PP Complications

Question 1

define PP hemorrhage after vaginal birth

Answer 1

> 500 cc

Question 2

define PP hemorrhage after c sec

Answer 2

> 1000 cc

Question 3

what is the biggest problem with PP hemorrhage?

Answer 3

• life threatening with little warning

- unrecognized until there are profound s/s

Question 4

PP hemorrhage etiology/risk factors

Answer 4

-uterine atony
- lacerations of the genital tract
- hematoma’s
-retained placenta
adherent or non adherent
-inversion of the uterus
-subinvolution of the utrus

Question 5

def inversion of the uterus

Answer 5

turning inside out of the uterus

Question 6

s/s of subinvolution of the uterus

Answer 6

• late PP bleeding
• prolonged lochial discharge
• irreg bleeding

Question 7

PP hemorrhage assessment

Answer 7

• early recognition critical

- eval contractility of the uterus

Question 8

PP hemorrhage interventions

Answer 8

• eval contractility of the uterus
• firmly massage fundus
• call for help STAT
• admin IV fluids and meds to manage bleeding
• may give pitocin to contract the uterus
• try to get pain meds to mom
• glove up
• manually pull out placental residue

Question 9

def thromboembolism

Answer 9

blood clot caused by inflammation or partial obstruction of bv

Question 10

causes of thromboembolism

Answer 10

venous stasis

hypercoag

Question 11

def Puerperal sepsis

Answer 11

any infec of the genital canal within 28 days after abortion or birth

Question 12

what are the most common infec agents in PP infecs?

Answer 12

streptococcal

anaerobic

Question 13

most common PP infecs

Answer 13

• endometritis
• wound infecs
• UTI’s
• mastitis

Question 14

what is the difference bx engorgement and mastitis

Answer 14

• engorgement may cause temp to go up a little, not a lot

- mastitis is infec of the breast

Question 15

s/s of mastitis

Answer 15

fever
weakness
engorgement
redness
swelling
discharge

Question 16

can a mom breastfeed if she has mastitis

Answer 16

yes

Question 17

can a mom breastfeed out of the infected breast with mastitis

Answer 17

yes

Question 18

what common abx is used for the tx of mastitis

Answer 18

Lorabid

Question 19

can a mom nurse while on an abx for mastitis

Answer 19

yes

Question 20

disorders of uterus/vagina r/t childbearing

Answer 20

• uterine displacement/prolapse

- urinary incontinence

Question 21

which is more serious: uterine displacement or prolapse?

Answer 21

prolapse

Question 22

def cystocele

Answer 22

protrusion of the bladder downward into the vagina when support structures in vescovaginal septum are injured

Question 23

def rectocele

Answer 23

herniation of the anterior rectal wall through relaxed or ruptured vaginal fascia and rectovaginal septum

Question 24

who does PP mental health disorders affect?

Answer 24

-mother
baby
entire family

Question 25

how does PP MH disorders affect PP

Answer 25

- interferes with attachment to newborn - interferes with fam integration of the newborn - threatens safety of mother, newborn, other children

Question 26

what is the difference bx baby blues and PP depression

Answer 26

- 70% of women experience baby blues after birth | - PP depression causes mom inability ot care for herself, baby, other children

Question 27

def PP depression w/o psychotic features

Answer 27

- an intense and pervasive sadness w/ severe and labile moods swings

Question 28

tx for PP depression

Answer 28

antidepressants anxiolytic agents ECT psychother

Question 29

what are psychother foci

Answer 29

fears and concerns of new repsonsibilities and roles | monitoring for suicidal or homicidal thoughts

Question 30

def PP depression w/ psychotic features

Answer 30

syndrome char by depression, delusions, hallucinations, and thoughts of harming infant or self

Question 31

PP depression w/ psychotic features is considered a Psych emergency

Answer 31

true

Question 32

tx options of PP depression w/ psychotic features

Answer 32

antipsychotics | mood stabilizers - lithium

Question 33

when can loss and/or grief be perceived?

Answer 33

- loss of hoped for, dreamed about, planned - loss of control during birth experience - birth of child w/ handicap - maternal or fetal/neonatal death

Question 34

what is the most common and serious OB PP complcation

Answer 34

PP hemorrhage

Question 35

t/f- hemorrhagic shock is considered an emergency

Answer 35

true

Question 36

how does hemorrhagic shock affect the body?

Answer 36

- decr blood perfusion to body organs severely compromised | - death