OB Test 2: High Risk Postpartum Flashcards Preview

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Flashcards in OB Test 2: High Risk Postpartum Deck (19)
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0

What is a postpartum hemorrhage?

More then 500mL vaginal
More then 1000 mL Caesarian

10% drop in Hct

1

What is early postpartum hemorrhage and it's causes

First 24 hours

Causes:
Uterine atony: not contracting
Lacerations: forces delivery
Retained tissue
Hematoma: blood goes in at hemorrhage rate in broad ligament
Coagulation: pt who has DIC

2

What are implantation abnormalities?

Accrete: placenta grown to deep in endometrium and won't let go
Increta: placental into muscle
Percreta: placenta into uterine wall

3

What is uterine inversion?

Pull on cord does that with accreta

4

What are the risk factors of early PP hemorrhage?

Over distention of the uterus
Hydraminos
Prolonged labor
Grand multipara
Meds: mag sulfate, Asian/Hispanic/light skin redhead

5

What are signs and symptoms of early Pp hemorrhage

Bleeding
-tremendous or continuous trickle
Hypocolemia

6

Why is treatment of PPH?

Fundal massage
Bimanual compression
Increase fluid and blood
Uterine stimulants
Oxygen
Positioning
Arterial embolization
Surgical invention

7

What are some uterine stimulants?

Oxytocin (Pitocin): causes phasic contraction
Methylergonovine maleate (Methergine): given to cause sustained uterine contraction
Prostaglandin F: last resort, cause hypertension and brnchospasm

8

What are nursing assessment for uterine stimulants?

Monitor fundus and blood loss: for when drug wears off
Fundal massage
Vital signs
I&O : count and weigh peripads

9

What are laceration risk factors?

Large baby
Forceps

10

What are hematomas?
S&S?
Treatment?

Boot clot
S: pain, Hypovolemia
T: less then 5cm, ice pack, pain med
More then 5cm tie off bleeding vessel

11

What are the causes, signs, and treatment of late Pp hemorrhage?

Cause: infection and subinvolution
Sign: after 24 hour - 6 week
Increase fundal height
Lochia Rubra, increased Lochia
Treat: rest if bleeding
0.2 mg methrogen PO
DNC
Antibiotic

12

What are the causes of thrombophlebitis?

Hypercoagubility
Venous stasis: blood sits there
Trauma: increa risk of clot formation

13

What s thrombophlebitis

Irritation of inside vein related to clot

14

What are the signs and treatment of thrombophlebitis

Signs: superficial vein thrombi
Tender, warm, induration (firm), redness along vein
Treatment: elevation affected part
Bed rest
Moist heat
Analgesic
TED hose

15

What are the symptoms of DVt?

Pain
Edema
Fever with chills
Red or pale and cool

16

Treatment of DVT?

IV Heprin
Elevate leg
Bed rest
Analgesic
Antibiotic
Comparison stocking
Coumadin

17

Look over puerperal infection slide because I am lazy.....sorry

.

18

What is mastitis symptoms and treatment?

Sign: sudden onset after 10 days, localized pain, redness, fever
Treat: analgesic, antibiotic, breast must be emptied, rest, hydration