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RLE > WARD SEMI MATERNA > Flashcards

WARD SEMI MATERNA Flashcards

1
Q

what rises and falls during pph

A

rise in pulse rate and fall of bp

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2
Q

pph occurs within

A

24 hours of childbirth but can also happen up to 12 weeks postpartum

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3
Q

how much ml of blood does a woman nsvd loses

A

500 ML

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4
Q

cesarean delivery within 24 hrs loses how much amount of blood

A

1Liters

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5
Q

Caesarian Hysterectomy blood loss vol

A

2L

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6
Q

state the
BP:
s&s:
DoS:

BV: 500-1000ml

A

Normal
palpitate, tachy, dizzy
compensated

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7
Q

state the
BP:
s&s:
DoS:

BV: 1000-1500

A

fall 80-100
weak, tachy, sweating
Mild

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8
Q

state the
BP:
s&s:
DoS:

BV: 1500-2000

A

70-80
restlestness, pallor, oliguria
moderate

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9
Q

state the
BP:
s&s:
DoS:

BV: 2000-3000

A

50-70
collapse, airhunger, anuria
severe

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10
Q

(the 6-week period of time
Classification based on amount of blood loss beginning immediately after birth)

A

puerperium

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11
Q

Classification based on amount of blood loss

A

● Minor: less than 1000 mL

● Major: greater than 1000 mL

● Severe: greater than 2000 mL

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12
Q

which stage of pph is where bleeding occurs before the
expulsion of the placenta.

A

3rd Stage Hemorrhage

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13
Q

which stage of pph is where Bleeding occurs after the expulsion of the placenta.

A

True Postpartum Hemorrhage

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14
Q

pph that occurs beyond 24 hours and within
puerperium

A

Secondary PPH

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15
Q

examples of Trauma

A

laceration
hematomas
uterine rupture

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16
Q

bleeding because the placental sites have
closed. This is referred to as

A

Tone

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17
Q

Retained placental fragments. This is also referred to as

A

tissue

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18
Q

DIC meaning

A

disseminated intravascular coagulation

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19
Q

Development of (DIC). This is also referred to as

A

Thrombin

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20
Q

four T’s of postpartum hemorrhage

A

tone, trauma, tissue and
thrombin.

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21
Q

word to describe uterus during tone

A

boggy

22
Q

examples on how uterus looks

A

excessive bright red bleeding

boggy uterus

high fundus

abnormal clot

23
Q

Causes for tone: Maternal

A

multipara
previous history of pph
Maternal anemia

24
Q

Causes for tone : pregnancy compli

A

Antepartume hemorrhage
overdistention of uterus

25
Q

Causes of tone: labour

A

Prolonged labour
induction of labor
Precipitate labor

26
Q

Causes of tone: drugs

A

Anesthetic drugs
Magnesium
Nifedipine

27
Q

therapeutic management of tone

A

bimanual compression

Administer oxytocin (PITOCIN)

28
Q

Therapeutic management : tone (drugs)

A

Carboprost 0.25 IM

Misoprostol 1,000 mg rectally

Methylergonovine 0.2 mg IM

29
Q

Trauma sites:

A

○ Vulva
○ Vagina
○ Perineum
○ Cervix
○ Paraurethral region
○ Rupture uterus

30
Q

Therapeutic management include: Trauma

A

○ Suture lacerations

○ Drain hematomas > 3 cm

○ Replace inverted uterus

31
Q

Retained tissue:

A

Bit of placenta
Blood clot

32
Q

Therapeutic management include: for retained tissue

A

○ Manual removal
○ Curettage
○ Methotrexate

33
Q

cause of thrombin

A

diminished pro coagulants (washout effect)

or increased
fibrinolytic activity.

34
Q

Conditions leading to thrombosis:

A

Placental abruption

Jaundice in pregnancy

Prolonged retention of dead fetus

Thrombocytopenic purpura

35
Q

Therapeutic management include: Thrombin

A

○ Fresh frozen plasma
○ Recombinant factor VIIa
○ Platelet transfusion

36
Q

RISK FACTORS: postpartum

A

distend the uterus

cervical or uterine lacerations

Inadequate blood coagulation

Uterus could not contract readily

37
Q

common symptoms of postpartum hemorrhage.

A

● Uncontrolled bleeding

● Decreased blood pressure

● Increased heart rate

● Decrease in the red blood cell count (hematocrit)

38
Q

. If the uterus is unable to contract, the physician might prescribe _____ to
maintain the tone of the uterus.

A

Pitocin

39
Q

a prostaglandin derivative that could help in
promoting sustained uterine contractions.

A

Carboprost tromethamine

40
Q

necessary to replace the blood loss.

A

Blood transfusion

41
Q

measurement of o2 to admnister

A

4L/min via face mask

42
Q

SURGICAL MANAGEMENT:

A

Hysterectomy

Suturing

43
Q

Nursing Assessment: PPH

A

● Assess the amount of bleeding.

● Assess maternal vital signs

● Assess for signs of shock.

● Assess the condition of the uterus.

44
Q

Assess ______frequently to determine if the amount discharged is still within the normal limits.

A

lochia

45
Q

POSSIBLE COMPLICATIONS:pph

A

Hypovolemic Shock

Anemia

Coagulation Disorders

Organ Damage

Infection

46
Q

Prolonged low blood flow can lead to damage in vital organs, such as

A

kidneys

heart

47
Q

condition that occurs due to severe blood loss and insufficient blood flow to the pituitary gland
during or after childbirth

A

SHEEHAN SYNDROME

48
Q

SHEEHAN SYNDROME is presented as what deficiency

A

anterior pituitary hormone deficiency

49
Q

Antenatal: management:

A

● Improvement of the health status (keep the
Hb level normal, >10 g/dl)

● Blood grouping

● Placental localization must be done

● Women with morbid adherent placenta with
high risk PPH delivered by senior consultant

50
Q

Intranatal: management

A

● Active management of 3rd stage of labor

● For cases with induced or augmented labor by
oxytocin, the infusion should be continued for
at least 1 hour after delivery

● Women delivered by caesarean given
oxytocin 5IU slow IV

● Exploration of uterovaginal canal for evidence
of trauma

RLE (33 decks)

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