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Women's Health > Exam 3 pt 3 > Flashcards

Exam 3 pt 3 Flashcards

(58 cards)

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1
Q

c section pot op nursing interventions

A

-turn, cough, deep breath
-incentive spirometry every 2-4 hrs
-pillow to splint incision
leg exercises every 15 min-2 hrs till ambulate
-SCDs
-monitor/manage pain/ PCA analgesic
-administer analgesic
-comfort measures
-encourage breathing, relaxation

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2
Q

when is incentive spirometry needed

A

every 2-4 hrs if pt needed general anesthesia

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3
Q

what type of analgesics given after c section

A
  • spinal anesthesia with 24 hr morphine (duramorph) which helps with postop pain
  • watch for respiratory distress though
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4
Q

what PCA analgesic is given post op csection

A

toradol

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5
Q

course of care for c section postop

A
  • indwelling cath 24 hrs
  • PCA/Epidural/IM meds
  • NPO at first, then liquids, then soft diet
  • headaceh
  • depression/anger/withdrawal
  • slower to bond/breastfeed
  • longer costlier stay at hospital
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6
Q

usually occur as the fetal head is being born

A

perineal lacerations

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7
Q

first degree perineal laceration

A

laceration that extends through the skin and vaginal mucous membrane but not the underlying fascia and muscle

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8
Q

second degree perineal laceration

A

laceration that extends through the fascia and muscles of the perineal body but not the anal sphincter

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9
Q

third degree perineal laceration

A

laceration that include the vaginal tissue, perineal muscle, and anal sphincter

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10
Q

fourth degree perineal laceration

A

laceration that extends completely through the rectal mucosa, disrupting both the external and internal sphincters

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11
Q

third and fourth degree lacerations must…

A

be carefully repaired so that the woman retains fecal continence

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12
Q

often occur in conjunction with perineal lacerations

circular and often the result of use of forceps, rapid fetal descent or precipituous birth

A

vaginal lacerations

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13
Q

injuries to the ____ can have adverse effects on future pregnancies and childbirth

A

cervix

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14
Q

occurs when the cervix retracts over the advancing fetal head

A

cervical injuries

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15
Q

what are causes of post partum hemorrhage

A

lacerations of cervix, vagina, and perineum

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16
Q

when should hemorrhage related lacerations be suspected

A

if bleeding continues despite firm, contracted uterine fundus

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17
Q

what are the most common of all injuries in the lower portion of the the genital tract

A

lacerations of the perineum

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18
Q

episiotomy

A

RARE (,10% of births)

incision into the perineum to enlarge the vaginal outlet

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19
Q

how are pelvic muscles supported

A

pelvic relaxation and Kegel exercises

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20
Q

when assessing for genital injury always look to…

A

rule out hematoma esp. if forceps/vacuum used for delivery

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21
Q

describe hematomas

A

deep, severe, unrelieved pain and feelings of pressure

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22
Q

treatment of genital injuries

A

-ice for 24 hr, then heat in form of Sitz bath
Tucks, Epifoam, Dermaplast
-Motrin for relief of pain and discomfort
-promote or suppress lactation depending on breastfeeding

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23
Q

how often should you sitz bath if genital injury

A

2-4 times a day

soothing and helps debride after 24 hrs

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24
Q

describe bowel evacuation

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A

occurs 2-3 days after childbirth

anal sphincter lacerations are associated with postpartum incontinence

25
nursing interventions for episiotomy
perineal tightening ice, then sitz bath, motrin (same as vaginal lacerations)
26
why does abdominal distension occur post op c section
surgery stops peristalsis for around 24 hrs after surgery gut may stop working due to block rigid/boardlike abdomen=BLEEDING
27
side effects and adverse effects caused by epidural and spinal anesthesia
hypotension, local anesthetic toxicity, dizziness, slurred speech, urinary retention, pruritus, headache, and infection
28
nursing intervention for perineal laceration
1) place woman in lateral sims, don gloves 2) check for redness, edema, hematoma 3) teach self check with mirror 4) instruct pt to change pad with every void 5) wipe perineum front to back 6) teach pt pain/discomfort relief measures ie ice, sitz, lavage, anesthetic spray
29
collection of blood in the connective tissue
pelvic hematomas
30
types of pelvic hematomas
vulvar, vaginal, retroperitoneal
31
most common and visible hematomas | s/s: persistent pain and feeling of pressure
vulvar
32
the least common hematoma but life threatening | s/s: minimal pain and shock
retroperitoneal
33
what is needs to evacuate hematoma
surgery
34
post op hematoma surgery nursing interventions
pain control (Percocet and ibuprogen) monitor for bleeding replace fluids monitor Hct and Hgb levels
35
reasons for post delivery headache and interventions
1) caffeine withdrawal (give cup of coffee) | 2) preeclampsia induced (do full head to toe)
36
what is included in head to toe assessment if positive for preeclampsia
clonus, hyper reflexes, abdominal RUQ pain, blurred vision
37
how to determine if spinal headache
pain in high fowlers but subsides in supine position then positive for spinal headache and call anesthesia
38
what creates bonding
having the baby close/proximity
39
the process by which a parent comes to love and accept a child and a child come to love and accept a parent
attachment
40
attachment occurs through the process of ___
bonding
41
the infant's behavior sand characteristics elicit a corresponding set of parental behaviors and characteristics
mutuality
42
eye contact, touching, talking and exploring the baby
acquantance
43
signaling behaviors
crying, smiling, and cooing
44
what is the claiming process
"like me or like you" | identification of the new baby (likeliness, differences, uniqueness)
45
assessment of attachment behaviors that should be noted prior to discharge
early contact, extended contact, senses, biorhythmicity
46
baby in tune with mothers natural rhythms (Arcadian and heart rhythms)
biorhythmicity
47
postpartum infection drugs
ampicillin | clindamycin
48
postpartum pain meds
``` Percocet Ibuprofen Extra Strength Tylenol Toradol Narcan ```
49
Percocet ingredients and how much in 24 hrs
oxycodone, acetaminophen and do not exceed 30-40 mg in 24 hrs
50
Percocet indications
relief of moderate to moderately severe pain
51
common and serious side effects of percocet
lightheadedness, dizziness, drowsiness, N/V | serious: resp depression, apnea, circulatory depression, hypotension, shock
52
pt teaching of percocet
1) assess BP 2) high concentration first 1-2 hrs (avoid breastfeeding) 3) change position slowly d/t orthostatic hypotension
53
how often can ibuprofen be given
800 mg PO q8h
54
ibuprofen indications and contraindications
treatment of mild to moderate pain and fever | contrainidcations: bleeding, GI ulcers, coagulopathy, thyrombocytopenia
55
common and serious side effects of ibuprofen
headache, dizziness, constipation, dyspepsia, N/V, abdominal discomfort serious: steven johnsons, anaphylaxis, GI bleed, MI
56
pt teaching of ibuprofen
1) avoid driving if drowsy 2) avoid concurrent NSAIDS and alcohol 3) consult HCP if bleeding, visual disturbance, headache 4) okay to consume when breastfeeding!!
57
how much tylenol in 24 hr
2x 500 mg tablets q6h | max daily dose is 4000 mg
58
tylenol indications and contraindications
mild to moderate pain and reduce fever | contraindicated: severe hepatic impairment and lever disease and concurrent alcohol usage

Women's Health (31 decks)

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