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OB Exam 2 > Postpartum Infections > Flashcards

Postpartum Infections Flashcards

(65 cards)

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1
Q

List risk factors of UTIs (4)

A
  • urinary catheterization
  • urinary stasis
  • trauma to urinary structures during birth
  • improper hygiene
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2
Q

what does urinary stasis mean?

A

holding urine for too long

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3
Q

why is urinary stasis common postpartum? (4)

A
  • pain
  • visitors
  • breastfeeding interruptions
  • embarrassment
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4
Q

what urinary structures may endure trauma during birth that can increase risk for UTIs?

A

bladder & urethra

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5
Q

If a postpartum woman has improper hygiene, what teaching points should the nurse make? (4)

A
  • Wipe front to back.
  • Use peri bottle instead of rubbing with toilet paper.
  • Change pads every 2-3 hours.
  • Pat dry instead of rubbing to prevent small pieces of toilet paper from remaining in the area and causing infection.
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6
Q

List methods for managing urinary retention (6)

A
  • Manage pain​
  • Pour warm water over perineal area → peri bottle​
  • Have woman lean forward​ on toilet
  • Run water​
  • Have woman blow bubbles through a straw​
  • aromatherapy​ (ex: peppermint oil)
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7
Q

why do we have women lean forward​ on toilet as management for urine retention?

A

to put pressure on bladder

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8
Q

why do we run water as management for urine retention?

A

sound triggers urination

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9
Q

why do we have woman blow bubbles through a straw​ as management for urine retention?

A

it relaxes pelvic floor

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10
Q

How can aromatherapy like peppermint oil be used as management for urine retention?

A

placing it in bedpan or toilet might help trigger urination

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11
Q

List sx of UTI (4)

A

Burning
Urgency
Frequency
Nocturia

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12
Q

list sx if UTI progresses to pyelonephritis (6)

A
  • Fever (up to 104°F).
  • Chills
  • Flank pain
  • Nausea
  • Vomiting
  • CVA tenderness (Costovertebral angle tenderness):
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13
Q

If the nurse performs percussion over pts flank and they experience severe pain, what should you expect?

A

kidney infection

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14
Q

what is UTI diagnosed with?

A

“clean catch” specimen

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15
Q

list first line abx for UTI (4)

A

Bactrim (Trimethoprim-Sulfamethoxazole).
Cephalosporins (e.g., Ceftriaxone).
Nitrofurantoin (Macrobid).
Augmentin (Penicillin-based).

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16
Q

List pharmacological tx for pyelonephritis (3)

A

IV antibiotics (e.g., Vancomycin, Clindamycin).
Antipyretics (Acetaminophen, Ibuprofen).
Antispasmodics (Pyridium) for pain relief

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17
Q

what is the most likely culprit of a postpartum wound infection?

A

Staph Aureus (can be MRSA)

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18
Q

list the risk factors for postpartum wound infection (4)

A
  • obesity
  • c-section staples
  • compromised health status
  • poor hygiene
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19
Q

how is obesity a risk factor for wound infection?

A

there is increased warmth & moisture in incision area

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20
Q

how are c-section staples a risk factor for wound infection?

A

multiple portals of entry for bacteria

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21
Q

what illness causing compromised health status increase the risk of postpartum wound infections? (4)

A
  • anemia
  • diabetes
  • PPH
  • malnutrition
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22
Q

what are two methods of poor hygiene that increase the risk of postpartum wound infection?

A

sharing towels
taking tub baths

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23
Q

List the sx of postpartum wound infection (5)

A

Redness at incision
Edema
Foul smelling drainage
Induration (hardness)
Severe pain that is beyond post-op pain

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24
Q

How are postpartum wound infections treated? (4)

A
  • Culture the wound
  • Pain relief
  • While waiting for culture results, use of agents that target S. Aureus
  • Antibiotics to specific organism
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25
why is pain relief essential for postpartum wound infections?
due to prolonged healing time
26
What happens if there is an abscess present on the wound infection? (3)
Provider may reopen wound & pack it. Wet-to-damp dressings for wound healing. Wound care education for home.
27
A wound-vac may be necessary but it may what?
take months to heal properly
28
what is the name for infection of the breast?
mastitis
29
mastitis is most common in who?
nursing mothers
30
List the risk factors for mastitis (4)
- cracked nipples - compromised health status - abx therapy - milk stasis
31
how do cracked nipples increase the risk of mastitis?
bacteria enters through ducts
32
how does abx therapy increase risk for mastitis?
may trigger candida/yeast in breast tissue
33
what is milk stasis?
not emptying breast fully
34
what causes milk stasis?
irregular nursing or pumping
35
how can milk stasis increase risk of mastitis?
Milk builds up, becomes "stuck", and bacteria multiply.
36
What is a sx of mastitis when there is not an infection yet?
plugged duct
37
how does a plugged duct present?
superficial red lump in the breast
38
list the sx of mastitis when infection occurs (4)
- fever - chills - flu-like sx - severe breast pain
39
if mastitis is caused by yeast, what are the sx? (2)
- bright pink nipples - sharp pain while nursing (feels like ground glass)
40
if mastitis is caused by yeast, what is required?
tx for mom & baby to prevent reinfection
41
if there is an abscess with mastitis, what is it, how does it present, and what needs to happen?
it is a collection of pus it presents as blue/black discoloration it requires incision & drainage
42
what is a crucial teaching point to make to nursing mothers with mastitis?
**Don’t stop nursing!** **Pump if nursing is too painful**
43
what can postpartum women with mastitis due to encourage milk expression?
use heat & massage
44
what can be used to tx mastitis? (3)
- abx usually cephalosporin, such as Keflex - anti-candidal diflucan for yeast - incision/drainage for abscess
45
What is endometritis?
Infection of the uterine cavity
46
endometritis is most common in who?
post c-section pts
47
with pre-operative abx, what is the incidence of endometritis?
less than or equal to 10%
48
without prophylactic abx, what is the incidence of endometritis?
about 35%
49
most women now receive pre-op abx for endometritis. when? what is an example?
within 1 hr of first infection ex: ancef
50
if administration of pre-op abx for endometritis is delayed, what must happen?
the pt must be retreated
51
list risk factors for endometritis (6)
- c-section - prolonged rupture of membranes (PROM) - multiple vaginal exams in labor - compromised health status - low socioeconomic status - instrumental deliveries
52
what is the major risk factor for endometritis ?
c-section
53
PROM is a risk factor for endometritis especially when?
if multiple vaginal exams were performed
54
how is low socioeconomic status a risk factor for endometritis ?
there are potential hygiene barriers for example: lack of access to pads
55
what instrumental devices increase risk of endometritis ?
forceps & vaccum
56
More trauma + insertion of foreign objects = ?
increased infection risk
57
list the signs and sx of endometritis (7)
- Foul-smelling lochia - Temperature 100.4 or greater - Tachycardia - Chills - Body aches - Lower abdominal pain - Uterine tenderness
58
what is the usual fever range for endometritis?
usually 101.0 to 104.0 F
59
management of endometritis is dependent on what?
causative organism
60
how long might a culture and sensitivity take for endometritis?
2-3 days
61
what is used to tx endometritis before culture results?
Empiric IV Abx → usually Cephalosporins/Penicillins unless allergic
62
how long are IV abx continued when pt has endometritis?
until fever-free for 24hrs
63
what are examples of severe cases of endometritis
parametritis or peritonitis
64
how are severe cases of endometritis tx?
they require stronger abx & aggressive management → Vancomycin, Gentamicin, Clindamycin
65
what is a long-term complication of endometritis that is rare but possible?
sequelae but most women recover quickly and without it

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