, fever, fibroids, rapid labor

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12
Q

S/S of altered tone

A

slow/profuse bleeding, boggy uterus, clotting

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13
Q

tone nursing actions

A

assist uterus w massage/meds, monitor bleeding, maintain fluid balance

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14
Q

uterine atony - tone

A

decreased uterine tone with bleeding

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15
Q

stg 1 of PPH

A

more than 500ml vag and 1000ml c/s w norm labs/VS

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16
Q

stg 2 of PPH

A

1000-1500ml, 2 uterotonics, monitor labs/VS

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17
Q

stg 3 of PPH

A

more than 1500mls, 1 unit packed RBC, 1 unit plasma, abnl VS/labs

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18
Q

stg 4 PPH

A

cardio collapse, shock, amniotic embolism

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19
Q

lacerations/hematoma risk factors - trauma

A

macrosomia, OVD, precipitous

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20
Q

laceration - trauma

A

tear during birth with continuous bright red blood

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21
Q

hematoma - trauma

A

bruise not always visualized that causes pain, heavy, rectal pressure and difficult voiding

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22
Q

if hematoma is too big

A

it displaces uterus and causes atony

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23
Q

retained placental tissue- tissue

A

part of placenta remain attached in uterus from manual removal

24
Q

S/S of retained placental tissue -tissue

A

profuse bleeding, subinvolution, fever, tachycardia, hypotension

25
Q

treatment of retained placental tissue- tissue

A

D+C, IV antibiotics, O2, s/s of shock

26
Q

coagulation disorders - thrombin

A

DIC, DVT, VTE, anaphylactic syndrome

27
Q

S/S of coagulation disorders -thrombin

A

pale, clammy, tachycardia, hypotension

28
Q

testing of coagulation disorders - thrombin

A

doppler, MRI, ultrasound, PTT

29
Q

treatment of coagulation disorders -thrombin

A

anticoagulation therapy, stockings, elevation, heparin

30
Q

thrombin disorders

A

preeclampsia/stillbirth caused by DIC, bleeding gums, s/s of shock, abnl clotting values

31
Q

managing thrombin disorders

A

early recognition, I+O, accurate blood loss, platelet replacement, O2, IV

32
Q

wound infections

A

laceration, episiotomy, c/s incision (staph/strep)

33
Q

risk factors of wound infections

A

obesity, diabetes, malnutrition, long labor

34
Q

S/s of wound infections

A

erythema, swelling, tender, drainage, fever, pain

35
Q

assessment of wound infections

A

REEDA, drainage, symptoms

36
Q

mastitis

A

infection/inflammation of breast tissue (staph)

37
Q

S/S of mastitis

A

tender, engorged, red

38
Q

nursing action of mastitis

A

keep breastfeeding, antibiotics, handwashing, massage

39
Q

acute onset of severe hypertension

A

more than 160/110

40
Q

management of severe hypertension

A

mag sulfate until 24 hrs after delivery, labetalol, hydralazine, nifedipine

41
Q

nursing actions of severe hypertension

A

assess BP every 5-10 mins, admin meds, monitor signs of preeclampsia

42
Q

diabetes type 1/2

A

should go back down to norm range of sugars after preg

43
Q

diabetes gestational

A

blood tests done 2-6wks post to make sure sugars are down (15-50% of getting type 2)

44
Q

mag sulfate

A

for pt at high risk for seizures from preeclampsia w severe features 24 hrs pre/post bith

45
Q

interventions for mag sulfate

A

monitor strict I+O, O2 saat, hrly BP/RR, assess DTR/lungs

46
Q

toxicity of mag sulfate

A

RR less than 12, UO less than 30ml in hr or 50ml in 2 hr, no DTR

47
Q

postpartum depression

A

severe depression in 6-12 mon postpartum w inability to care for self/infant

48
Q

risk factors of postpartum depression

A

hx of depression, anxiety, lack of support, poor relationships, complicated preg

49
Q

assessment of postpartum depression

A

sleep/appetite changes, uncontrolled crying, fear and anxiety

50
Q

manage of postpartum depression

A

psychotherapy(mild) + meds (mod) and intensive inpt treatment (severe)

51
Q

baby blues

A

3rd day post for 2 wks from hormonal changes/lack of sleep w ability to still care for child

52
Q

baby blues S/S

A

weepy, happy, exhausted, overwhelmed, emotional lability

53
Q

manage baby blues

A

rest, take time to self, monitor symptoms

54
Q

postpartum psychosis

A

variant of bipolar disorder w cog impairment and disorganized behavior in first 3 wks

55
Q

risk factors of postpartum psychosis

A

bipolar disorder

56
Q

assessment of postpartum psychosis

A

paranoia, mood swings, agitation, confusion, strange beliefs, infant/suicide

57
Q

manage postpartum psychosis

A

hosp, psych eval, therapy, remove infant

OB (9 decks)

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