Risk factors for postpartum hemorrhage Quizlet
Terms in this set (48)•Occurs when blood loss in the first 24 hours is greater than 500 ml for a vaginal delivery or greater than 1000 ml for a cesarean delivery Early Postpartum Hemorrhage aka PRIMARY •Hemorrhage that occurs after the first 24 hours with same volume as indicated above Late Postpartum Hemorrhage aka SECONDARY 1 gm = 1 ml of blood Expect decrease/drop in Hg-- removal of excess hemo volume Main Causes of Postpartum Hemorrhage (PPH) are: •Uterine atony (decreased tone) The myometrium fails to contract (involute) and the uterus fills with blood due to the lack of pressure on the open Uterine Atony Uterine Atony Predisposing Factors •Prolonged
labor What is the most common cause of hemorrhage (PPH)? Uterine Atony •Key to successful
management is: PREVENTION! Protect the norm! (check often, check lochia/pad, empty bladder) Signs and Symptoms of Uterine Atony A boggy uterus that does not respond to massage Nursing Care of uterine atony •Document Vaginal Bleeding On documenting vaginal bleeding: Remember-- scant, small, medium, large, excessive PREDISPOSING FACTORS: 1. Spontaneous or Precipitous delivery •Signs and Symptoms 1. Bright, red bleeding, a steady trickle of blood, firm uterus. •Treatment and Nursing Care 1.
Meticulous inspection of the entire lower birth canal You are assigned to Mrs. B. who delivered vaginally. During the post-partum assessment, you notice that she has an excessive amount of lochia rubra on the peri-pad. Touch the fundus! Is it firm? It is, then the problem is elsewhere. Look at perineum! Check sutures! Check for hematomas! •Incomplete separation of the placenta and fragments of placental tissue are retained. Retained Placental Fragments Treatment for Retained Placental Fragments? •D & C Major Symptom of Hematoma? What's a major vital sign symptom that? Treatment? Major Symptom: PAIN- deep, severe, unrelieved, feelings of pressure, pain Treatment: If you see a hematoma.....? Might have to insert what? •Use ICE Might have to insert foley cath if pressure is on the urtethra. What is the most common cause of Late Postpartum Hemorrhage? •Most common cause is retained placental fragments What is done to treat Late Postpartum Hemorrhage? (2) •D & C Are these Early, Late, or Both ? •Uterine Atony--- EARLY, usually Postpartum Infections ... •Definition Micro Culprits? Postpartum Infections •Causes Predisposing Factors for Postpartum Infections 1. Trauma Critical to Remember •Signs and Symptoms of Postpartum Infection (5) 1.Temperature increase of 100.4 or higher on any 2 consecutive days of the first10 days post-partum, not including the first 24 hours. TREATMENT AND NURSING CARE Postpartum INFECTION What do you do? •Administer broad spectrum antibiotics What is the classic sign of a Postpartum Infection? Temperature increase of 100.4 or higher on any 2 consecutive days of the first10 days post-partum, not including the first 24 hours. Complications of Postpartum Infections Signs and Symptoms?: •Spiking a fever of 102-104 How to prevent Postpartum Infections •Prompt treatment of anemia (HGB LESS THAN 10) Where might you see localized infection? Signs? Treatment? •Infection of the episiotomy, perineal laceration, vaginal or vulva lacerations •Signs: Mrs. X. was admitted with endometritis and Mrs. Y. was admitted with an infection of her cesarean incision. Are both classified
as a puerperal Infection? YES, both are puerperal infections. Both incurred bc of delivery. Mrs X. Endometritis-- not visible. May not see much Postpartum Cystitis ... •Causes of Postpartum Cystitis •Stretching or trauma to the base of the bladder results in edema of the trigone that is great enough to obstruct the urethra and cause acute retention. •Prevention/Treatment of Postpartum Cystitis •Monitor the patients urination diligently! •Treatment Marked Engorgement Mastitis Types of Mastitis Mammary Cellulitis inflammation of the connective tissue BETWEEN the lobes in the breast Mammary Cellulitis infection in the ducts and lobes of the breasts Mammary Adenitis look as causes of slide ... Treatment of Mastitis What antibiotics? •Rest Preventive Measures: Mastitis •Meticulous Hand washing Breast Abscess Breast feeding is stopped on the affected side, but may feed on the unaffected side. Treatment: Incision and drainage, antibiotics Thromboembolic Disease Predisposing Factors? •Stasis of blood in the legs •Signs and Symptoms •Treatment of Thromboembolic Disease •Heparin --does not cross
into breast milk •Risk factors: for Post Partum Depression •Primiparity •Predisposing Factors for Postpartum Psychosis •Similar to factors for postpartum depression Treatment for Mood Disorders Drug therapy (SSRI) •How do the signs and symptoms of hematoma differ from those of uterine atony or a laceration? •What laboratory order should the nurse expect if the woman is on heparin anticoagulation? •What is the significance of a board-like abdomen in a woman who has endometritis? •Why is it important for the breast-feeding mother to continue breast-feeding during treatment for mastitis? •What is the key difference between postpartum blues and postpartum depression? ... Sets with similar termsComplications in Post-Partum period (full)41 terms Coco3807 MOD 1 Postpartum Complications82 terms nikhitam94 postpartum74 terms lovansarah Chapter 2874 terms Andrew_Nelson77 Sets found in the same foldermore comps of labor and delivery62 terms ruddergrl Complications of Pregnancy127 terms ruddergrl RNSG 2432 - Valvular HD, Aneurysms, Myop…51 terms ruddergrl Emergency88 terms ruddergrl Other sets by this creatorTerms10 terms ruddergrl Chapter 8 cell energy review41 terms ruddergrl Shoot system15 terms ruddergrl The human body systems66 terms ruddergrl Recommended textbook solutions Pharmacology and the Nursing Process7th EditionJulie S Snyder, Linda Lilley, Shelly Collins 382 solutions
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What are the etiology and risk factors for developing postpartum hemorrhage quizlet?The most common cause of early postpartum hemorrhage is uterine atony, but it can also be caused by trauma, lacerations, and hematomas. Late postpartum hemorrhage is most commonly caused by retained placental fragments. This is the most common cause of early postpartum hemorrhage.
What are the 4 causes of PPH?As a way of remembering the causes of PPH, several sources have suggested using the “4 T' s” as a mnemonic: tone, tissue, trauma, and thrombosis.
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