C4: NURSING CARE OF A FAMILY EXPERIENCING A POSTPARTAL COMPLICATIONS

Question 1

blood loss from the uterus greater than 500 mL within a 24-hour period

Answer 1

Postpartal hemorrhage

Question 2

greatest danger of hemorrhage is in the

Answer 2

first 24 hours

Question 3

most frequent cause of postpartal hemorrhage

Answer 3

Uterine atony, or relaxation of the uterus

Question 4

ambulating to the bathroom

Answer 4

at least every 4 hours to be certain her bladder is empty

Question 5

experiencing respiratory distress from decreasing blood volume,

Answer 5

administer oxygen by face mask at a rate of about 4 L/min

Question 6

Small lacerations or tears of the birth canal. they occur most often:

Answer 6

With difficult or precipitate births
• In primigravidas
• With the birth of a large infant (9 lb)
• With the use of a lithotomy position and instruments.

Question 7

CERVICAL LACERATIONS

causes:

Answer 7

(1) Rigidity of cervix, (2) abnormal structure due to scarring from previous surgery, and (3) Rapid delivery of head in breech presentation.

Question 8

prolapse of the fundus of the uterus through the cervix so that the uterus turns inside out. This usually occurs immediately after birth.

Answer 8

Uterine inversion

Question 9

INCOMPLETE RETURN OF THE UTERUS to its prepregnant size and shape.

Answer 9

Subinvolution

Question 10

Subinvolution causes

Answer 10

may result from a small retained placental fragment, a mild endometritis (infection of the endometrium), or an accompanying problem such as a uterine myoma that is interfering with complete contraction.

Question 11

subinvolution management

Answer 11

Antibiotics, Exploration of uterus for fragments, Pessary in prolapse, Methargin-enchance involution process

Question 12

collection of blood in the subcutaneous layer of tissue of the perineum. The overlying skin, as a rule, is intact with no noticeable trauma.

Answer 12

perineal hematoma

Question 13

perineal hematoma most likely to occur

Answer 13

after rapid, spontaneous births and in women who have perineal varicosities.

Question 14

usually begins as only a local infection, it can spread to involve the peritoneum (peritonitis) or the circulatory system (septicemia). These conditions can be fatal in a woman whose body is already stressed from childbirth.

Answer 14

puerperal infection

Question 15

inflammation of the lining of a blood vessel.

Answer 15

PHLEBITIS

Question 16

inflammation with the formation of blood clots.

Answer 16

THROMBOPHLEBITIS

Question 17

thrombophlebitis management

Answer 17

use a sidelying or back-lying (supine recumbent) position for birth, rather than a lithotomy position (lithotomy position can increase the tendency for pooling of blood in the lower extremities).

Question 18

the organism causing the infection usually enters through cracked and fissured nipples. Therefore, measures that prevent cracked and fissured nipples also help prevent

Answer 18

mastitis

Question 19

occurs as a result of inadequate bladder emptying.
After childbirth, bladder sensation for voiding is decreased because of bladder edema caused by the pressure of birth. Unable to empty, the bladder fills to overdistention.

Answer 19

Urinary retention

Question 20

cardinal symptoms of pregnancy induced hypertension (PIH)

Answer 20

proteinuria, edema, and hypertension

Question 21

treatment measures for postpartal PIH

Answer 21

bed rest, a quiet atmosphere, frequent monitoring of vital signs and urine output, and administration of magnesium sulfate or an antihypertensive agent.

Question 22

uterus are weakened

Answer 22

Problems of retroflexion, anteflexion, retroversion, and anteversion or prolapse of the uterus may occur.

Question 23

SEPARATION OF THE

SYMPHYSIS PUBIS treatment

Answer 23

Bed rest and the application of a snug pelvic binder to immobilize the joint are necessary to relieve pain and allow healing.
As with all ligament injuries, a 4- to 6-week period is necessary for healing to take place