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19 Cards in this Set
- Front
- Back
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UTI:
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Marked increase urine production in 1st 48 hr after delivery. Trauma to bladder, urethra, and cauterization during and after delivery.
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UTI Management:
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Urine specimen, note possibly contaminated by lochia, Teach to wipe from front to back
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UTI treatment::
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Sulfa drugs contraindicated for breastfeeding women, need broad spectrum antibiotic such as amoxicillin or ampicillin, force fluids, teach prevention methods
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Sepsis (puerperal infection):
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Leading cause of morbidity and mortality throughout the world. Presence of fever of 38 C or more on 2 successive days (not counting 1st 24 hrs) after birth
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Puerperal infection incidence:
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1-3% after vaginal birth, 5-15% after planned c/s, 30-35 % after prolonged labor and ROM. A puerperal infection is always serious,
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Endometritis infection:
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Infection of the lining of the uterus. Often begins at plantation site, spreads to entire endometrium, increased incidence after c/s.
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Endometritis infection s/s:
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Fever, increased pulse, chills, anorexia,nausea, fatigue and lethargy, pelvic pain, uterine tenderness, foul smelling, profuse lochia, elevated WBC, marked elevation RBC sed rate and anemia. Blood cx or other cx results in 48 hr.
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Wound infection:
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C-section incision site, repaired laceration or episiotomy site.S/s: erythema, edema, warmth, tenderness, seropurulent drainage, wound separation, fever and pain
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Sepsis factors: Antepartal factors:
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1. Pre-existing anemia
2. Local vag infection at time of birth. 3. DM 4. Alcoholism 5. Drug abuse 6. Malnutrition |
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Sepsis factors: Intrapartal factors:
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1. ROM over 24 hr.
2. C-section 3. Invasive procedure 4. Retained placental fragments 5. Prolonged and difficult labor 6. Postpartal hemorrhage 7. Chorioamnionitis 8. Prolonged labor 9. Multiple vag exam after ROM 10. Bladder catherize 11. Epidural 12. Episiotomy or lacerations |
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Prognosis of sepsis:
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1. Virulence of the invading organism
2. General health of the woman 3. Portal of entry 4. Degree of uterine involution 5. Presence of lacerations in the reproductive system |
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Sepsis management:
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1. C & S (1st priority)
2. Start abx 3. Monitor temp 4. If infection involves drainage, newborn visitation may be restricted 5. Handwashing before touching baby 6. Arrange for infant care |
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Mastitis is:
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Infection of the breast which occurs in 2-10% of all lactating women, rarely in non lactating women. Usually first time mothers, unilateral, staph is usual cause, infection usually enters through cracked or fissured nipples.
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Mastitis assessment:
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Localized pain in affected breast, swelling and redness, fever accompanies 1st symptoms within 24 hrs. Breast milk becomes scant
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Mastitis management:
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1. Broad spectrum abx
2. continue breastfeeding 3. pump if breastfeeding painful 4. Cold or ice compresses for pain relief 5. Warm compresses reduces inflammation 6. Supportive bra 7. prevention is best treatment |
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Post partum hemorrhage is:
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Leading cause of maternal morbidity and mortality in the US and around the world.
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Post partum hemorrhage incidence:
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Maternal exsanguinations can occur in a matter of minutes, approx 5% of all women who deliver vaginally experience PPH, 25% of all preg related deaths result from PPH
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PPH definition:
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The loss of 500 ml of blood after a vaginal birth or 1000 ml after a c-section, HCT levels that decrease 10% from pre to post birth levels also included in definition
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PPH priority:
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Don't massage uterus with 2 hands, call for help, had full bladder, preeclamptic, have mag sulfate
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