Postpartum Complications ch17

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Postpartum Complications ch17
2015-01-09 11:49:34
postpartum ob maternity
eastern suffolk boces
ob maternity chapter 17
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  1. Common Postpartum complications
    • hemorrhage
    • thromboembolic disorders
    • subinvolutuon of uterus
    • infections
    • depression
  2. Postpartum hemorrhage
    -how much blood loss ( for vaginal and cesarean birth)
    -when can it occur
    • -blood loss more than 500 ml after uncomplicated vaginal birth  & 1000 ml after cesarean birth
    • -can occur early 24 hrs after deliver OR  Late 24hrs-6 weeks after birth
  3. causes of ostpartum hemorrhage
    • -early: uerine atony and laceration
    • -late: retained placental fragment or subinvolution
  4. inability of the myometrium muscle to contract and stay contracted around the open blood vessels; hypertonic uterus is called___
    uterine atony
  5. causes of uterine atony
    -mechanical factors
    • retained placental fragments
    • large blood clots
    • extreme uterine distention (multifetal)
    • full urinary bladder
  6. causes of uterine causes (metabolic factors
    • muscle exhaustion due to lactic acid buildup
    • hypocalcemia
  7. causes of uterine atony drugs
    magnesium sulfate calcium channel blockers
  8. if uterus is firm and bleeding what is happening
    hemorrhage d/t lacerations or episiotomy
  9. differemce between firm fundus and full bladder
    bladder feels more like a balloon, fundus feels like grapefruit
    suppose to feel fundus to go down ______
    1-2 finger breaths day
    you clott, but u lost all reserves nothing to sustain clot so u bleed again..clot bleed clot bleed over and over again. oozing from an iv site, petechiae, ecchymosis oliguria and restlessness
  12. in pregancya nd early postpartum shock is considered
  13. in preegnancy and early post partum  is  shock considered an early or late sign of DIC.? and why?
    late and go look up why! :-)
  14. inherited disorder. decrease in plasma.....
  15. anaphylactoid dyndrome of pregnancy
  16. s/s of pulmonary embolism
    • -bp goes up then down
    • petechia
    • tachypnea
    • tachycardia
  17. clot resolves in__-__ days
    7-10 days
  18. risk factors for postpartum hemorrhage
    • hydramnios
    • bladder distention
    • macrosomia
    • uterine atony
  19. type of embolism can cause significant damage to the heart of a postpartum woman.
    A. pulmonary embolism
    B. amniotic fluid
    C. aortal
    D. cerebral
    B. amniotic fluid
    (this multiple choice question has been scrambled)
  20. signs and symptoms of postpartum (Pueral) infection
  21. difference between postpartum blues and postpartum pyschosis
    pyschosis: safety of woman and her newborn are at risk, psychiatric interventions, including medications, confusion, restlessness, anxiety and suicidal thoughts, delusional thoughts may be expressed

    • postpartum blues-transient state; rarely lasts more than 10 to 14 days, feeling overwhelmed and unable to cope, oversensitive with periods of unexplained tearfulness.
    • treatment: rest anticipatory guidance, empathy, reassurance, support and assistance
  22. NCLEX: Postpartum hemorrhage is traditionally defined as the loss of more than 500 ml after an uncomplicated vaginal birth or:
    1. 600 ml after a cesarean birth
    2. 800 ml after a cesarean birth
    3. 1000 ml after a cesarean birth
    4. 1200 ml after cesarean birth
    1000 ml after cesarean birth
  23. when performing a morning assessment on a 1-day postpartum mother, the nurse notes excessive bright red vaginal bleeding with uterine fundus firmly contracted.
    1. hematoma
    2. placenta accreta
    3. disseminated intravascular coagulation
    4. lacerations
  24. the first action with uterine atony should be to
    1. assess for bladder distention
    2. massage  the uterus until firm
    3. express clots
    4. administer oxytocin intravenously
    massage the uterus until firm
  25. retained placental fragments can be a late or early sign of postpartum hemorrhage  lacerations and uterine atony happen before it though
    read pg 344-345 for more clarification please and thank you
  26. note to self !!! finish entering nclex questions from chapter 17