Postpartum-At-Risk

What are some of the causes of postpartum hemorrhage?

-Trauma to birth canal
-coagulation disorder
-retained placenta
-prolonged labor
-Use of oxytocin
-multiparity

What are the classic symptoms of postpartum endometritis?

-foul smelling lochia
-fever & chills
-tenderness upon palpation of the uterus
-tachycardia
-low abdomen pain

A nurse does a postpartum assessment of a woman 24 hours postpartum. The patient had a vaginal delivery of a 9 lb 2 oz. male infant with a 2nd degree perineal laceration. The perineal assessment reveals a reddened slightly edematous perineum with good app

Encourage sitz baths

Celestina had her 3rd baby by cesarean birth yesterday. The nurse's assessment reveals an elevation in temperature, chills, nausea, and increased pain. The nurse notifies the physician and receives the following orders: ampicillin 500 mg. IV every 6 hours

ampicillin 500 mg

What can be done to prevent postpartum cystitis?

-encourage frequent voiding
-monitor bladder for distension
-straight cath-if unable to void
-perineal care-keep area clean
-encourage fluid intake
-aseptic technique during foley care
-utilize ice packs, warm water sitz baths

Yaeko, a 24 yo G1P1001 develops mastitis 1 week postpartum. She is re-admitted for IV antibiotics. One nursing diagnosis is deficient knowledge about appropriate breastfeeding techniques. What nursing interventions can be instituted to address this diagno

-encourage regular, consistent emptying of the breast
-switch breasts for feeding
-gentle massage of hard, lumpy areas while feeding
-make sure the baby is properly latched on while feeding
- place warm washcloth on affected breast prior to feeding

The home health nurse is visiting a new mother whose baby was delivered by emergency C/section after a car accident. The mother seems dazed, irritable, and unaware of her surroundings. She tells the nurse she has trouble sleeping. The nurse would suspect

Post-traumatic stress disorder

What are the characteristics of superficial thrombophlebitis?

-Clotting process involves saphenous vein- tender palpable cord
-Usually appears on 3rd or 4th PP day
-Management: leg elevation, moist packs, bed rest, elastic support hose

What are the characteristics of Deep Vein Thrombosis (DVT)?

-more frequently seen in women with hx of thrombosis
-edema of ankle & leg, low grade fever and leg pain
-chills, change in limb color (pale, cool to the touch)
difference in limb circumference of more than 2 cm

What are the characteristics of Pulmonary embolism (PE)?

-Sudden onset of sweating, pallor, dyspnea and chest pain, SOB tachycardia
-prompt intervention with heparin, oxygen, lidocaine
-treatment: IV heparin and bedrest

Define "baby blues

occurs within 1st few days after birth-2 weeks
-Doesn't affect patient functioning
-occurs in 85% of women
S&S: rapid mood swings, emotional hypersensitivity,
-self-limiting from a few hrs to 2 weeks
-worse in 1st time moms

Define postpartum depression

clinical depression
-can occur throughout the 1st year and affects mom's functions
-Risk factors: past PPD, history of depression, biopolar disorder, GAD, psychosis, lack of social support, stressful events in pregnancy

How is infection related to perinatal loss?

- prolonged retention of the fetus can lead to severe infection
-maternal infection (Flu, UTI) can infect the fetus- decrease blood flow- ultimately fetus dies

A family experiences perinatal loss at 23 weeks. The mother declines to see the baby immediately after birth. What is a nursing action that will help her process her grief?

-open communication
-nonjudgmental attitude
-physical presence
-normalization of grief reactions
-acknowledge the difficulty of situation and let them know you are available to talk when ready

Define bereavement

the state or condition caused by loss through death
-suffering the event of loss

Define grief

emotional response to loss
-individuals reaction to the loss

Define mourning

process by which individuals incorporate the experience of grief into their lives

What does the responding mnemonic stand for?

?Recognition and validation of the loss
?Emotional availability
?Spiritual and cultural accommodation
?Physical presence
?Open communication
?Normalization of grief reactions
?Decision-making assistance
?Interprofessional involvement
?Nonjudgmental attitu