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GRCC High Risk postpartum care

What are the primary physiological disorders postpartum? Hemorrhage, coagulation disorders and infection.
What are the primary psychological disorders? Postpartum depression and postpartum psychosis.
What is a major complication of postpartum hemorrhage? Hemorrhagic shock related to hypovolemia.
What is early postpartum hemorrhage (PPH)? Defined as blood loss of greater than 500 mL within the first 24 hours.
What are causes of early PPH? Uterine atony, lacerations and hematomas.
What are causes of late PPH? hematomas, subinvolution and retained placental tissue.
subinvolution Failure of the uterus to return to its normal size following childbirth.
Risk factors of PPH Neonatal macrosomia; polyhydraminos; operative vag delivery; induced labor;ineffective uterine contractions;precipitous labor;general anesthesia.
Polyhydrminos presence of excessive amniotic fluidamniotic fluid surrounding the unborn infant.
Signs and symptoms of early PPH 10% increase in hct post birth; saturation of peripad within 15 minutes;fundus that remains boggy after massage;tachycardia; decrease in blood pressure.
Thrombosis A blood clot within the vascular system. women are at risk for forming blood clots during pregnancy through the first 6 weeks of pg
Risk factors for thrombosis Normal physiological changes in coagulation related to pregnancy; c-section (5x greater than vag birth); endometrititis; decreased mobility; obesity; increased parity
Signs and symptoms of thrombosis Positive homans sign, tenderness and heat over the affected area, leg pain with walking, swelling in the affected leg.
Medical mgmt of thrombosis Doppler ultrasonagraphy;compression stockings; coagulation therapy; antibiotic and bed rest.
What is the major cause of death for mama's? Genital tract infection.
What is the major cause for endometritis? Streptococci...it is a local infection of the endometrium- who lining of the uterus can get infected.
Signs and symptoms of endometritis Increased temp, increased pulse, chills and malaise. Decreased appetite, back ache and sever after birth pain. Also, foul smelling lochia..unless streptococcus is present, then lochia is scant and odorless.
Risk factors for endometritis Prolonged rupture of membranes; prolonged labor; c-section;internal fetal and uterine monitoring; anemia;malnutrition; PPH; diabetes
Medical mgmt of endometriosis Antibiotic;UA, CBC, Blood culture; endometrial culture; have mama sit in fowler position
Salpingitis Infection of fallopian tubes transmitted from uterus to venous how tubes infected
Signs and symptoms of salpingitis Increase temp, increase pulse, rigidity ab.
Med mgmt of salpingitis antibiotics and analgesics.
Complications of salpingitis Infertility, usually just one side
Nursing actions for endometris Min fluid intake of 3000 ml/day, change peripads each time they void, proper hand washing techniques, high diet in protein and vitamin C,.
Cystitis is an infection of the bladder This is a common occurence in the postpartum period. If left untreated, could lead to pyelonephritis.
Signs and symptoms of cystitis Low grade fever (<38.5c/101F), burning urination, supapubic pain, urgency to void, small frequent voids (less than 150 ml/voiding)
Med mgmt of cystitis Encourage to void, if not more than 200 ml/void, then you'll have to cath the mom. Give antibiotics and get labs (UA, CBC, urine culture)
How many times/day should a woman void if she has cystitis? Every three to four hours
What foods would you recommend for someone with cystitis cranberry juice, apricots and plums.
Thrombolitis Blood clots in legs due to extra blood; puts pressure on femoral arteries; use support stockings.
Treating thrombolitis Encourage early ambulation to avoid blood pooling.
Thromobolitis manifestations warmth, swelling reddish
Med mgmt of thrombolitis Give heparin
Complications of thrombolitis Pulmonary emboli, filling of lungs, pneumonia.
Mastitis Inflammation/infection of the breast- usually unilaterally w/in first 2 postpartum weeks after milk flow
When does infection resolve if mama has mastitis? Usually within 24 to 48 hours of antibiotic therapy.
Risk factors for mastitis History of it, cracked and or sore nipples, use of antifungal nipple cream (usually applied when NB has thrush)
If abscess occurs in breast encourage mama to continue expressing milk to promote flow and prevent it from plugging up.
Treating mastitis Broad spectrum antibiotics, apply heat and/or cold, breastfeed every 2 to 3 hours
Post partum depression Requires psychiatrtic interventions, occurs within 6 months post partum, unable to safely care for baby or self
Post partum blues Symptoms disappear without medical intervention, occurs within 2 weeks postpartum, able to safely care for baby and self.
Post partum psychosis varian bi-polar disorder; delusional, mood swings, agitation;confused thinking;strange beliefs.
Created by: Wends1984