30 Questions
Why is it important to keep the bladder empty during the early postpartal period?
To prevent interference with effective uterine contractions
What is the purpose of weighing perineal pads before and after use?
To measure the amount of blood loss accurately
What is the initial step in managing uterine atony?
Massaging the uterus gently
What is the significance of tachycardia and hypotension in the early postpartal period?
Significant vital sign changes in hemorrhage
What is the purpose of bimanual uterine compression?
To compress the uterus through the abdomen and vagina
What is the last resort in managing uterine atony?
Hysterectomy
What is the definition of Small for Gestational Age (SGA) infant?
An infant whose birth weight is below the 10th percentile on an intrauterine growth curve
What is a possible cause of intrauterine growth restriction or retardation (IUGR)?
Mother's poor nutrition during pregnancy
What is a characteristic of SGA infants' appearance?
Below average in weight, length, and head circumference
What is a nursing diagnosis for SGA infants?
Risk for impaired parenting related to child’s high-risk status and possible cognitive impairment from lack of nutrients
What is an assessment tool used in prenatal care to detect SGA?
All of the above
What is a possible complication of SGA due to small liver?
Difficulty regulating protein, glucose and bilirubin
What is the primary reason why large hematomas are potentially dangerous?
They may rupture and cause severe bleeding and infection
What is the purpose of applying ice packs wrapped in a towel to the woman?
To stop bleeding by vasoconstriction
What is the general term used to describe infection of the genital tract after delivery?
Childbed fever
What makes a newly delivered woman susceptible to infection?
Lowered resistance due to blood loss and fatigue
Which of the following is a predisposing factor for infection?
All of the above
What type of organism can cause infection in the genital tract after delivery?
Any of the above
What is the purpose of placing a tube in the infant's trachea and suctioning as it is withdrawn?
To remove any blockages or secretions
What is a potential complication of perinatal asphyxia?
Residual brain damage due to lack of oxygen
What is a potential diagnosis for an infant of a diabetic mother?
Ineffective airway clearance
What is a treatment option for an infant with perinatal asphyxia?
use of a breathing machine (ventilator)
What is a common problem in infants of diabetic mothers?
All of the above
Why may an infant be placed in the special care nursery or newborn intensive care unit?
For close observation
What is the age range of children that parents should be cautious of regarding symptoms?
5-14 years old
What is the drug of choice for eradication of streptococcus?
Penicillin
What is the duration of secondary prophylaxis for children who have had rheumatic fever?
5 years or until age 21, whichever is longer
Why is it important to conduct a thorough physical exam?
To note the child’s physical condition and observe for signs or symptoms
What is the purpose of taking a complete and up-to-date history from the child and caregiver?
To determine the extent of the illness and obtain information about recent sore throat or upper respiratory infection
What is the role of aspirin and corticosteroids in therapeutic management?
To reduce inflammation and alleviate pain
Study Notes
Uterine Atony Management
- Massage the uterus gently when a relaxed and boggy uterus is palpated
- Keep the bladder empty to facilitate effective uterine contractions
- Monitor vital signs and blood loss during the early postpartal period
- Weigh perineal pad before and after use to measure blood loss accurately
- Check under the hips for pooled blood
- Tachycardia (PR > 100) and hypotension are significant vital signs changes in hemorrhage
- Administer oxytocin as ordered if sustained uterine contractions are not achieved by massage
- Perform blood transfusion and IVF to replace blood loss
- Conduct manual exploration of the uterine cavity, cervix, and vagina for retained placental fragments and laceration
- Perform bimanual uterine compression if bleeding cannot be controlled
- Hysterectomy is performed as a last resort if bleeding cannot be controlled
Small for Gestational Age (SGA)
- An infant is SGA if the birth weight is below the 10th percentile on an intrauterine growth curve for that age
- SGA infants are small for their age due to intrauterine growth restriction or retardation (IUGR) or failed to grow at the expected rate in utero
- Causes of SGA include mother's nutrition, placental anomaly, systemic diseases, smoking, and chromosomal abnormalities
- Assessment of SGA includes fundic height, sonogram, biophysical profile, and ultrasound
- Appearance of SGA infants includes below-average weight, length, and head circumference, wasted appearance, and small liver
- Nursing diagnoses for SGA include ineffective breathing pattern, risk for ineffective thermoregulation, and risk for impaired parenting
Hematomas
- Large hematomas are potentially dangerous because they may rupture and cause severe bleeding and infection
- Treatment for hematomas includes bringing the woman back to the DR for incision and ligation of bleeding vessels, analgesics for pain, application of ice packs, broad-spectrum antibiotics, and blood transfusion
Puerperal Infection
- Puerperal infection is a general term used to describe infection of the genital tract after delivery
- Predisposing factors include prolonged labor, postpartum hemorrhage, anemia, retained placental fragments, intrauterine manipulation, and malnutrition
- Infecting organisms include anaerobic streptococci, Escherichia coli, Chlamydia trachomatis, and Staphylococci
- Assessment of puerperal infection includes the presence of infection elsewhere in the body or in the genital tract during labor, delivery, and puerperium
Infant of Diabetic Mother
- Effects of poor glycemic control in pregnant diabetic women include congenital abnormalities, macrosomia, birth trauma, perinatal asphyxia, RDS, hypoglycemia, and hyperbilirubinemia
- Therapeutic management includes penicillin, erythromycin, anti-inflammatory agents, and secondary prophylaxis for 5 years or through age 21-25 years
Test your knowledge on managing uterine atony, including the first actions to take when a relaxed and boggy uterus is palpated, the importance of keeping the bladder empty, and monitoring vital signs and blood loss postpartum.
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