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nur 112 > pp complications > Flashcards

pp complications Flashcards

1
Q

Traditionally, postpartum
hemorrhage (PPH) has been
defined as greater than _______
mL estimated blood loss associated
with vaginal delivery or greater
than ________estimated blood loss
associated with cesarean delivery.

A

500 ml and 1000 ml

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2
Q

Meds Route
* oxytocin (Pitocin * BRAND*):
* methogonovine (Methergine):
* carboprost (Hemabate):
* misoprostol (Cytotec):

A

IV, oral

IM

IM

RECTAL/ ANTI ULCER

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3
Q

UTERINE TAMPONADE & CURETTE

DNC

A

stop post-partum hemorrhage due to a relaxed uterus
& to remove the uterine tissues during surgical procedures.

scrapping

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4
Q

Bimanual Compression done by:

A

Physician

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5
Q

1gm = _____ ml blood loss

dry-wet

A

1ml

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6
Q

hematoma

A

a bad bruise. It happens when an injury causes blood to collect and pool under the skin

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7
Q

PUERPERAL INFECTION

postpartum infection

A

infection of the genital tract occurring at labour or within 42 days of the postpartum period
.bacteria infect the uterus and surrounding areas after a female gives birth. It’s also known as a postpartum infection.

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8
Q

postion to put pt in shock in

A

trendelenburg position

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9
Q

CYSTITIS
* Prevention!!!
* Hand washing – NURSE and Patient

A

Cystitis is inflammation of the bladder, usually caused by a bladder infection
There is also increased pressure on your bladder, which can reduce the flow of your urine and lead to an infection.

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10
Q

GESTATIONAL HTN ( this is the base) * when can you diagnosis/ values*

A

After 20 weeks in normotensive women
140/90 x 2 taken at least 4 hrs apart

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11
Q

PRE-ECLAMPSIA ( branch of gestational diabetes)
( when/ how long/ signs)

A

After 20 weeks

Can happen up to 6 weeks PP

Warning signs: Severe headache, visual
changes, epigastric pain, Proteinuria, swelling

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12
Q

Mild VS Severe PRE-ECLAMPSIA

A

BP>140/90 , Proteinuria>300mg/24
hr or 30 dipstick

BP > 160/110, Proteinuria>2
g/24hr

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13
Q

Risk Factors

preeclampsia/ 11

A

HISTORY OF :
-HIGH BLOOD PRESSURE,
- KIDNEY DISEASE
- DIABETES
-EXPECTING MULTIPLES
FAMILY HISTORY OF PREECLAMPSIA
*AUTOIMMUNE CONDITIONS
*AMA
*AFRICAN AMERICAN
*1ST PREGNANCY
*IVF
*PCOS
*OBESITY

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14
Q

Taking a baby aspirin

purpose…think about major complications

A

daily starting
in early pregnancy (by 12 weeks
gestation) has been demonstrated
to decrease the risk of developing
preeclampsia by approximately 15% .

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15
Q

MAP –MEAN ARTERIAL Pressure

A

Systolic BP + 2 (diastolic BP)
3
120/80 = 120 + 160 = 93

Preeclampsia  MAP > 105

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16
Q

Normal pregnancy is a vasodilated state

A

50% >blood volume
30% cardiac output
> GFR
Pre-eclampsia
Vasoconstriction
Can affect all organ systems
Renal, hepatic, coagulation, CNS

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17
Q

Hyperreflexia with pre-eclampsia

A

a person’s reflexes become unusually active. Increasing blood pressure will lead to increasing hyperreflexia (overactive reflexes), until eventually uncontrollable seizures result

18
Q

Normal reflex is

A

+2

19
Q

ECLAMPSIA (whats the sign to say this is eccmaplmsia)

A

Signs- Headache, blurred vision, severe
epigastric/abdominal pain, altered LOC

Convulsions
Maintain airway
Fetal monitoring

20
Q

Magnesium Sulfate (MgS04) ; IV
* Toxicity
* Level >

  • anditote for mg toxicity =
A

Level > 9.6 mg/dl
< RR, hyporeflexia, fetal distress

  • Antidote; calcium gluconate Calcium
    antagonizes the action of magnesium at a cellular
    level. It is very effective in reversing the clinical
    effects of magnesium toxicity
21
Q

MAGNESIUM SULFATE
*

A

Prevents convulsions by depressing the
central nervous system and blocking the
transmission of nerve signals to the
muscles to make them contract
* Reduces the release of acetylcholine, a
chemical that nerve cells secrete to
make muscles contract

22
Q

MAINTAIN UTERINE PERFUSION

A

Left side lying
* O2 if Pulse ox < 95%
* FHT with doppler

23
Q

HELLP SYNDROME

  • Hemolysis
    Hbg <
  • Low Platelet Count
    <
A
  • Hemolysis
    Hbg <6
  • Elevated Liver Enzymes
    AST/LST (MIRCO THROBMIN IN LIVER DAMAGE HEPATIC CELLS)
  • Low Platelet Count
    < 100,000
24
Q

INTERVENTIONS Preeclampsia

A

Deliver if still pregnant
Assess for hemorrhage if newly PP

Plasma volume expander
* Antihypertensive – labetalol
* Weekly BP x6weeks PP
* Liver function tests up to 3-6weeks PP

25
Q

lassitude

A

It’s a signal from your body to slow down and give it time to adjust to the incredible changes happening inside.

26
Q

Coagulation Disorders( causes 5)

A

Coagulation pathways are hyperstimulated
Depletes clotting factors leading to hemorrhage
* Causes:
* Abruptio placenta (primary cause)
* HELLP
* Amniotic Fluid Embolism (AFE)
* Anaphylactic syndrome of pregnancy
* Sudden Dyspnea
* Can occur during pregnancy, labor, birth or within
the first 24hours of PP period
* Two stage process when amniotic fluid that
contains fetal cells enters the maternal vascular

27
Q

Abruptio placenta

A

a serious condition in which the placenta separates from the wall of the uterus before birth.

28
Q

Disseminated (all over the place) intravascular (within the blood vessels) coagulation (blood clots).

( s/s , whats going on)

A

Coagulation Disorders: coagulation pathways hyper-stimulated and woman’s body breaks down clots faster than can form them- quickly depletes body of clotting factors, leading to massive hemorrhage and deat

Purpura at pressure sites
Abnormal clotting study
* Anxious
* Signs of shock r/t to blood
loss

  • Panic, Pale and clammy
    skin, tachycardia,
    tachypnea, hypotension
29
Q

INTERVENTIONS DIC

A
  • Emergency- treat for shock
  • VS
  • Foley, I&O
  • Oxygen
  • Fluids/Blood
  • D-Dimer
  • IV Heparin
30
Q

POSTPARTUM
CARDIOMYOPATHY

A

Can be due to fluid volume
overload during labor
* Risk factors

31
Q

BABY BLUES

A
  • Education needs to start in the prenatal period
  • The baby blues can be affected by lack of
    sleep, stress and hormonal changes
  • Baby blues tend to peak in that first week
    after delivery and resolve within the first two
    weeks
  • The key is severity
32
Q

early hemorrhage vs late

A

early: 1 to 24 hrs

late: after 24 hrs

33
Q

PRIMARY CAUSES OF PPH - 4 T’S

Tone-
Tissue-
Trauma-
Thrombin disorders-

A
  • Tone- Uterine Atony
  • Tissue- Retained tissue fragments
  • Trauma- Lower genital tract
    lacerations
  • Thrombin disorders- Disseminated
    Intravascular Coagulation (DIC)
34
Q

Anaphylactoid syndrome of pregnancy

A

is a rare emergency with significant mortality and morbidity, in which the amniotic fluid and fetal cells enter the maternal circulation leading to respiratory failure, altered mental status, hypotension, and disseminated intravascular coagulation

35
Q

endometriumitis

A

. Inflammation of the uterus can cause scarring

36
Q

mastitis

A

Mastitis is inflammation (swelling) in the breast, which is usually caused by an infection. It is most common when a woman is breastfeeding, but it can happen at other times as well. A clogged milk duct that doesn’t let milk fully drain from the breast, or breaks in the skin of the nipple can lead to infection.

37
Q

MAP

A

SBP + 2 (DBP)/ 3

38
Q

medication to avoid :

A

aspirin

39
Q

Imminent Convulsion

A
40
Q

subcapsular hemorrhage

A

an accumulation of blood between Glisson’s capsule and the liver parenchyma;

nur 112 (23 decks)

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