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25 Cards in this Set
- Front
- Back
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Postpartum infections |
any clinical infection of the vaginal canal and perineum that occurs within 28 days of delivery |
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Women predisposed to infection include those with |
-ROM> 24 hrs -any lacerations or operative incisions -hemorrhage -hematomas -lapses in aseptic technique before/after delivery -anemia or poor physical health before delivery -intrauterine manipulation, manual removal of placenta, retained placenta fragments |
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Women predisposed to puerperal morbidity include |
-with a temp of 38C or higher -in whom morbidity occurs within first 24 hrs after delivery -in whom temp elevation occurs on 2 successive days or in 2 successive 4hr assessments |
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Most common organisms of infection |
streptococcal and anaerobic organisms least common is staphylococcus |
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Assessment data for for perineal infection |
-temp 38.3C to 40C -red, swollen, very tender perineum (episiotomy site) -purulent drainage, induration |
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Assessment data for for endometritis (infection of lining of uterus |
-temp 38.3C-38.8C -pulse >100 -malaise, anorexia -excess fundal tenderness long after it is expected -uterine subinvolution -lochia returning to rubra from serosa -foul-smelling lochia |
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Assessment data for for parametritis (pelvic cellulitis) |
-temp 39.4C-40C -tachycardia, tachypnea -severe uterine and cervical tenderness -WBC >25,000 -palpable pelvic abscess |
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Assessment data for for peritonitis |
-chills and temp to 105F -rapid, thready pulse -decrease UO -paralytic ileus, abdom distention, absence of bowel sounds |
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Assessment data for for thrombphlebitis (deep vein) |
-minimal fever -positive homan sign -pain in calf or dull ache in leg -swelling in extremity below pain |
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Assessment data for for UTI or cystitis (bladder) |
-slight or no fever -dysuria, freq, urgency, suprapubic tenderness -hematuria, bacteriuria -cloudy urine |
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Assessment data for for pyelonephritis (kidney) |
-temp 38.8-higher ,chills -flank pain and costovertebral-angle tenderness -N/V -dysuria, urgency, cloudy urine, hematuria, bacteriueria |
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Assessment data for mastitis (breast) |
-sore, cracked nipple -flulike symptoms: malaise, chills, and fever -red, warm lump in breast |
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General care for diagnosed infection |
-use and teach good handwashing technique -assess and record vital signs, esp temp, every 4 hrs or more -manage fever by increasing fluids, providing cool cloths, admin acetaminophen PO or by suppository -assess for signs of dehy, maintain hydration -promote nutrition: teach to include 4 basic food groups and increase intake of foods containing vitamin C for healing and protein for tissue repair |
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General care for perineal infection |
-teach to stay warm, but not to use hot water bottle in bed if chilled -assess site daily for decrease in redness, pain, and discharge -assist with sitz bath and perineal lamp 2-3 times daily; encourage meticulous perineaum care -admin antibiotics/analgesics as prescribed |
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General care for endometritis
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-usually maintain bed rest (fowler or semi-fowler position) with bathroom privileges -palpate fundus and abdomen every 8 hrs to assess pain and involution -admin antibiotics, usually IV, commonly using a saline lock |
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General care for Parametritis |
-promote lochial and uterine drainage by instructing client to use semi-fowler position -determine amount and odor of lochia -monitor for dev of pelvic thrombophlebitis: clot in ovarian vein |
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General care for peritonitis |
-client is transferred to intensive care; MEDICAL EMERGENCY -give o2 facemask -administer IV antibiotics -insert ng tube for gastric decompression and prevention of vomiting caused by paralytic ileus -assess abdomen 3x daily for tympany, distention, bowel sounds -monitor I/O |
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General care for Mastitis |
-obtain culture/sensitivity breast milk -instruct client to breastfeed every 2-3 hrs and make sure breasts are emptied with each feed -don't let client cease breastfeeding abruptly unless HCP so prescribes -tell client that she may have to discontinue breastfeeding if there is pus in milk or antibiotic is CI in breastfeeding (mother should manually empty breasts and discard) -if newborn dev diarrhea, contact HCP |
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Mastitis is usually treated at home by PO antibiotics. TRUE or FALSE Tell client to walk once a day. |
TRUE False, tell pt to maintain bed rest for 48 hrs Monitor for abscess formation, need for incision and drainage |
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General care for DVT |
Admin anticoagulant therapy (heparin for 6 wks) |
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General care for Cystitis and pyelonepritis |
-collect urine for analysis and culture -avoid catheterization if at all possible |
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General care for STDs |
breastfeeding and rooming in are affected when mother has STD |
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Why should a nurse be especially supportive of a postpartum client with infection/ |
Because it imples isolation from newborn until organism is identified and treatment begun. Arrange phone calls to nursery and window viewing. |
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The most common iatrogeniic cause of a UTI |
urinary catheterization encourage pts to void freq and not ignore the urge. IV antibiotics are admin to pts with pyelonephritis |
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The risk for postpartum infections is HIGHER or LOWER with clients who experienced problems in pregnancy? |
higher |
