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NCB IV > pp complications > Flashcards

pp complications Flashcards

1
Q

etiology of pp cramping

A

rhythmic contractions pp in attempt to involute uterus

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2
Q

risk factors for pp cramping

A

prolonged labor
poor muscle tone
over-distension of uterus
multiparity

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3
Q

ssx pp cramping

A

mild to severe cramps usu beginning in 4th stage
may last hours to days
comes and goes
often accompanies latching and nursing

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4
Q

managment of pp cramping

A

keep bladder empty
massage frequently
nurse baby regularly

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5
Q

when is pp cramping abnormal?

A

pain after 3 days

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6
Q

prenatal uterine tonic to prevent cramping

A

rubus 2 pts, medicago 1 pt, urtica 1 pt
infuse for 15 mins, drink 1 cup 2x/day
start by 36 weeks

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7
Q

partus prepator formula

A

caulophyllum 4dr, cimicifuga 4dr

15gtt/day, start week 37

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8
Q

caulopyllum

A

30gtt/hr, then prn: pains dt debility, fullness and weight in pelvis, pains in legs.

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9
Q

cimicifuga

A

30gtt/hr, then prn: tense, aching pains

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10
Q

gelsemium

A

10-20gtt/2hrs prn; pains dt nervous exhaustion. *DO NOT GIVE IMMEDIATELY POSTPARTUM

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11
Q

leonorus

A

30gtt/hr prn; gentle anti-spasmodic, uterine tonic, laxative

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12
Q

viburnum

A

20gtt/15min, then prn; sever, spasmodic pains

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13
Q

arnica 200c

A

3pellets s.l./hr x 3hr; achey, bruised pain w shocky, dazed sensorium. Does not want to be touched.

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14
Q

bellis perennis 200c

A

intense soreness, bruised feeling dt trauma,

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15
Q

mag phos 30c, 200c

A

cramping, spasmodic pains, intense, can be sharp.

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16
Q

etiology of hemorrhoids

A

increased venous stasis
physical pressure of baby’s weight
valsalva pressure during 2nd stage

17
Q

risk factors for hemorrhoids

A

existing hemorrhoids
prolonged 2nd stage
poor nutrition
obesity

18
Q

ssx hemorrhoids

A

pain
protruding, bulging veins
bleeding

19
Q

management of hemorrhoids

A 
counter-pressure during 2nd stage
inflatable donut cushions
sitz bath- achillea, quercus, plantago, symphytum, hammemelis
epsom salts
suppositories
keep stools soft
20
Q

risk factors for hematomas

A 
varicosities
prolonged 2nd stage
excessive use of perineal stretching
instrumentation
macrosomia
21
Q

ssx hematoma

A 
swelling
bruising
pain
displacement of uterus
signs of shock
22
Q

management of hematoma

A

apply pressure- truss, ice pack, sanitary pad
stop bleeding
prevent infx

23
Q

etiology urinary incontinence

A

weakened pelvic structures including muscles, ligaments, bladder sphincter

24
Q

risk factors urinary incontinence

A 
prolonged 2nd stage
poor nutrition
intrapartum or PP urinary retention
obesity
multiparity
25
Q

ssx urinary incontinence

A

incontinence due to stress (valsalva)

cystocele

26
Q

managment of urinary incontinence

A

pelvic floor exercise

27
Q

botanicals for urinary incontinence

A

Arnica - 5gtt tid: Incontinence due to bruising and trauma
Achillea - 30gtt qid : Incontinence due to tissue laxity. (Astringent)
Claviceps - 10gtt tid: Weakness of the bladder. Caution, toxic botanical.
Helonias - 30-60 gtt tid: Incontinence due to prolapse (tones pelvic tissue)
Piper - 20gtt tid: Tones urinary apparatus
*CAUTION: can have sedative effect on nursing newborn.
Thuja - 20gtt qid: Weak bladder sphincter, dribbling with cough

28
Q

homeopathics for urinary incontinence

A

Helonias - Stress incontinence dt prolapse, weak feeling in pelvis
Nat mur - Involuntary when walking, coughing. Good after disappointing birth experience.
Pulsatilla - Involuntary urination worse with coughing and passing flatus, < at night
Sepia - Involuntary urination, esp during first sleep, pelvic weakness and uterine prolapse, slow sluggish urination.
Staphysagria - incontinence due to cystocele, feeling pressure on bladder.
Causticum- night watching and worry about something bad happening to baby

29
Q

what is the biggest risk of thrombosis?

A

PE

30
Q

risk factors for thrombosis

A 
c-section
>35yo
high parity
obesity
suppression of lactation
smoking
immobility
trauma to legs
31
Q

ssx thrombosis

A

superficial thrombophlebitis- tenderness, veins hard/red/warm
DVT- pain, homan’s sign, swelling

32
Q

management of thrombosis

A 
prophylactic tx- prevent trauma, exercise
prompt tx of DVT:
supportive hoses/bandages, legs elevated
Vit E 400-1200IU
Bioflavonoids – GSE, pycnogenol, diosmin (Thorne)
Immune stimulating herbs
Bromelain 1000mg 4x/d (3rd tri only)
Heparin/Warfarin
33
Q

ssx PE

A 
severe CP
dyspnea
shock
slight hemoptysis
collapse
cyanosis
hypotension
34
Q

what is an amniotic embolism?

A

amniotic fluid enters maternal circ, can obstruct pulmonary vessel but MC causes anaphalaxis

35
Q

risk factors for amniotic embolism

A

precipitous labor
multiparity
excessive use of oxytocic drugs
uterine trauma

36
Q

ssx amniotic embolism

A 
sudden onset dyspnea
rapid shallow breaths
pulmonary edema
tachycardia
hypotension
convulsions/seizures
pt often says she is going to die

NCB IV (7 decks)

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