Management of Hemorrhagic Shock
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Management of Hemorrhagic Shock

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Questions and Answers

What is the recommended duration for exclusive breastfeeding according to AAP?

  • 9 months
  • 6 months (correct)
  • 12 months
  • 4 months

    • What is the primary cause of jaundice in newborns?

  • Poor feeding practices
  • Overproduction of bilirubin due to liver failure
  • Increased hemoglobin levels
  • Shorter lifespan of RBCs (correct)

    • At what age does the AAP recommend introducing solid foods to infants?

  • 3 months
  • 4 months
  • 6 months (correct)
  • 12 months

    • What are the mechanisms of neonatal heat loss?

    <p>Conduction, conversion, evaporation, and radiation</p> Signup and view all the answers

    Which of the following conditions can result from untreated jaundice in newborns?

    <p>Acute bilirubin encephalopathy</p> Signup and view all the answers

    What is the purpose of the Apgar score?

    <p>To evaluate a newborn's health immediately after birth</p> Signup and view all the answers

    What is the first step in managing postpartum hemorrhage (PPH)?

    <p>Firm massage to uterus/fundus</p> Signup and view all the answers

    Which of the following antibiotics is commonly used to treat mastitis?

    <p>Dicloxacillin</p> Signup and view all the answers

    What is a common predisposing factor for mastitis in breastfeeding women?

    <p>Sore, cracked nipples</p> Signup and view all the answers

    Which procedure is NOT part of the management for postpartum hemorrhage?

    <p>Restricting fluid intake</p> Signup and view all the answers

    Which breast quadrant is most commonly affected by mastitis?

    <p>Upper outer quadrant</p> Signup and view all the answers

    What is an important aspect of postpartum care to prevent infection?

    <p>Strict adherence to aseptic techniques</p> Signup and view all the answers

    Which is NOT a symptom of mastitis?

    <p>Joint pain</p> Signup and view all the answers

    What should patients be taught before discharge to manage potential mastitis?

    <p>Signs and symptoms of mastitis</p> Signup and view all the answers

    What is the primary consequence of hemorrhagic (hypovolemic) shock?

    <p>Severely compromised organ perfusion</p> Signup and view all the answers

    Which of the following is a key focus in the interprofessional care management of hemorrhagic shock?

    <p>Restoring circulating blood volume</p> Signup and view all the answers

    What is the role of uterine massage in the management of hemorrhage?

    <p>It aids in stimulating uterine contractions</p> Signup and view all the answers

    Why are postpartum urinary tract infections (UTIs) common?

    <p>As a result of labor-related trauma</p> Signup and view all the answers

    Which approach is most effective for preventing postpartum infection?

    <p>Hygiene education for new mothers</p> Signup and view all the answers

    What is a major cause of maternal morbidity and mortality worldwide?

    <p>Postpartum hemorrhage</p> Signup and view all the answers

    What condition is caused by increased amounts of glucose crossing the placenta in infants of diabetic mothers?

    <p>Hyperinsulinemia</p> Signup and view all the answers

    Which of the following is NOT a potential complication for infants of mothers with pregestational diabetes?

    <p>Cerebral palsy</p> Signup and view all the answers

    What distinguishes cephalhematoma from caput succedaneum?

    <p>Cephalhematoma is a collection of blood under the periosteum</p> Signup and view all the answers

    Which condition is characterized by subcutaneous edema over the presenting part of the fetal head?

    <p>Caput succedaneum</p> Signup and view all the answers

    What is a potential volume of blood that the subgaleal compartment can hold in a 3-kg newborn?

    <p>240 mL</p> Signup and view all the answers

    Which of these complications is NOT associated with the infant of a diabetic mother in the postnatal period?

    <p>Hypotension</p> Signup and view all the answers

    What is the primary goal of the interventions when managing postpartum hemorrhage?

    <p>To identify and treat the underlying cause of bleeding</p> Signup and view all the answers

    Which medication is NOT classified as a uterotonic for controlling postpartum hemorrhage?

    <p>Ibuprofen</p> Signup and view all the answers

    What is a common sign of subinvolution of the uterus?

    <p>Prolonged lochial discharge</p> Signup and view all the answers

    Which component is NOT part of the California Maternal Quality Care Collaborative safety bundle for obstetric hemorrhage?

    <p>Retreat and Recovery</p> Signup and view all the answers

    Which intervention is considered a surgical management option for postpartum hemorrhage?

    <p>Uterine artery embolization</p> Signup and view all the answers

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

    <p>Tone, Trauma, Tissue, Thrombin</p> Signup and view all the answers

    Which of the following is a symptom of inversion of the uterus?

    <p>Acute pain and hemorrhage</p> Signup and view all the answers

    What is an initial nursing intervention before administering uterotonics for postpartum hemorrhage?

    <p>Empty the bladder</p> Signup and view all the answers

    Study Notes

    Hemorrhagic (Hypovolemic) Shock

    • Emergency resulting from significant blood loss, compromising organ perfusion.
    • Potentially leads to death without timely intervention.
    • Interprofessional care focuses on restoring blood volume and addressing hemorrhage causes.
    • Treatment includes fluid or blood replacement therapy and maintaining oxygen delivery to tissues.

    Management of Hemorrhagic Shock

    • Uterine massage and prompt calling of code hemorrhage are essential.
    • Use a hemorrhage cart and adhere to standing orders.
    • Establish large bore IV access (typically 18 or 20 gauge) for isotonic fluids.
    • Ensure bladder is emptied to facilitate uterine contraction.
    • Administer uterotonics such as Pitocin, Hemabate, Methergine, and Cytotec.
    • Laboratory tests include CBC, Type/Screen, and preparation of blood products.
    • Apply physical pressure through tamponade or devices (Foley, Bakri balloon) and remove placental products.
    • Surgical options may include uterine artery embolization, removal of retained products, uterine repair, or hysterectomy.

    Postpartum Hemorrhage (PPH) Management

    • Importance of standardized protocols and routine emergency drills in healthcare settings.
    • Utilize a safety bundle addressing readiness, recognition, prevention, response, reporting, and system learning.
    • Early recognition and treatment are critical for effective management of PPH.
    • Medical management includes firm uterine massage and IV oxytocin infusion.
    • Surgical management may be required if medical interventions fail.

    Causes of Postpartum Hemorrhage (4 T’s)

    • Tone: Uterine atony due to subinvolution or inversion can lead to severe bleeding.
    • Subinvolution: Delayed return of the uterus to pre-pregnancy size, often from retained placental fragments.
    • Inversion: Rare but life-threatening condition where the uterus turns inside out during childbirth.
    • Trauma, Tissue, Thrombin: Other potential causes of PPH requiring assessment.

    Appropriate Postpartum Care

    • Strict adherence to aseptic techniques during childbirth and postpartum decreases infection risks.
    • Continuous vigilance and communication among healthcare personnel improve outcomes.

    Newborn Nutrition and Breastfeeding

    • Mastitis: infectious breast issue presenting with flu-like symptoms and localized pain, common 2-4 weeks postpartum.
    • Prevention is key; educate mothers on signs of mastitis and encourage timely contact with healthcare providers.
    • Treatment includes bed rest, antibiotics, and anti-inflammatory medication.
    • AAP recommends exclusive breastfeeding for the first 6 months, continuing for at least 12 months, followed by solid foods introduction.

    Jaundice in Newborns

    • Newborns may experience jaundice at higher bilirubin levels due to shorter RBC lifespan.
    • Metabolism occurs in the liver and spleen, with bilirubin binding to albumin before excretion.
    • Acute bilirubin encephalopathy, or kernicterus, poses a significant risk if untreated.

    Neonatal Withdrawal and Heat Loss

    • Understanding of different mechanisms: conduction, convection, evaporation, and radiation critical for infant care.

    Apgar Score

    • Rapid assessment tool evaluating newborn health post-delivery through appearance, pulse, grimace, activity, and respiration.
    • Scores of 7 or higher indicate good overall condition.

    Infant of a Diabetic Mother

    • Hyperinsulinemia can lead to various complications such as macrosomia, birth injuries, respiratory distress, and metabolic conditions like hypoglycemia.
    • Increased bilirubin levels in neonates may arise from excessive RBCs due to maternal diabetes complications.

    Neonate Head Assessment

    • Caput succedaneum: subcutaneous edema from birth pressure; cephalhematoma: blood collection not crossing suture lines.
    • Monitor for more serious complications like subgaleal hemorrhage, which can be life-threatening.

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    Related Documents

    Postpartum Infection Exam Study Guide PDF

    Description

    This quiz focuses on the management of hemorrhagic shock, detailing intervention protocols critical for restoring blood volume and ensuring organ perfusion. Key topics include uterine massage techniques, the use of uterotonics, and necessary laboratory tests. Understanding prompt action in emergencies is crucial for effective patient care.

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