QUIZ 5: NURSING CARE OF A FAMILY EXPERIENCING A POSTPARTAL COMPLICATION Flashcards
pulmonary embolism, anemia, hypertension (eclamptic patient)
Cardiogenic
clotting disorders, postpartum hemorrhage
Hypovolemic
allergic response
Anaphylactic
puerperal infection (bacterial infection of the uterus)
Septic
Occurs when volume of blood is depleted and cannot fill the circulatory system
If not corrected quickly, the woman can die
HYPOVOLEMIC SHOCK
Initially: increase heart (tachycardia) and respiratory rates (tachypnea)
Body’s response to hypovolemia
occurs when a woman loses more than 500 mL of blood in a normal delivery and more than 1000mL of blood in a cesarean delivery within 24 hours period
POSTPARTAL HEMORRHAGE
relaxation of the uterus
UTERINE ATONY
Small ___ or tears of the birth canal are common and considered normal consequence of childbearing
lacerations
Found on the sides of the cervix
Blood loss if artery is torn
CERVICAL LACERATIONS
Vaginal tissue is friable, ___ are hard to repair
May be packed to maintain pressure on the suture line
VAGINAL LACERATIONS
Sutured and treated as an episiotomy repair
PERINEAL LACERATIONS
Collection of blood within tissue
Birth trauma, usually on vulva or inside vagina
If seen looks like bulging bluish or purplish mass
Unrelenting pain unrelieved by analgesics
Perineal Hematoma
Causes
Retention of placental fragments
Subinvolution
LATE POSTPARTUM HEMORRHAGE
The slower-than-expected or failure of the uterus to return to its normal prepregnant condition
Normally the uterus descends at the rate of 1 cm per day
SUBINVOLUTION OF THE UTERUS
Placenta not delivered in its entirety; fragments of it separate and are left behind
Retained portion keeps the uterus from contracting fully, uterine bleeding occurs
RETAINED PLACENTAL FRAGMENTS
A venous thrombosis is a blood clot within a vein
THROMBOEMBOLIC DISORDERS
is inflammation of the lining of a blood vessel
Phlebitis
is inflammation with the formation of blood clots
Thrombophlebitis
An infection or ___ after childbirth, with a fever of 38° C (100.4° F) after the first 24 hours and for at least 2 days during the first 10 days postpartum
septicemia
An infection of the breast – occurs usually 2-3 weeks after birth
Organism causing infection usually enters through cracked and fissured nipples
MASTITIS
It is the infection of endometrium, the lining of the uterus.
The clinical manifestation of this are fever, elevated WBC PP, chills,loss of appetite, general malaise, uncontracted uterus and painful to touch, dark brown lochia
ENDOMETRITIS
An infection at the peritoneal cavity that usually occurs as an extension of endometritis.
This is one of the gravest complications of childbearing and
high mortality rate from puerperal infection.
The infection spreads through lymphatic system or fallopian tubes
PERITONITIS
Result of inadequate bladder emptying
Bladder sensation for voiding is decreased because of bladder edema caused by pressure of birth
URINARY SYSTEM DISORDERS
___ is a pervasive and sustained emotion that can color one’s view of life.
MOOD DISORDERS
Common after birth
Mother has periods where she feels let down
Overall finds pleasure in her new role as a mother
Usually self-limiting as woman adjusts to her new role
POSTPARTUM BLUES “BABY BLUES”
Serious impairment of one’s perception of reality
More serious than postpartum blues
Usually manifests within 4 weeks after delivery
May interfere with mother’s ability to respond to her infant’s cues
Maternal-infant bonding may also be affected
POSTPARTUM DEPRESSION
Characterized by episodes of mania
Bipolar disorders
Deep feelings of worthlessness, guilt, and sleep and appetite disturbances
Major depression
Lack of permanent home
Often have difficulty accessing care
Follow-up is difficult
Prior to discharge, ensure mother has a place to go and a way of accessing help
HOMELESS MOTHER AND NEWBORN