PP Complications Flashcards
define PP hemorrhage after vaginal birth
> 500 cc
define PP hemorrhage after c sec
> 1000 cc
what is the biggest problem with PP hemorrhage?
- life threatening with little warning
- unrecognized until there are profound s/s
PP hemorrhage etiology/risk factors
-uterine atony
- lacerations of the genital tract
- hematoma’s
-retained placenta
adherent or non adherent
-inversion of the uterus
-subinvolution of the utrus
def inversion of the uterus
turning inside out of the uterus
s/s of subinvolution of the uterus
- late PP bleeding
- prolonged lochial discharge
- irreg bleeding
PP hemorrhage assessment
- early recognition critical
- eval contractility of the uterus
PP hemorrhage interventions
- eval contractility of the uterus
- firmly massage fundus
- call for help STAT
- admin IV fluids and meds to manage bleeding
- may give pitocin to contract the uterus
- try to get pain meds to mom
- glove up
- manually pull out placental residue
def thromboembolism
blood clot caused by inflammation or partial obstruction of bv
causes of thromboembolism
venous stasis
hypercoag
def Puerperal sepsis
any infec of the genital canal within 28 days after abortion or birth
what are the most common infec agents in PP infecs?
streptococcal
anaerobic
most common PP infecs
- endometritis
- wound infecs
- UTI’s
- mastitis
what is the difference bx engorgement and mastitis
- engorgement may cause temp to go up a little, not a lot
- mastitis is infec of the breast
s/s of mastitis
fever weakness engorgement redness swelling discharge
can a mom breastfeed if she has mastitis
yes
can a mom breastfeed out of the infected breast with mastitis
yes
what common abx is used for the tx of mastitis
Lorabid
can a mom nurse while on an abx for mastitis
yes
disorders of uterus/vagina r/t childbearing
- uterine displacement/prolapse
- urinary incontinence
which is more serious: uterine displacement or prolapse?
prolapse
def cystocele
protrusion of the bladder downward into the vagina when support structures in vescovaginal septum are injured
def rectocele
herniation of the anterior rectal wall through relaxed or ruptured vaginal fascia and rectovaginal septum
who does PP mental health disorders affect?
-mother
baby
entire family
how does PP MH disorders affect PP
- interferes with attachment to newborn
- interferes with fam integration of the newborn
- threatens safety of mother, newborn, other children
what is the difference bx baby blues and PP depression
- 70% of women experience baby blues after birth
- PP depression causes mom inability ot care for herself, baby, other children
def PP depression w/o psychotic features
- an intense and pervasive sadness w/ severe and labile moods swings
tx for PP depression
antidepressants
anxiolytic agents
ECT
psychother
what are psychother foci
fears and concerns of new repsonsibilities and roles
monitoring for suicidal or homicidal thoughts
def PP depression w/ psychotic features
syndrome char by depression, delusions, hallucinations, and thoughts of harming infant or self
PP depression w/ psychotic features is considered a Psych emergency
true
tx options of PP depression w/ psychotic features
antipsychotics
mood stabilizers - lithium
when can loss and/or grief be perceived?
- loss of hoped for, dreamed about, planned
- loss of control during birth experience
- birth of child w/ handicap
- maternal or fetal/neonatal death
what is the most common and serious OB PP complcation
PP hemorrhage
t/f- hemorrhagic shock is considered an emergency
true
how does hemorrhagic shock affect the body?
- decr blood perfusion to body organs severely compromised
- death
