Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

LCON OB > Exam 3 Blueprint > Flashcards

Exam 3 Blueprint Flashcards

1
Q

Postpartum Hemorrhage.

A
  • Its severe bleeding after giving birth
  • Its the 1000mL or cumulative blood loss
  • Bleeding with hypovolemia within 24 hrs of birth
  • Its the leading cause of maternal death worldwide
  • Pts with Hemophilia are at risk of PPH
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Hemorrhagic (hypovolemic)
shock

A
  • Its a an emergency in which the perfusion of body organs can become severely compromised & death can occur.

🔸 Its caused by Excess blood/fluid loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Nursing Interventions of Hemorrhagic (hypovolemic)
shock

A

➤ Continuous assessment every 2 hrs
➤ Assess the vital signs (SPO2, BP, Temp, HR, RR)
➤ Check for Abnormal labs (HCT, RBC, HGB)
➤ Check the urine output for signs of oliguria
➤ Identify the cause of the Hemorrhage & treat it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Postpartum (puerperal)
infections

A
  • Any infection of the genital tract that occurs within the 28 days of:-
    * Miscarriage
    * Abortion
    * Birth
  • Fever of 38 degrees (100.4 F) or more on two successive days of the 1st 10days (not including the 1st 24hrs after birth)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Examples of Postpartum Infections

A
  • UTI
  • Mastitis (Breast duct clogging)
  • Respiratory tract infection
  • Endometriosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Risk Factors of Postpartum Infection

A
  • Anemia
  • Diabetes
  • Malnutrition
  • Drug abuse
  • Immunosuppression
  • Frequent vaginal exam
  • Catheterization during labor & delivery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Nursing Interventions for Postpartum Infection

A

➤ Antibiotic (Oral & IV)
➤ Hydration
➤ Wound care (clean & dry)
➤ Wipe front to back
➤ Encourage sitz bath
➤ Assess vital signs
➤ Give pain meds
➤ Encourage voiding & pad changing every 2 hrs
➤ Perineal cleaning with warm water
➤ Encourage pt to drink Cranberry juice for UTI management.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Signs & symptoms for Endometritis

A
  • Fever >2days
  • Tachycardia
  • Uterine pain & tenderness
  • Foul smell
  • Elevated WBC
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Which Postpartum infection is most common after birth/miscarriage?

A

Endometritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Signs & symptoms for Wound infection

A
  • Redness
  • Smell
  • Warmth upon touch
  • Wound separation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Signs & symptoms for UTI

A
  • Flank pain
  • Frequent painful urination
  • Burning sensation while urinating
  • Cloudy foul urine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Postpartum Psychotic Disorders

A
  • Its the most serious disorder
  • Happens 2-4 days after birth
  • Manifesting through :-
    * Crying
    * Mood swings
    * Sleep disturbance
  • It causes :-
    * Hallucination
    * Thoughts of harming themselves/baby

🔸 Baby Blues lasts more than 1 wk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Nursing interventions of Postpartum Depression

A

➤ Ask them how they feel
➤ Share information & knowledge of what they are to expect
➤ Encourage regular exercises, meditation & relaxation
➤ Encourage them to share their feelings with people they trust or support groups
➤ Treat with Mood Stabilizers, Benzodiazepines, Lithium (safe for breastfeeding)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Postpartum fundal height (involution)

A
  • The Fundus descends 1-2 cm every 24 hours.

🔸 Immediately after birth - 2 cm above the umbilicus

🔸 12 hrs - 1 cm above the umbilicus

🔸 1 hr (after birth) - 12 hrs - Midline the umbilicus

🔸 24 hrs (after birth) - 1cm below the umbilicus

🔸 2 days (after birth) - 2cm below the umbilicus

🔸 Full bladder - 1 to 2 cm above the umbilicus

🔸 2 wks after birth, the fundus should nolonger be palpable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is Lochia?

A

Lochia - is the postbirth uterine discharge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Lochia changes

A

🔸 Lochia Rubra
- Its Normal
- Its bright red in color
- It lasts 1-3/3-4 days after birth
- Blood & decidual & trophoblastic debris

🔸 Lochia Serosa
- its pink/brown in color
- it lasts 22-27/4-10 days after birth
- Old blood, serum, leukocytes & debris

🔸 Lochia Alba
- Its white/yellow in color
- It lasts 2-6 wks after birth
- Leukocytes, decidua, epithelial cells, mucus, serum & bacteria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Postpartum fluid loss physiology

A

🔸 Profuse diaphoresis
- Its Normal
- Occurs in the first 12 hrs - 3 nights
- Its the body returning to base

🔸 Excessive bleeding
- Its due to displacement of the uterus if the bladder is full

🔸Uterine Atony
- If someone is bleeding out 3 hours post-partum we would say patient had uterine atony

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Nursing interventions for Postpartum Hemorrhage

A

➤ Massage the fundus (maintins the uterine tone)
➤ Empty the bladder (prevent bladder distension)
➤ Administer Pitocin (encourages uterine contraction)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Postpartum Hemorrhage Vital signs & labs

A

🔸Vital signs
* BP (Hypotension)
* SPO2 (Low O2 saturation)
* Temperature ( Hypothermia/low temp)
* HR (tachycardia)
* RR (tachypnea)

🔸Labs
* RBC (low)
* Hct (low)
* Hgb (low)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

4th trimester

A
  • Its the period after childbirth during which the mother’s reproductive organs return to their original non-pregnant condition.
  • It lasts between 3-6 wks after birth
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Postpartum headaches

A

🔸 Facts
* They are common in the first week postpartum
* Assess the BP

🔸 Causes
* Postpartum Preeclampsia
* HTN
* Spinal headaches

🔸 Nursing interventions
* Encourage the pt to lay flat to relieve pain
* A Blood patch may be needed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Kegel exercises

A
  • They are pelvic exercises that encourage healing on the pelvic muscles

➤ Pretend like your peeing and stop urine stream…. Squeeze

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Nursing care for Episiotomy/Laceration pts

A

🔸Apply ice packs in the first 24 hours after birth that reducing pain and
promoting healing and comfort.

🔸Use sitz baths 3-4 times a day for a maximum of 20 minutes each time.

🔸Change the pads every 2 to 4 hours.

🔸 Keep the area around the stitches clean and dry by washing the area from front to back, and the dry with a clean towel after urinate or have a bowel movement.

🔸 Drink lots of water and eat foods with plenty of fiber this will prevent
constipation.

🔸 Explain that these sutures usually dissolve within 10 days

🔸 Inspect the perineum for redness, sloughing of sutures, pus formation,
drainage at the suture, and if the pain gets worse.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Engorgement

A
  • Its the overfilling of breasts with milk
  • Often occurring in the early days postpartum
  • It results in :-
    * Swollen
    * Hard
    * Painful breasts
  • It may lead to :-
    * Premature cessation of breastfeeding
    * Decreased milk production
    * Cracked nipples
    * Mastitis
  • The discomfort decreases within 24 -36 hrs

🔸 Nursing Interventions
- Apply cold cabbage leaves on the breasts
- Wearing a well-fitting bra

➤ Do not use cabbage leaves on a lactating mother, but only when the mother intends to stop breastfeeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Cultural care/therapeutic communication

A
  • Sometimes in birth there are different cultures.
  • The nurse should try to accommodate what is being asked of you even if you don’t believe in it.
  • Use therapeutic communication with them.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What are the causes of Postpartum Hemorrhage?

A

➤ Uterine tone/boggy uterus (leading cause)
➤ Retained placenta fragments
➤ Hematomas (collection/pooling of blood under the skin)
➤ Infection
➤ Coagulation disorder
➤ Subinvolution of the uterus
➤ Lacerations of the genital tract that were not repaired following the birth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Quantitative Blood Loss (QBL) vs Estimated Blood Loss (EBL)

A

EBL or QBL of 1500 mL…what is our expected finding as far as vital signs for mom?

  • Hypotension (she’s hemorrhaging).
  • Blood loss of 1000mL is a hemorrhage .
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is the process for QBL (quantitative blood lost)?

A
  • Weigh a dry pad and a soaked pad and the difference is QBL.
  • Always measured by weight of the pads and if you’re in OR they’ll add blood that’s in the canisters prior to rupture.
29
Q

Venous Thromboembolic Disease (VTE)

A
  • Its the formation of the Blood Clots in the Lower Extremities caused by:
    * Inflammation
    * Partial obstruction of vessels

🔸 Nursing Care
- Check the leg circumference
- Assess for edema
- Check the peripheral pulses
- Compression socks
- SCD’s
- Elevate the leg
- Ambulation

30
Q

Nursing Interventions of VTE

A

🔸Graduated compression stockings.
- Compression stockings prevent dislodgement of the thrombus.

🔸Pneumatic compression device.
- Intermittent pneumatic compression devices increase blood velocity beyond that produced by the stockings.

🔸Leg exercises.
- Encourage early mobilization and leg exercises to keep the blood circulating adequately.

31
Q

Clinical manifestations of VTE

A
  • Chest pain
  • Shortness of breath (SOB)
32
Q

Risk factors of VTE

A
  • Maternal Age
  • Underlying disease
  • Smoking
  • C- section
33
Q

Etiology of VTE

A

Hypercoagulation

34
Q

Superficial Venous Thrombosis

A
  • Also known as Varicose veins
  • Its the most common form of postpartum VTE
  • Occurs mostly Behind the Knee where the skin is the thinnest
  • It may be unilateral or bilateral
35
Q

Signs & symptoms of Superficial Venous Thrombosis

A
  • Warmth
  • Redness
  • Swelling & discoloration
  • Dull pain in the affected extremity
  • Tenderness in the affected extremity
36
Q

Deep vein Thrombosis (DVT)

A
  • Its a blood clot that forms in a Vein deep in the body
  • Mostly occur in the Lower leg or Thigh
  • A DVT can break loose & cause a serious problem in the :-
    * Lungs (Pulmonary Embolism)
37
Q

DVT is more common in the?

A
  • Left leg
  • Iliofemoral vein
38
Q

Signs & symptoms of DVT?

A
  • Swelling
  • Warmth
  • Redness
  • Sudden onset of unilateral pain
  • Positive Homan’s sign (rapid dorsiflexion of the foot)
39
Q

Which diagnostic testing is used for DVT?

A
  • MRI
  • Doppler ultrasound
40
Q

Nursing interventions for a DVT

A

➤ Don’t massage the leg
➤ Use Compression socks
➤ Elevate the leg 30 degrees
➤ Administer pain meds
➤ Teach pt how to use stockings
➤ Teach pt to watch for the s/s of DVT
➤ Administer Anti-coagulant meds (Heparin)
➤ Assess for bleeding
➤ Have Protamine sulfate close by
➤ Avoid contraceptives

41
Q

Bladder distention.
If a pt had an epidural and is pp floor. Went to bathroom and couldn’t pee. Walked to bathroom just and still can’t pee. What would you do?

A
  • Put some warm water in peri-bottle and spray on vagina.
  • Turn the faucet and the the water run
  • Put an In and Out catheter (Last resort)
42
Q

Rhogam administration

A
  • Its due 12 hrs - 72 hrs after delivery
  • We give Rhogam when the (Negative mom & Positive baby)
43
Q

Postpartum period

A
  • Its the period/interval between Birth & the return of reproductive organ to their non-pregnant state (Usually 6 wks)
44
Q

What is Subinvolution

A
  • Its the failure of the uterus to return to non-pregnant state
  • Its caused by :-
    * Infection
    * Retained placental fragments
45
Q

Where should the Fundus be 2 wks after delivery

A
  • Behind the symphysis pubis
  • Which is also the exact spot where we push down if we have a should dystocia.
46
Q

What are the priority assessments before discharging a woman from the recovery area?

A
  • Airway (1st/important)
  • Level of Consciousness
47
Q

What does LDRP stand for?

A

Labor
Delivery
Recovery
Postpartum

48
Q

BUBBLEHE

A

Breast
Uterus (Fundus)
Bladder
Bowels
Lochia
Episiotomy
Hemorrhage
Emotional state

49
Q

Blood loss assessment

A

🔸 Scant
< 2.5 cm

🔸 Light
< 10 cm

🔸 Moderate
> 10 cm

🔸 Heavy
- 1 pad soaked in 2hrs

🔸 Excessive Blood loss
- 1 pad saturated in 15 mins or less

50
Q

What is first thought when you think of sewing someones rectum back together? What kind of medicine will be want to give them?

A
  • Stool softners
  • Encourage walking
  • Increasing fiber intake
  • Increase fluids
  • Recommend Peri-bottle & Witch Hazel
51
Q

Risk factors for Uterine atony (Boggy uterus)

A
  • Multigravida
  • Polydramnios
  • Macrosomnia
  • Infection (infected muscle won’t contract the way we need it to)
52
Q

Which Meds are given for Postpartum Hemorrhage?

A
  • Oxytocin/Pitocin
  • Methergen
  • Cytotec/Misopristol,
  • Hemabate(carboprost)

🔸 CODE BROWN (watch out for asthma with hemabate/carboprost contraindicated)

53
Q

How would you tell if your kidneys are being profused?

A
  • A Urine output of 30 mL/hr or more is normal.
54
Q

What is the first sign we are looking for if someone is septic after delivery? Septic

A
  • A Temp of 100.4 or higher
55
Q

What type of patient are we worried about the most as far as postpartum infection?

A

Diabetic Pts

56
Q

What do we want to teach patient with UTI?

A
  • Don’t hold urine
  • Wipe front to back,
  • Drink water (PUSH FLUIDS)
  • Med compliance & finish all antibiotics
57
Q

What are some endometritus symptoms?

A
  • Tenderness
  • Pain
  • Discomfort
  • Rubra (excessive if they just had baby)

🔸 Remember infected muscle can’t contract!!!

58
Q

What do we use to test for PP depression?

A

Edinburg Post Natal Depression Scale

59
Q

What do we worry about someone who says they don’t like their baby?

A

Worry about harm to self or baby

60
Q

What can we give to reverse heparization (someone who has had too much heparin or someone who is bleeding excessively?

A

Protamine sulfate

61
Q

Where is most common spot for VTE?

A

Directly behind knee

62
Q

How do we know if someone is experiencing a PE or AFE?

A
  • Chest pain,
  • Trouble breathing
63
Q

What are time period of early PPH and late PPH?

A
  • Early PPH - is within 24 hours
  • Late PPH - is after 24 hours and lasts upto 12 weeks.
64
Q

What causes DVT?

A

Venous Stasis (The pt is just laying in bed, not moving)

65
Q

What do you do if a pt has a boggy uterus when you walk into the patients room?

A

Massage the Fundus

66
Q

What are the causes of Maternal death?

A
  • Hemorrhage
  • Infection
  • Pulmonary Embolism (PE)
  • Hypertension
  • Cardiomyopathy
  • Trauma
67
Q

Bladder distention can lead to?

A
  • Hemorrhage
  • Bladder damage
  • Risk for UTI
68
Q

Estimated Blood Loss (EBL) Postpartum hemorrhage

A

500mL for Vaginally
1000mL for C-section

69
Q

When giving Methergine we should assess for?

A
  • Assess the BP (the BP may increase)

LCON OB (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions