MCN Midterm Reviewer 2

Question 1

• reproductive tract infection developing after delivery

* may spread to the peritoneum (peritonitis) or the circulation system (septicemia)

Answer 1

Post Partum Infection / Puerperal Infection

Question 2

7 Risk Factors of Post Partum Infection / Puerperal

Answer 2

1. Post Partual Hemorrhage
2. Local Vaginal Infection
3. Prolonged Rapture of membrane
4. Retained Placental Fragment
5. Preexisting anemia
6. Frequent unsterile vaginal exam
7. Prolonged and difficult labor

Question 3

blood lost and eventually the immune system will be waken

Answer 3

Post Partual Hemorrhage

Question 4

occurs after 24 hours / more than 24 hours before birth

Answer 4

Prolonged Rapture of membrane

Question 5

anemia may cause the immune system lowered

Answer 5

Preexisting anemia

Question 6

7 Manifestation or S/S of Puerperal infection / Post Partum Infection

Answer 6

• 4 cardinal signs of inflammation are included
  1. Rubor- redness
  2. Calor- Heat
  3. Dolor-Pain
  4. Tumor- swelling

5 burning in urination

6. presence of fever
   * temp of 38’C for 2 Days
7. wound discharges

Question 7

4 Prevention of Puerperal Infection / Post Partum Infection

Answer 7

1. Use Sterile Gloves and Instruments during labor, delivery and postpartum period
2. Proper Perineal Care by the client
3. Hand Washing
4. Administer antibiotic as prescribed - broad

Question 8

why no antibiotic during breast feeding

Answer 8

antibiotic passes into the breast milk and causes the development of fungal infection to the baby
*whitish build up on the mouth of the baby

Question 9

5 Possible infections for Postpartum

Answer 9

1. Endometritis
2. Wound infection of the perineum
3. UTI
4. Perineal Hematoma
5. Thromboembolic Disorder

Question 10

Inflammation in the lining of the uterus

Answer 10

Endometritis

Question 11

8 Manifestation of Endometritis

Answer 11

1. fever - occurs day 2 or 3
2. increase in WBC
3. presence of chill
4. lost of appetite
5. general body “malaise”- painful muscle, flu like symptoms
6. strong after pain
7. uterus is not well contracted and painful to touch
8. dark brown lochia and foul smelling odor

Question 12

7 Management of Endometritis

Answer 12

1. administer antibiotic
2. administer oxytocic agent
3. increase oral fluid intake
4. administer analgesics as prescribe for strong after pain
5. sitting in low fowlers position, or encourage the women to ambulate or walk
   * for lochia drainage by gravity
6. wearing gloves when changing perineal pads
7. early recognition of signs of endometritis
   * presence of fever, swelling, pain, redness, inflammation

Question 13

suture line from the laceration repair serves the portal entry for bacterial invasion
*when pain, heat, fever, open suture with drainage, what will you do

Answer 13

notify the physician at once

Question 14

5 Manifestations S/S of UTI

Answer 14

1. painful or burning sensation upon urination *dysuria
2. presence of blood in the urine *hematuria
3. feeling of frequent urination *polyuria
4. presence of low grade fever
5. presence of lower abdominal pain

Question 15

Diagnostic test to confirm UTI

Answer 15

Urinalysis

Question 16

3 Management

Answer 16

1. administer of antibiotic
   * 5-7 days * discontinue breast feeding
2. encourage the women to drink large amount of fluid
3. administer analgesic if there’s a pain

Question 17

• Collection of blood in the subcutaneous tissue in the perineum
• Cause by injury to the blood vessels in the perineum during birth
• It may occur at the side of the episiotomy or laceration

Answer 17

Perineal Hematoma

Question 18

4 Manifestations or S/S or assessment finding of Perineal Hematoma

Answer 18

1. severe pain the perineal are
2. feeling of pressure between legs
3. presence of hematoma
   * purplish discoloration with 2cm to 8cm diameter swelling
4. presence of tenderness upon palpation

Question 19

5 Nursing care management of Perineal Hematoma

Answer 19

1. report hematoma immediately to the physician
2. assess swelling
3. administer analgesic
4. apply cold compress to the hematoma with towel
5. if hematoma is large or continuous to increase
   * advice the women to go back to the delivery room

Question 20

Bold clots are form when there is stasis when there is a repair of damage tissue

Answer 20

Thromboembolic Disorder

Question 21

Thrombi / Thrombus

Answer 21

Clots and stationary

Question 22

Embolus / Embolic

Answer 22

Dislodge and go with the circulation

Question 23

8 Risk Factors of Thromboembolic Disorder

Answer 23

1. History of varicosities in the legs
2. Obesity
3. Over 30 yrs. old
4. Multi Parati
5. Use of estrogen supplement
6. History of thromboembolic disease
7. Smoking
8. Trauma to extremities with DM

Question 24

3 Causes of Thromboembolic Disorder:

Answer 24

1. Injury to blood vessels * occurs after and during delivery
2. Increase clotting
   * occurs after and during delivery
3. Blood Stasis

Question 25

Diagnostic test for Thrombophlebitis

Answer 25

Ultra sound | Xray

Question 26

Types of Thromboembolic disorder according to location

Answer 26

1. Superficial thrombophlebitis | 2. Deep Vein Thrombosis / Thrombophlebitis

Question 27

Refers to the inflammation affecting the superficial veins of the extremities

Answer 27

Superficial Thrombophlebitis

Question 28

Symptoms Superficial Thrombophlebitis

Answer 28

Tenderness and pain at the effected vein followed by edema

Question 29

Inflammation of the vein within a muscle tissue

Answer 29

Deep Vein Thrombosis / Thrombophlebitis

Question 30

Main danger is the presence of emboli which may reach the lungs and obstruct pulmonary blood flow

Answer 30

Pulmonary Embolism

Question 31

Types of Thromboembolic Disorder according to types of veins affected

Answer 31

1. Femoral Thrombophlebitis 2. Superficial Venous Thrombosis / Theombophlebitis 3. Deep Vein Thrombosis / Thrombophlebitis

Question 32

Infections of the veins of the legs particularly the femoral and popliteal veins

Answer 32

Femoral Thrombophlebitis

Question 33

Manifestation of Femoral Thrombophlebitis

Answer 33

1. Homan's Sign 2. Phlegmasia Alba Dolens or Milk Leg 3. Swelling, Pain and Stiffness of the affected leg 4. Fever 5. lower abdominal pain and flank pain * additional manifestation If the uterine pelvic ovarian veins are affected

Question 34

Calf pain upon Dorsi flexion of the foot

Answer 34

Homan's Sign

Question 35

The leg is shiny white appearance because of extreme swelling and lack of circulation

Answer 35

Phlegmasia Alba Dolens or Milk Leg

Question 36

Management of Femoral Theombophlebitis

Answer 36

1. Encourage early ambulation after delivery 2. The use of support stocking in women with varicosities * promote circulation and prevent blood stasis * put the stocking before rising from bed in the morning 3. Provide adequate hydration 4. Avoid trauma to extremities particularly during delivery * to avoid pressures to the vein * to promote venous return 5. Avoid activities that contribute venous stasis

Question 37

Only involves the small veins

Answer 37

Superficial Venous Thrombosis / Theombophlebitis

Question 38

Manifestation of Superficial Venous Thrombosis

Answer 38

1. Pain in the area | 2. Presence of clot

Question 39

Management Superficial Venous Thrombosis / Theombophlebitis

Answer 39

1. Administer analgesic 2. Application of hot compress 3. NSAID - Non Steroidal 4. Instruct the client not to massage the area

Question 40

Manifestation of DVT

Answer 40

1. Fever, Swelling presents of veins

Question 41

Management *it requires intensive management to prevent

Answer 41

1. Administration of anti coagulant - warfarin ( Coumadin ) *Antidote- (Vit. K), Heparin- *Antidote-(Protamine Sulfate) 2. Requires hospitalization during the acute phase 3. Bed rest until sign and symptoms disappear * encourage gradual imbulation 4. Encourage to elevate the legs 5. Administration of analgesic, antibiotic and antipyretic * Major Danger * presents of emboli and may lead to pulmonary embolism

Question 42

Thrombosis

Answer 42

Clot

Question 43

Thrombophlebitis

Answer 43

Clot and Inflammation