Post Partum Complications 1

Front 1

temperature best signals postpartal infection?

Back 1

A temperature over 100.4°F (38°C) after the first 24 hours is suggestive of postpartal infection.

Front 2

Normal wbc count postpartal?

Back 2

WBC of 20,000 to 30,000 mm3 probably as a result of inflammation of the uterus

Front 3

Massaging a uterus is a measure to control postpartal bleeding. To do this, you would

Back 3

place one hand at the base of the uterus to anchor it.

Front 4

A saturated perineal pad contains approximately how much blood?

Back 4

Weighing pads to determine the weight (1 gm = 1 mL) is as an effective way to determine the amount of blood in a pad (about 25 to 50 mL).

Front 5

All women in the postpartum period are at high risk for thrombophlebitis. This is because

Back 5

-stasis of lower extremity vessels due to dilation.
-Stasis in dilated vessels leads to increased clotting.

Front 6

If a woman develops a deep vein thrombus in the femoral vein, a common intervention would be to

Back 6

-apply moist heat over the site
-.Moist heat helps to decrease inflammation and prevent further clotting.

Front 7

The antidote for Warfarin (Coumadin) is

Back 7

Vit K
-Coumadin blocks the hepatic synthesis of vitamin-K-dependent clotting factors, supplying vitamin K increases these factors and counteracts the effect of the drug

Front 8

high risk for urinary retention postpartally?

Back 8

large fetus can cause urinary retention
-Bladder edema can lead to decreased emptying ability

Front 9

Uterine atony,

Back 9

or relaxation of the uterus, is the most frequent cause of postpartal hemorrhage.
-The uterus must remain in a contracted state after birth to keep the open vessels at the placental site from bleeding.

Front 10

the first step in controlling hemorrhage is

Back 10

uterine massage to encourage contraction

Front 11

fundal Massage should be done only when.

Back 11

uterus is not firm; otherwise muscle fatigue and uterine relaxation may occur

Front 12

Aggressive fundal massage may lead to

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partial or complete uterine prolapse.

Front 13

Third degree Perineal Lacerations:
Fourth degree

Back 13

3rd: Entire perineum, extending to reach the external sphincter of the rectum

-4th: Entire perineum, rectal sphincter, and some of the mucous membrane of the rectum

Front 14

Nursing interventions for 3rd and 4th degree perineal laceration

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-No enema or rectal suppository
-no rectal temp

Front 15

incomplete return of the uterus to its prepregnant size and shape.

Back 15

Subinvolution
-uterus is enlarged & soft at 4-6 wks postpartal
-locial d/c present
-cause:retained placental fragment (a mild endometritis)
or uterine myoma

Front 16

endometritis:

Back 16

infection of the endometrium

Front 17

A chronic loss of blood from subinvolution will result in infection or anemia and lack of energy, conditions that possibly could interfere with

Back 17

infant bonding.

Front 18

Oxytocic drugs are going to be prescribed for the retained placental fragments (POC), how do you know the drug is effective?

Back 18

-if pt c/o cramping
uterus is come down 1 fingers breath/day
if uterus does not come down= subinvolution

Front 19

an infection of the endometrium, the lining of the uterus

Back 19

Endometritis

Front 20

S/S of endometritis:

Back 20

chills, loss of appetite,
general malaise
uterus painful to touch, not contracted well
lochia will be dark brown w/ foul odor

Front 21

Should complete bed rest be recommended for this pt?

Back 21

No
-Sitting in a Fowler's position or walking encourages lochia drainage by gravity and helps prevent pooling of infected secretions.

Front 22

infection of the peritoneal cavity, usually occurs as an extension of endometritis.

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Peritonitis
- It is one of the gravest complications of childbearing and is a major cause of death from puerperal infection

Front 23

Tx for thrombophelbitis (DVT):

Back 23

Treatment consists of strict bed rest w/ the affected leg elevated, admin of anticoagulants, and application of moist heat.

Front 24

Drug prevents formations of more clots but doesn't dissolve the clot
-given to pt's w/ DVT?

Back 24

Heparin drip
-lochia will increase w/ an anticoagulant
-safe to breastfeed w/ heparin but not coumadin

Front 25

How is DVT assessed/dx or confirmed?

Back 25

Homan's sign (pain in the calf of the leg on dorsiflexion of the foot
-skin: stretched from swelling, shiny and white
*Confirms DVT: doppler ultrasound or venography

Front 26

Cause of urinary retention (impaired urinary elimation r/t)?

Back 26

-use of anesthesia
-trauma
-infection
-deviated fundus

Front 27

What assessment would indicate pt is having urinary retention?

Back 27

-Voiding is very frequent & in small amounts; her overall output is inadequate. Always measure the amt of a woman's first voiding after birth. As a rule, if this voiding is < 100 mL, suspect urinary retention

Front 28

Amt of urine output post partum?

Back 28

3000mL/day

Front 29

urinary retention is confimed by:

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catheterizing a woman immediately after she voids. If the amt of urine left in the bladder after voiding (termed residual) is < 100 mL, the woman has retention of more than the normal amount