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Maternal Newborn-MJ > T3-Post-Partum Complications > Flashcards

T3-Post-Partum Complications Flashcards

1
Q

What is PPH?

A

Blood loss greater than 500 mL in 24 hours

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2
Q

What is early PPH?

A

Within 24 hours of delivery

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3
Q

What is late PPH?

A

After first 24 hours of delivery

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4
Q

What are some common causes of PPH? (6)

A
  • Uterine atony
  • Lacerations
  • Retained placenta (or fragments)
  • DIC
  • Inversion of uterus
  • Subinvolution of uterus
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5
Q

What is the number one cause of PPH?

A

Uterine atony

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6
Q

What is uterine atony?

A

Failure of muscles to contract effectively could be due to overstretched muscle from multiple preg, polyhydraminos, or macrocosmic infant

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7
Q

What are some clinical signs of uterine atony? (3)

A
  • Hypotonic uterus (boggy)
  • Excessive blood loss
  • Hypotensive shock
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8
Q

What are s/s of hypotensive shock?

A
  • Tachycardia and tachypnea
  • BP decreasing
  • Skin changes (cool, clammy, pallor)
  • Restlessness and dyspnea
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9
Q

What are some drugs used for PPH?

A
  • Pitocin
  • Methergine
  • Prostin E2 (mom may throw up with this one)
  • Prostaglandin
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10
Q

PPH r/t lacerations What are the clinical signs?

A
  • Continuous trickle of blood; firm fundus (this is the big clue…if she is saturating pads but her fundus is firm, check for laceration!)
  • Decreasing Hct
  • S/s of hypovolemic shock
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11
Q

PPH r/t lacerations…What is treatment?

A
  • Surgical repair if necessary
  • Hygiene and sit baths
  • Nothing PR
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12
Q

PPH r/t hematoma

What are clinical signs?

A
  • Pressure
  • VS or skin color changes
  • Hct lower w/o apparent blood loss
  • Bulging mass
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13
Q

PPH r/t retained fragments of placenta

What are signs?

A
  • Dark colored bleeding
  • Large clots
  • Boggy uterus (even past massage)
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14
Q

PPH r/t retained fragments of placenta

What is treatment?

A
  • Control bleeding with drugs (oxytocin)
  • Sonogram
  • Curretage and antibiotics
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15
Q

Coagulation problem with bleeding and increased clotting occurring at the same time

A

DIC

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16
Q

What is treatment of DIC?

A

Correct underlying problem

17
Q

Uterus soft and boggy causing bladder to be distended and displaced= ?

A

Uterine atony

18
Q

A cut above causing bright red bleeding in spite of contracted uterus= ?

A

Laceration(s)

19
Q

Left behind so a soft/non-contracted uterus with slow trickle of dark red blood= ?

A

Retained placenta

20
Q

If uterine atony, lacerations, and retained placenta have all been ruled out, what may be the problem?

A

Coagulation problems

21
Q

What are some objective symptoms of hypovolemic shock? (6)

A
  • Peripad soaked w/in 15 min
  • Complaint of light-headed or dizzy
  • Appears anxious; air hunger
  • Skin cool and clammy; pale
  • HR increased
  • BP decreased
22
Q

What are some interventions for PP Hypovolemic shock?

A
  • Stay with client
  • Notify physician
  • Massage fundus/expel clots
  • *LR or NS per primary line
  • Oxytoxic med
  • Indwelling catheter
  • Prep for possible surgery
23
Q

Collection of platelets and fibrin on a vessel wall

A

Thrombus

24
Q

Confined to lower leg involving superficial veins

A

Superficial thrombosis

25
Q

Clot dislodges and settles in the pulmonary artery

A

PE

26
Q

Veins from lower leg to femoral region

A

DVT

27
Q

What is the definition of puerperal infection?

A

Elevated temp of 100.4 or higher or 2 successive days of the first 10 PP days (not counting first 24 hours)

28
Q

What are risk factors for PP infection?

A
  • ROM more than 24 hours before delivery
  • Placental fragments retained (growth medium for bacteria)
  • Anemia
  • Difficult labor (suction or forceps)
  • C-section
29
Q

Symptoms of PP infection?

A
  • Fever
  • Chills
  • Abdominal tenderness; strong afterpains
  • Lochia (increased or scant; dk brown in color)
  • WBC elevated
30
Q

Is it ok to obtain a culture from a peripad?

A

No; culture vagina

31
Q

Treatment of PP infection: What do we do/give to encourage UC?

A

Encourage fluids; give oxytoxic agent

32
Q

Treatment of PP infection: What positioning to do put client in to prevent pooling of secretions?

A

High fowlers

33
Q

Breast infection r/t staph

A

Mastitis

34
Q

Symptoms of mastitis?

A
  • Fever to 103 or greater and with chills
  • Breast reddened, hard (abscess)
  • Elevated WBC
35
Q

What is treatment for mastitis?

A
  • Antibiotics (Pen G 48-72 hours; cephalexin for 10-14 days)
  • Warm compresses before feeding
  • Pump to empty breasts
  • I&D of abscess

*some physicians recommend breastfeeding be discontinued temp–pen does cross into milk but wouldn’t harm baby

Maternal Newborn-MJ (29 decks)

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