WARD SEMI MATERNA

Question 1

what rises and falls during pph

Answer 1

rise in pulse rate and fall of bp

Question 2

pph occurs within

Answer 2

24 hours of childbirth but can also happen up to 12 weeks postpartum

Question 3

how much ml of blood does a woman nsvd loses

Answer 3

500 ML

Question 4

cesarean delivery within 24 hrs loses how much amount of blood

Answer 4

1Liters

Question 5

Caesarian Hysterectomy blood loss vol

Answer 5

2L

Question 6

state the
BP:
s&s:
DoS:

BV: 500-1000ml

Answer 6

Normal
palpitate, tachy, dizzy
compensated

Question 7

state the
BP:
s&s:
DoS:

BV: 1000-1500

Answer 7

fall 80-100
weak, tachy, sweating
Mild

Question 8

state the
BP:
s&s:
DoS:

BV: 1500-2000

Answer 8

70-80
restlestness, pallor, oliguria
moderate

Question 9

state the
BP:
s&s:
DoS:

BV: 2000-3000

Answer 9

50-70
collapse, airhunger, anuria
severe

Question 10

(the 6-week period of time
Classification based on amount of blood loss beginning immediately after birth)

Answer 10

puerperium

Question 11

Classification based on amount of blood loss

Answer 11

● Minor: less than 1000 mL

● Major: greater than 1000 mL

● Severe: greater than 2000 mL

Question 12

which stage of pph is where bleeding occurs before the
expulsion of the placenta.

Answer 12

3rd Stage Hemorrhage

Question 13

which stage of pph is where Bleeding occurs after the expulsion of the placenta.

Answer 13

True Postpartum Hemorrhage

Question 14

pph that occurs beyond 24 hours and within
puerperium

Answer 14

Secondary PPH

Question 15

examples of Trauma

Answer 15

laceration
hematomas
uterine rupture

Question 16

bleeding because the placental sites have
closed. This is referred to as

Answer 16

Tone

Question 17

Retained placental fragments. This is also referred to as

Answer 17

tissue

Question 18

DIC meaning

Answer 18

disseminated intravascular coagulation

Question 19

Development of (DIC). This is also referred to as

Answer 19

Thrombin

Question 20

four T’s of postpartum hemorrhage

Answer 20

tone, trauma, tissue and
thrombin.

Question 21

word to describe uterus during tone

Answer 21

boggy

Question 22

examples on how uterus looks

Answer 22

excessive bright red bleeding

boggy uterus

high fundus

abnormal clot

Question 23

Causes for tone: Maternal

Answer 23

multipara
previous history of pph
Maternal anemia

Question 24

Causes for tone : pregnancy compli

Answer 24

Antepartume hemorrhage
overdistention of uterus

Question 25

Causes of tone: labour

Answer 25

Prolonged labour induction of labor Precipitate labor

Question 26

Causes of tone: drugs

Answer 26

Anesthetic drugs Magnesium Nifedipine

Question 27

therapeutic management of tone

Answer 27

bimanual compression Administer oxytocin (PITOCIN)

Question 28

Therapeutic management : tone (drugs)

Answer 28

Carboprost 0.25 IM Misoprostol 1,000 mg rectally Methylergonovine 0.2 mg IM

Question 29

Trauma sites:

Answer 29

○ Vulva ○ Vagina ○ Perineum ○ Cervix ○ Paraurethral region ○ Rupture uterus

Question 30

Therapeutic management include: Trauma

Answer 30

○ Suture lacerations ○ Drain hematomas > 3 cm ○ Replace inverted uterus

Question 31

Retained tissue:

Answer 31

Bit of placenta Blood clot

Question 32

Therapeutic management include: for retained tissue

Answer 32

○ Manual removal ○ Curettage ○ Methotrexate

Question 33

cause of thrombin

Answer 33

diminished pro coagulants (washout effect) or increased fibrinolytic activity.

Question 34

Conditions leading to thrombosis:

Answer 34

Placental abruption Jaundice in pregnancy Prolonged retention of dead fetus Thrombocytopenic purpura

Question 35

Therapeutic management include: Thrombin

Answer 35

○ Fresh frozen plasma ○ Recombinant factor VIIa ○ Platelet transfusion

Question 36

RISK FACTORS: postpartum

Answer 36

distend the uterus cervical or uterine lacerations Inadequate blood coagulation Uterus could not contract readily

Question 37

common symptoms of postpartum hemorrhage.

Answer 37

● Uncontrolled bleeding ● Decreased blood pressure ● Increased heart rate ● Decrease in the red blood cell count (hematocrit)

Question 38

. If the uterus is unable to contract, the physician might prescribe _____ to maintain the tone of the uterus.

Answer 38

Pitocin

Question 39

a prostaglandin derivative that could help in promoting sustained uterine contractions.

Answer 39

Carboprost tromethamine

Question 40

necessary to replace the blood loss.

Answer 40

Blood transfusion

Question 41

measurement of o2 to admnister

Answer 41

4L/min via face mask

Question 42

SURGICAL MANAGEMENT:

Answer 42

Hysterectomy Suturing

Question 43

Nursing Assessment: PPH

Answer 43

● Assess the amount of bleeding. ● Assess maternal vital signs ● Assess for signs of shock. ● Assess the condition of the uterus.

Question 44

Assess ______frequently to determine if the amount discharged is still within the normal limits.

Answer 44

lochia

Question 45

POSSIBLE COMPLICATIONS:pph

Answer 45

Hypovolemic Shock Anemia Coagulation Disorders Organ Damage Infection

Question 46

Prolonged low blood flow can lead to damage in vital organs, such as

Answer 46

kidneys heart

Question 47

condition that occurs due to severe blood loss and insufficient blood flow to the pituitary gland during or after childbirth

Answer 47

SHEEHAN SYNDROME

Question 48

SHEEHAN SYNDROME is presented as what deficiency

Answer 48

anterior pituitary hormone deficiency

Question 49

Antenatal: management:

Answer 49

● Improvement of the health status (keep the Hb level normal, >10 g/dl) ● Blood grouping ● Placental localization must be done ● Women with morbid adherent placenta with high risk PPH delivered by senior consultant

Question 50

Intranatal: management

Answer 50

● Active management of 3rd stage of labor ● For cases with induced or augmented labor by oxytocin, the infusion should be continued for at least 1 hour after delivery ● Women delivered by caesarean given oxytocin 5IU slow IV ● Exploration of uterovaginal canal for evidence of trauma