Questions and Answers
What is a primary cause of postpartum urinary tract infections (UTIs)?
Which of the following describes a critical aspect of managing hemorrhagic (hypovolemic) shock?
What is the most effective approach for preventing postpartum infections?
Which intervention is critical in restoring oxygen delivery during a hemorrhagic shock situation?
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What is a serious maternal complication associated with clotting disorders during obstetric care?
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What physiological process contributes to the development of hypovolemic shock?
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What defines a postpartum infection regarding fever?
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Which of the following is the most common postpartum infection?
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What is the preferred management for endometritis?
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What percentage of mothers experience wound infections after cesarean birth?
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Postpartum urinary tract infections (UTIs) are characterized by which symptoms?
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What complication can occur with prolonged rupture of membranes?
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Which treatment is indicated for mastitis?
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Which of the following conditions is NOT commonly associated with postpartum fever?
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What is the first step in the management of postpartum hemorrhage?
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Which of the following is NOT a uterotonic medication used to manage postpartum hemorrhage?
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What are the 4 T's that are causes of postpartum hemorrhage?
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Which intervention involves emptying the bladder during postpartum hemorrhage treatment?
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Which complication involves a delayed return of the uterus to its nonpregnant size?
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What is the recommended continuous IV infusion range for oxytocin in managing postpartum hemorrhage?
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What is a potential life-threatening complication of postpartum hemorrhage that is rare but serious?
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Which of the following describes a safety bundle recommended for obstetric hemorrhage management?
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What is the AAP's recommendation for the duration of exclusive breastfeeding?
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Which of the following factors has contributed to the rise in U.S. breastfeeding rates in the past decade?
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How does bilirubin production in newborns compare to that in adults?
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What is the primary system where bilirubin metabolism is initiated in newborns?
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What are the dimensions of neonatal heat loss mechanisms?
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What does the Apgar score evaluate immediately after birth?
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Which of the following is NOT a contraindication to breastfeeding?
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What is a physiological cause of engorgement in breastfeeding mothers?
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Which position is NOT commonly recommended for breastfeeding?
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What should mothers do if they are infected with COVID-19 while breastfeeding?
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What is an appropriate initial treatment for engorgement?
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Breastfeeding is generally considered safe in the presence of which condition?
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Engorgement typically occurs after how many days postpartum?
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What is the primary reason for recommending specific breastfeeding positions?
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Study Notes
Postpartum Infections
- Definition: Puerperal infection occurring within 28 days post-miscarriage, abortion, or birth.
- Symptoms: Fever of 38° C (100.4° F) in first 10 postpartum days indicates infection.
- Endometritis: Most common postpartum infection; characterized by fundal tenderness and fever. Associated with prolonged rupture of membranes and manual bacteria introduction.
- Management: IV antibiotics (e.g., Gentamicin & Clindamycin) for 24 hours afebrile; cultures not typically performed.
Wound Infections and UTIs
- Wound Infections: Rates after cesarean birth range from 3% to 5%; may develop post-discharge.
- Urinary Tract Infections (UTIs): Occur in 2% to 4% of postpartum women; symptoms include dysuria and suprapubic pain. Diagnosis via urinalysis.
Other Fever/Infection Causes
- Possible causes include pneumonia, flu, DVT/PE, and mastitis (milk duct infection). Mastitis treated with dicloxacillin.
Postpartum Hemorrhage (PPH)
- A major cause of maternal morbidity/mortality and obstetric ICU admissions globally.
- Hemorrhagic (hypovolemic) shock is life-threatening; early intervention is crucial.
- Clotting disorders can complicate postpartum conditions.
Hemorrhagic Shock Management
- Focus on restoring blood volume and eliminating the cause.
- Use of fluid or blood replacements, uterotonics (e.g., Pitocin, Hemabate).
Interprofessional Care for PPH
- Standards involve teamwork and protocols for quick recognition and response to PPH.
- Early recognition and intervention critical; includes uterine fundus massage and IV medication.
- Surgical interventions may be necessary for severe cases.
Causes of Postpartum Hemorrhage (4 T's)
- Tone: Issues with uterine contraction leading to subinvolution or inversion.
- Trauma: Injury during labor/cesarean delivery.
- Tissue: Retained placental fragments causing complications.
- Thrombin: Coagulation disorders exacerbating bleeding.
Breastfeeding Considerations
- Breastfeeding generally safe even with maternal illness; COVID-19 not transmitted through breast milk.
- Contraindications include maternal infections (HIV, untreated brucellosis, active TB) and newborn's galactosemia.
- Varied breastfeeding positions may alleviate discomfort.
Engorgement and Infant Feeding Recommendations
- Physiological engorgement occurs around 3 days postpartum; resolves within 24 hours with treatment (ice packs, cabbage leaves).
- AAP recommends exclusive breastfeeding for first 6 months, continuing for at least 12 months with solid foods introduced thereafter.
Neonatal Considerations
- Jaundice: Newborns produce bilirubin at higher levels; metabolism primarily occurs in the liver.
- Neonatal Heat Loss: Methods of heat loss include conduction, convection, evaporation, and radiation.
Apgar Score
- Quick assessment of newborn health immediately post-birth, evaluating appearance, pulse, grimace, activity, and respiration.
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Description
Prepare for Exam #3 with this comprehensive study guide focused on postpartum infections, also known as puerperal infections. Learn about their definition, symptoms, and clinical significance in the postpartum period. This guide will help you understand the criteria for identifying these infections and their impact on maternal health.