Exam #3 Study Guide: Postpartum Infections

Questions and Answers

What is a primary cause of postpartum urinary tract infections (UTIs)?

Hormonal changes during pregnancy

Trauma experienced during labor (correct)

Improper catheterization techniques

Increased fluid intake post-delivery

Which of the following describes a critical aspect of managing hemorrhagic (hypovolemic) shock?

Use of sedatives to calm the patient

Standardized management protocols and teamwork (correct)

Immediate administration of antibiotics

Strict bed rest and observation only

What is the most effective approach for preventing postpartum infections?

Regular administration of pain relievers

Frequent monitoring of vital signs

Immediate surgical intervention

Preventive measures are key (correct)

Which intervention is critical in restoring oxygen delivery during a hemorrhagic shock situation?

Blood transfusion therapy Signup and view all the answers

What is a serious maternal complication associated with clotting disorders during obstetric care?

Postpartum infection Signup and view all the answers

What physiological process contributes to the development of hypovolemic shock?

Severe hemorrhage Signup and view all the answers

What defines a postpartum infection regarding fever?

Presence of a fever of 38° C (100.4° F) in the first 10 postpartum days Signup and view all the answers

Which of the following is the most common postpartum infection?

Endometritis Signup and view all the answers

What is the preferred management for endometritis?

IV broad-spectrum antibiotic therapy Signup and view all the answers

What percentage of mothers experience wound infections after cesarean birth?

3% to 5% Signup and view all the answers

Postpartum urinary tract infections (UTIs) are characterized by which symptoms?

Burning, frequency, and suprapubic pain Signup and view all the answers

What complication can occur with prolonged rupture of membranes?

Endometritis Signup and view all the answers

Which treatment is indicated for mastitis?

Dicloxacillin Signup and view all the answers

Which of the following conditions is NOT commonly associated with postpartum fever?

Anemia Signup and view all the answers

What is the first step in the management of postpartum hemorrhage?

Call code hemorrhage Signup and view all the answers

Which of the following is NOT a uterotonic medication used to manage postpartum hemorrhage?

Aspirin Signup and view all the answers

What are the 4 T's that are causes of postpartum hemorrhage?

Tone, Thrombin, Trauma, Tissue Signup and view all the answers

Which intervention involves emptying the bladder during postpartum hemorrhage treatment?

Medical management Signup and view all the answers

Which complication involves a delayed return of the uterus to its nonpregnant size?

Subinvolution of the uterus Signup and view all the answers

What is the recommended continuous IV infusion range for oxytocin in managing postpartum hemorrhage?

10 to 40 units Signup and view all the answers

What is a potential life-threatening complication of postpartum hemorrhage that is rare but serious?

Inversion of the uterus Signup and view all the answers

Which of the following describes a safety bundle recommended for obstetric hemorrhage management?

Readiness, Recognition and Prevention, Response, Reporting and Systems Learning Signup and view all the answers

What is the AAP's recommendation for the duration of exclusive breastfeeding?

6 months Signup and view all the answers

Which of the following factors has contributed to the rise in U.S. breastfeeding rates in the past decade?

Personal and sociocultural factors Signup and view all the answers

How does bilirubin production in newborns compare to that in adults?

Newborns produce bilirubin 2-2.5 times that of adults Signup and view all the answers

What is the primary system where bilirubin metabolism is initiated in newborns?

Reticuloendothelial system Signup and view all the answers

What are the dimensions of neonatal heat loss mechanisms?

Conduction, conversion, evaporation, and radiation Signup and view all the answers

What does the Apgar score evaluate immediately after birth?

Infant's appearance, pulse, grimace, activity, and respiration Signup and view all the answers

Which of the following is NOT a contraindication to breastfeeding?

Mothers with mild hypertension Signup and view all the answers

What is a physiological cause of engorgement in breastfeeding mothers?

Temporary congestion of veins and lymphatic vessels Signup and view all the answers

Which position is NOT commonly recommended for breastfeeding?

Sitting cross-legged on the floor Signup and view all the answers

What should mothers do if they are infected with COVID-19 while breastfeeding?

Wear a mask and practice hand hygiene Signup and view all the answers

What is an appropriate initial treatment for engorgement?

Ice packs Signup and view all the answers

Breastfeeding is generally considered safe in the presence of which condition?

COVID-19 Signup and view all the answers

Engorgement typically occurs after how many days postpartum?

3 days Signup and view all the answers

What is the primary reason for recommending specific breastfeeding positions?

To prevent pain associated with improper feeding technique Signup and view all the answers

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.