EXAM 3

Question 1

Define Croup

Answer 1

inflammation of the larynx, trachea, and major bronchi. Occurs in children 6m-3yrs

Question 2

Define Bronchiolitis

Answer 2

Inflammation and edema of the fine bronchioles and small bronchi due to a viral illness. Most common cause is RSV. Common in children younger than 2yrs, peaking at ages 3-6months.

Question 3

Define iron-deficiency anemia

Answer 3

common anemia of infancy and childhood. The diet of the child should be altered to be high in iron and Vitamin C.

Question 4

What is a big concern of vomiting and diarrhea?

Answer 4

fluid and electrolyte loss

Question 5

isotonic dehydration

Answer 5

water and salt are lost in proportion to eachother

Question 6

hypertonic dehydration

Answer 6

body looses more water then electrolytes

Question 7

hypotonic dehydration

Answer 7

body looses more electrolytes than water

Question 8

range for pH of blood

Answer 8

7.35-7.45

Question 9

range for dissolved carbon dioxide in blood (PCO2)

Answer 9

35-45 mm Hg

Question 10

range for bicarbonate (HCO3) in blood

Answer 10

22-26mEq/L

Question 11

Describe postpartal blues

Answer 11

feeling overwhelming sadness after birth

Question 12

define involution

Answer 12

the reproductive organs return to their non pregnant state. Danger of hemorrhage if this does not happen

Question 13

2 steps of involution of the uterus

Answer 13

1. area where placenta was implanted is sealed off to prevent bleeding
2. uterus is reduced to approximate pre-gestational size

Question 14

uterine atony

Answer 14

relaxed uterus postpartum… BAD!!! ( risk of hemorrhage)

Question 15

What is the normal urine output for for postpartum patients?

Answer 15

3,000mL per day during 2-5th day postpartum

Question 16

What is lactogenesis

Answer 16

human milk production

Question 17

define a hematoma

Answer 17

collection of blood in the subcutaneous space from bleeding from the episiotomy incision that can become so extensive it causes intense pain and disrupts suture line

Question 18

define postpartum hemorrhage

Answer 18

bloodloss of 1,000mL+ after vaginal birth or C-Section.

Question 19

when is the greatest danger for PP hemmhorage?

Answer 19

first 24 hrs PP

Question 20

what are the 4 main reasons for PP hemorrhage?

Answer 20

uterine atony, trauma, retained placental fragments, DIC

also known as “The 4 T’s of pp hemorrhage”
-Tone
-Trauma
-Tissue
-Thrombin

Question 21

describe bimanual compression

Answer 21

Provider inserts 1 hand into vagina while pushing against fundus through the abdominal wall with other hand

Question 22

define lacerations regarding PP

Answer 22

small tears of the birth canal are common. large tears however can be sources of infection or hemorrhage.
RF:
-difficult births
-primigravidas
-birth of large infant
-use of instruments

Question 23

what commonly happens if patient is placed in a lithotomy position for birth instead of supine?

Answer 23

perineal lacerations. Why? Bc this position puts more pressure on on perineum

Question 24

Perineal lacerations first degree

Answer 24

Vaginal mucous membrane and skin of the perineum to the fourchette

Question 25

Perineal lacerations second degree

Answer 25

Vagina, perineal skin, fascia, levator ani muscle, and perineal body

Question 26

Perineal lacerations third degree

Answer 26

Entire perineum, extending to reach the external sphincter of the rectum

Question 27

Perineal lacerations fourth degree

Answer 27

Entire perineum, rectal sphincter, and some of the mucous membrane of the rectum

Question 28

Should a pt with a 3rd or 4th degree laceration ever have an enema or rectal suppository?

Answer 28

NO. Why? The hard tips of equipment could open sutures near area

Question 29

define a succenturiate placenta

Answer 29

placenta with an accessory lobe. This puts patient at high risk for PP hemorrhage

Question 30

Uterine inversion

Answer 30

prolapse of the fundus of the uterus through the cervix causing the uterus to turn inside out. Occurs immediately after birth

Question 31

DIC

Answer 31

deficiency in clotting ability due to vascular injury

Question 32

subinvolution

Answer 32

the incomplete return of the uterus to its pre-pregnant size and shape. With sub-involution, at a 4- o4 6- week PP visit, the uterus is still enlarged and soft.

Question 33

vulvar hematomas

Answer 33

a collection of blood below the epidermis of the vulva

Question 34

what does a hematoma look like?

Answer 34

area of purplish discoloration with obvious swelling

Question 35

puerperal infection

Answer 35

infection of the reproductive tract in the postpartum period

Question 36

endometritis

Answer 36

infection of the endometrium (the lining of the uterus). Bacteria enters through vagina

Question 37

Are WBC an accurate way to identify infection in a PP patient?

Answer 37

No. during PP period patients commonly have increased WBC of 20,000-30,000 due to stress of labor. Instead look for temp above 100.4F 2x within 24hrs

Question 38

thrombophlebitis

Answer 38

inflammation with the formation of blood clots

Question 39

phlebitis

Answer 39

inflammation of the lining of a blood vessel

Question 40

S&S of pt with femoral thrombophlebitis

Answer 40

unilateral localized symptoms: redness, swelling, warmth, hard inflamed vessel in affected leg

Question 41

Mastitis

Answer 41

infection of breast. May occur as early as 7th day PP- or as late as when baby is months old

Question 42

Postpartum psychosis

Answer 42

response to crisis of childbearing. Majority of these pts have symptoms of mental illness before pregnancy.