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29 Cards in this Set
- Front
- Back
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temperature best signals postpartal infection?
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A temperature over 100.4°F (38°C) after the first 24 hours is suggestive of postpartal infection.
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Normal wbc count postpartal?
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WBC of 20,000 to 30,000 mm3 probably as a result of inflammation of the uterus
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Massaging a uterus is a measure to control postpartal bleeding. To do this, you would
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place one hand at the base of the uterus to anchor it.
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A saturated perineal pad contains approximately how much blood?
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Weighing pads to determine the weight (1 gm = 1 mL) is as an effective way to determine the amount of blood in a pad (about 25 to 50 mL).
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All women in the postpartum period are at high risk for thrombophlebitis. This is because
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-stasis of lower extremity vessels due to dilation.
-Stasis in dilated vessels leads to increased clotting. |
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If a woman develops a deep vein thrombus in the femoral vein, a common intervention would be to
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-apply moist heat over the site
-.Moist heat helps to decrease inflammation and prevent further clotting. |
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The antidote for Warfarin (Coumadin) is
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Vit K
-Coumadin blocks the hepatic synthesis of vitamin-K-dependent clotting factors, supplying vitamin K increases these factors and counteracts the effect of the drug |
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high risk for urinary retention postpartally?
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large fetus can cause urinary retention
-Bladder edema can lead to decreased emptying ability |
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Uterine atony,
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or relaxation of the uterus, is the most frequent cause of postpartal hemorrhage.
-The uterus must remain in a contracted state after birth to keep the open vessels at the placental site from bleeding. |
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the first step in controlling hemorrhage is
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uterine massage to encourage contraction
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fundal Massage should be done only when.
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uterus is not firm; otherwise muscle fatigue and uterine relaxation may occur
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Aggressive fundal massage may lead to
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partial or complete uterine prolapse.
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Third degree Perineal Lacerations:
Fourth degree |
3rd: Entire perineum, extending to reach the external sphincter of the rectum
-4th: Entire perineum, rectal sphincter, and some of the mucous membrane of the rectum |
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Nursing interventions for 3rd and 4th degree perineal laceration
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-No enema or rectal suppository
-no rectal temp |
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incomplete return of the uterus to its prepregnant size and shape.
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Subinvolution
-uterus is enlarged & soft at 4-6 wks postpartal -locial d/c present -cause:retained placental fragment (a mild endometritis) or uterine myoma |
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endometritis:
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infection of the endometrium
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A chronic loss of blood from subinvolution will result in infection or anemia and lack of energy, conditions that possibly could interfere with
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infant bonding.
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Oxytocic drugs are going to be prescribed for the retained placental fragments (POC), how do you know the drug is effective?
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-if pt c/o cramping
uterus is come down 1 fingers breath/day if uterus does not come down= subinvolution |
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an infection of the endometrium, the lining of the uterus
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Endometritis
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S/S of endometritis:
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chills, loss of appetite,
general malaise uterus painful to touch, not contracted well lochia will be dark brown w/ foul odor |
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Should complete bed rest be recommended for this pt?
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No
-Sitting in a Fowler's position or walking encourages lochia drainage by gravity and helps prevent pooling of infected secretions. |
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infection of the peritoneal cavity, usually occurs as an extension of endometritis.
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Peritonitis
- It is one of the gravest complications of childbearing and is a major cause of death from puerperal infection |
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Tx for thrombophelbitis (DVT):
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Treatment consists of strict bed rest w/ the affected leg elevated, admin of anticoagulants, and application of moist heat.
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Drug prevents formations of more clots but doesn't dissolve the clot
-given to pt's w/ DVT? |
Heparin drip
-lochia will increase w/ an anticoagulant -safe to breastfeed w/ heparin but not coumadin |
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How is DVT assessed/dx or confirmed?
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Homan's sign (pain in the calf of the leg on dorsiflexion of the foot
-skin: stretched from swelling, shiny and white *Confirms DVT: doppler ultrasound or venography |
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Cause of urinary retention (impaired urinary elimation r/t)?
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-use of anesthesia
-trauma -infection -deviated fundus |
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What assessment would indicate pt is having urinary retention?
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-Voiding is very frequent & in small amounts; her overall output is inadequate. Always measure the amt of a woman's first voiding after birth. As a rule, if this voiding is < 100 mL, suspect urinary retention
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Amt of urine output post partum?
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3000mL/day
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urinary retention is confimed by:
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catheterizing a woman immediately after she voids. If the amt of urine left in the bladder after voiding (termed residual) is < 100 mL, the woman has retention of more than the normal amount
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