High Risk Postpartum Nursing Care- 14 Flashcards

Question

hematomas s/s

Answer 1

● Women express severe pain in the vaginal/perineal area, and the intensity of pain cannot be controlled by standard post-partum pain management. ● Presence of tachycardia and hypotension. ●can displace the uterus- uterine atony

Answer 2

● Apply ice to the perineum for the first 24 hours to decrease the risk of hematoma. ● Assess the degree of pain by using a pain scale. ● Monitor for decrease in blood pressure and an increase in pulse rate, symptoms that indicate shock. ● Administer prescribed analgesia for pain management. ● Review laboratory reports such as H&H, as a decrease in H&H may be an indication of blood loss.

Answer 3

uterus does not decrease in size and does not descend into the pelvis

Answer 4

● The uterus is soft and larger than normal for the days postpartum. ● Lochia returns to the rubra stage and can be heavy. ● Back pain is present.

Answer 5

● Review prenatal and labor records for risk factors. ● Monitor women who are at risk for subinvolution of the uterus more frequently. ● Patient education is the primary action, as PPH from subinvolution usually occurs after discharge.`

Answer 6

small portions of the placenta called cotyledons remain attached to the uterus during the third stage of labor. can interfere with involution of the uterus, potentially leading to endometritis and subinvolution of the uterus.

Answer 7

an inflammatory condition of the lining of the uterus and is usually due to an infection

Answer 8

● Profuse bleeding that suddenly occurs after the first postpartum week ● Subinvolution of the uterus ● Elevated temperature and uterine tenderness if endometritis is present ● Pale skin color ● Tachycardia ● Hypotension

Answer 9

education on warning signs

Answer 10

● Assess the fundus and lochia every hour and PRN for the first 4 hours and then PRN. ● Instruct the woman on how to assess the fundus, how to do fundal massage, and the signs of PPH that should be reported to the health care provider. ● Increase oral and IV fluid intake to decrease risk of hypovolemia. ● Explain the importance of preventing bladder distention to reduce the risk for further PPH. ● Assist with ambulation since there is an increase of orthostatic hypotension related to blood loss. ● Anticipate the risk of fatigue related to blood loss. ● Provide uninterrupted rest periods while in the hospital. ●H&H labs ●info on diet high in iron to decrease risk of anemia ●psychosocial- talk about feelings

Answer 11

syndrome in which the coagulation pathways are hyperstimulated. When this occurs, the woman’s body breaks down blood clots faster than it can form them, quickly depleting the body of clotting factors and leading to hemorrhage and death.

Answer 12

● Prolonged, uncontrolled uterine bleeding ● Bleeding from the IV site, incision site, gums, and bladder ● Purpuric areas at pressure sites, such as blood pressure cuff site ● Abnormal clotting study results, such as low platelets and activated partial thromboplastin time ● Increased anxiety ●shock

Answer 13

● Reduce risk of DIC. ● Obtain IV site with large-bore intracatheter as per orders- fluids ● Administer oxygen as ordered. ● Obtain laboratory specimens as ordered. ● Review laboratory results and notify the physician of results. ● Start blood transfusion as ordered. ● Provide emotional support and information to the woman and her family to decrease level of anxiety. ● Facilitate transfer to ICU.

Answer 14

amniotic fluid enters the maternal vascular system. Amniotic fluid within the vascular system initiates a cascading process that leads to cardiorespiratory collapse and DIC

Answer 15

● Dyspnea ● Seizures ● Hypotension ● Cyanosis ● Cardiopulmonary arrest ● Uterine atony that causes massive hemorrhage and leads to DIC ● Cardiac and respiratory arrest

Answer 16

- monitor for warning signs - notify physician about changes - administer O2 - Establish two IV sites with large-bore intracatheters: one for IV fluid replacement and one for blood replacement. - labs - blood replacement - emotional support

Answer 17

blood clot that starts in a vein

Answer 18

which is a clot in a deep vein, usually in the leg but sometimes in the arm or other veins

Answer 19

DVT clot breaks free from a vein wall, travels to the lungs, and blocks blood supply.

Answer 20

Hypercoagulability, increased venous stasis, decreased venous outflow, uterine compression of the inferior vena cava and pelvic veins, reduced mobility, and changes in levels of coagulation factors

Answer 21

dependent edema, abrupt unilateral leg pain, erythema, low-grade fever, and positive Homan’s sign (i.e., pain with dorsiflexion of foot)

Answer 22

shortness of breath, tachypnea, tachycardia, dyspnea, pleural chest pain, and anxiety.

Answer 23

- ambulations after symptoms dissipate - elastic stockings - manage pain - Teach woman how to administer heparin subcutaneously to her abdomen. - Instruct woman to report side effects such as bleeding gums, nosebleeds, easy bruising, or excessive trauma at injection site.

Answer 24

infection of the endometrium, myometrium, and/or parametrial tissue that usually starts at the placental site and spreads to encompass the entire endometrium.

Answer 25

● Elevated temperature greater than 100.4°F (38°C) with or without chills ● Midline lower abdominal pain or discomfort ● Uterine tenderness ● Tachycardia ● Subinvolution ● Malaise ● Headache ● Chills ● Lochia heavy and foul-smelling when anaerobic organisms are present

Answer 26

- reduce risk - teach proper hand wash - proper pericare - change pad frequently - early ambulation- uterine drainage - intake of fluids - high protein and vitamins C diet - monitor WBC count - monitor for S/S - antibiotics - pain management - emotional support - discharge teaching

Answer 27

A woman’s urethra and bladder are often traumatized during labor and birth due to intermittent or continuous catheterizations and the pressure of the infant as it passes through the birth canal. bladder and urethra lose tone after delivery

Answer 28

lower urinary tract infection.

Answer 29

● Low-grade fever (101.3°F [38.5°C]) ● Burning on urination ● Suprapubic pain ● Urgency to void ● Small, frequent voidings—less than 150 mL per voiding

Answer 30

- assist to bathroom a few hours after birth - cath if needed - remind woman to void 2-3 hours - measure voids - change pads - postpartum women should drink 3000ml/day - monitor for s/s - labs when needed - antibiotics - push hydration - education

Answer 31

inflammation/infection of the breast tissue that is common among lactating women. usually from newborns mouth

Answer 32

● Breast tenderness or warmth to the touch ● Generally feeling ill (malaise) ● Breast swelling and hardness ● Pain or a burning sensation continuously or while breastfeeding ● Skin redness, often in a wedge-shaped pattern ● Fever of 101°F (38.3°C) or greater

Answer 33

education - complete emptying - clean hands - methods to decrease irritation and tissue breakdown - diet - educate on massage of breasts - palpate and inspect breasts - antibiotics - pain management - warm compression

Answer 34

can occur at the laceration site, episiotomy site, and cesarean incision site.

Answer 35

● Erythema ● Heat ● Swelling ● Tenderness ● Purulent drainage ● Low-grade fever ● Increased pain at incision or laceration site

Answer 36

● Obesity ● Diabetes ● Malnutrition ● Long labor ● Prolonged operative time during cesarean section ● Premature rupture of membranes ● Preexisting infection, including chorioamnionitis ● Immunodeficiency disorders ● Corticosteroid therapy ● Poor suturing technique

Answer 37

IV labetalol and hydralazine The goal is not to normalize BP but to achieve a range of 140–150/90–100 mm Hg to prevent repeated, prolonged exposure to severe systolic hypertension.

Answer 38

education and empowerment is critical from the outset, and appropriate postpartum follow-up is essential

Answer 39

Insulin requirements for the pregestational diabetic woman decrease in the immediate postpartum period. - higher risk for infection - breastfeeding can reduce risk for type 2 diabetes

Answer 40

Most women with gestational diabetes return to normal glucose tolerance postpartum women with a history of GDM have a sevenfold increased risk of developing type 2 diabetes

Answer 41

●education-diet,lifestyle, resources ●follow up appointment 2-6weeks ●encourage breastfeeding ● Assessing knowledge, risk perception, self-efficacy, current prevention behaviors, and intention to change behavior. ● Identifying barriers to health promoting behaviors and solutions to promote behavior change

Answer 42

increased incidence of infection and wound complications risk factor for venous thromboembolism Obesity-related complications during pregnancy are associated with future metabolic dysfunction in these women.

Answer 43

associated with early termination of breastfeeding, postpartum anemia, and depression

Answer 44

● Fever ● Foul-smelling lochia ● Large blood clots (golf ball–sized or bigger) or bleeding that saturates a pad in 1 hour ● Discharge, erythema, or severe pain from incisions or stitched areas ● Hot, red, painful areas on the breasts or legs ● Bleeding and/or severe pain in the nipples or breasts ● Severe headaches and/or blurred vision ● Chest pain and/or dyspnea without exertion ● Frequent, painful urination ● Signs of depression

Answer 45

physical, social, and psychological well-being and a discussion of the desired form of contraception.

Answer 46

beneficial for women at high risk of complications, such as postpartum depression, cesarean or perineal wound infection, lactation difficulties, or chronic conditions

Answer 47

short-term and require no medical intervention

Answer 48

major and minor depressive episodes that occur during pregnancy or in the first 12 months after delivery

Answer 49

mood disorder characterized by severe depression that occurs within the first 6 to 12 months postpartum and affects an estimated 11.5% of postpartum women

Answer 50

● Sleep and appetite disturbance ● Fatigue greater than expected when caring for a newborn ● Despondency ● Uncontrolled crying ● Anxiety, fear, and/or panic ● Inability to concentrate ● Feelings of guilt, inadequacy, and/or worthlessness ● Inability to care for self and/or baby ● Decreased affectionate contact with the infant ● Decreased responsiveness to the infant ● Thoughts of harming baby ● Thoughts of suicide

Answer 51

variant of bipolar disorder, is the most serious type of postpartum mood disorder develops frank psychosis, cognitive impairment, and grossly disorganized behavior that represents a complete change from previous functioning. require immediate hospitalization and evaluation, as they are at risk for injuring themselves or their infants.

Answer 52

● Paranoia, grandiose or bizarre delusions, usually associated with the baby ● Mood swings ● Extreme agitation ● Depressed or elated moods ● Distraught feelings about ability to enjoy infant ● Confused thinking ● Strange beliefs, such as that she or her infant must die ● Disorganized behavior

Answer 53

● Hospitalization to the psychiatric unit ● Psychiatric evaluation ● Antidepressant and antipsychotic drug treatment ● Psychotherapy ● Electroconvulsive therapy

Answer 54

During the first few months postpartum, the man’s testosterone levels decrease and estrogen levels increase. Lower levels of testosterone are linked with depression in men.

Answer 55

* The man or health care provider fails to recognize signs and symptoms of PPND * Lack of guidelines for assessing and treating PPND * The man downplaying the degree to which the symptoms affect his life and relationships * The man’s reluctance to discuss his depression symptoms with friends, family, or health care professionals * The man resisting mental health treatment; worried about stigma of depression * Few existing programs that address PPND

Answer 56

● The man may withdraw from social interactions. ● The man may be cynical in his interactions and experience irritable moods. ● The man may demonstrate avoidance behaviors such as spending more time away from the family. ● The man’s affect may appear to be anxious or mad versus sad.

Answer 57

● Irritable ● Overwhelmed ● Frustrated ● Indecisive ● Avoidance of social situations ● Cynical ● Increased alcohol consumption ● Drug use ● Domestic violence

High Risk Postpartum Nursing Care- 14 Flashcards

(81 cards)