Maternal Flashcards
(41 cards)
Postpartum endometritis
Risk factors
Cesarean birth Intraamniotic infection Group B Streptococcus colonization Prolonged rupture of membranes Operative vaginal delivery
Postpartum endometritis
Clinical
features
Fever >24 hr postpartum
Uterine fundal tenderness
Purulent lochia
Postpartum endometritis
Etiology
Polymicrobial infection
Postpartum endometritis
Priority Treatment
Clindamycin & gentamicin
Endometritis is characterized by
uterine tenderness and subinvolution, foul-smelling or purulent lochia
fever
tachycardia
chills.
Postpartum endometritis
comfort measures
repositioning, oral hydration, pain medication) can be
provided after antibiotic therapy is initiated.
Postpartum endometritis is
an infection of the endometrium (uterine lining) and is characterized
proper breastfeeding and latch technique include:
Breastfeed every 2-3 hours on average (8-12 times/day)
• Breastfeed “on demand” whenever the newborn exhibits hunger cues (eg, sucking, rooting reflex)
• Position the newborn “tummy to tummy” with mouth in front of nipple and head in alignment with body
• Ensure a proper latch (ie, grasps both nipple and part of areola)
• Feed for at least 15-20 minutes per breast or until the newborn appears satisfied
• Insert a clean finger beside the newborn’s gums to break suction before unlatching (Option 3)
• Alternate which breast is offered first at each feeding
Lactational mastitis
(infection and inflammation of breast tissue) result from inadequate milk duct drainage or poor breastfeeding technique.
Lactational mastitis
Manifestations
fever, muscle aches, and breast pain and
inflammation (eg, warmth, redness, edema)
lactational mastitis
Treatment
antibiotic therapy, continued breastfeeding, breastfeeding support (eg, proper latch technique), warm compresses, massage, adequate
nutrition and hydration, and appropriate analgesics (eg, ibuprofen, acetaminophen).
Postpartum vaginal bleeding
saturates a perineal pad in <1 hour is considered excessive.
Bladder distension
fundus is also elevated above
the umbilicus and deviated to the right
Bladder distention
Treatment
assisted to void then perform fundal massage
Oxytocin infusion should
be initiated
is a uterotonic
if initial attempts to control postpartum bleeding (relief of bladder distention and
fundal massage) have failed.
Pregnancy is a hypercoagulable state
increases risk for deep venous thrombosis and pulmonary embolism (PE).
pulmonary embolism (PE) Sign
anxiety/restlessness, pleuritic chest pain/tightness, shortness of breath, tachycardia, hypoxemia, and hemoptysis
deep venous thrombosis (DVT)
Who at risk
cesarean section
obesity
smoking
genetic predisposition.
DVT may progress to
pulmonary embolism (PE)
deep venous thrombosis (DVT) /PE
nurse’s priority is rapidly step
- assessing respiratory status
- administering supplemental oxygen
- before administering requested pain medication
- notifying the health care provider (HCP)
Postpartum depression (PPD)
Symptoms
crying irritability difficulty sleeping (or sleeping more than usual) anxiety feelings of guilt.
Postpartum depression (PPD)
Symptoms typically arise
4 weeks of delivery
feelings of inadequacy or guilt as they experience challenges in caring for their infant (eg, breastfeeding difficulties, infant colic).
Postpartum depression (PPD) Questions to ask
specific questions about depression hopelessness to assess for PPD
thoughts of self-harm or harm to the
newborn.
Postpartum hemorrhage (PPH)
uterine atony may require uterotonic drug administration to reverse excessive bleeding (may cause overdistension of the uterus)
