Metritis and Puerperal Infection Quiz
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Questions and Answers

Which of the following is NOT a common symptom experienced during metritis?

  • Abdominal pain
  • Fever
  • Anorexia
  • Headache (correct)

    • Which symptom is specifically characterized by a reduction in appetite during metritis?

  • Anorexia (correct)
  • Chill
  • Malaise
  • Fever

    • Which of the following symptoms suggests a systemic reaction during metritis?

  • Malaise
  • Chill (correct)
  • Abdominal cramping
  • Nausea

    • During an episode of metritis, which symptom is most directly related to discomfort in the abdominal area?

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

    Which of the following manifestations is characterized by general weakness and lack of energy in metritis?

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

    Which complication of metritis involves inflammation of the fallopian tubes?

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

    What position should a nurse place a woman in to promote drainage of lochia?

    <p>Fowler's position</p> Signup and view all the answers

    Oophoritis, a complication of metritis, may lead to what serious condition?

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

    Which of the following is NOT a nursing consideration for metritis?

    <p>Monitoring vital signs</p> Signup and view all the answers

    Peritonitis, as a complication of metritis, may result in which potential outcome?

    <p>Pelvic abscess</p> Signup and view all the answers

    What is the minimum temperature indicating a puerperal infection?

    <p>38°C</p> Signup and view all the answers

    Which of the following is NOT a recognized risk factor for puerperal infection?

    <p>Frequent hand washing</p> Signup and view all the answers

    Which of these risk factors is associated with trauma in childbirth that can lead to puerperal infection?

    <p>Large baby</p> Signup and view all the answers

    What is the time frame during which a fever must occur for it to be classified as puerperal infection?

    <p>First 10 days post-childbirth</p> Signup and view all the answers

    Which type of puerperal infection specifically involves inflammation of the endometrium?

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

    What is a common etiology for mastitis during the postpartum period?

    <p>Incomplete emptying of the breast</p> Signup and view all the answers

    Which symptom is NOT typically associated with mastitis?

    <p>Sudden weight gain</p> Signup and view all the answers

    When should vital signs be assessed for a patient with fever?

    <p>Every two hours, transitioning to four hours if stable</p> Signup and view all the answers

    What comfort measure is recommended for a patient experiencing symptoms of mastitis?

    <p>Cool compresses</p> Signup and view all the answers

    What is the primary therapeutic management for mastitis?

    <p>Antibiotics and emptying the breast</p> Signup and view all the answers

    What is the recommended course of action if an abscess ruptures into the breast duct?

    <p>Immediately perform surgical drainage and start antibiotics</p> Signup and view all the answers

    Which supportive measure is NOT advised for managing breast discomfort?

    <p>Wearing a tight bra for support</p> Signup and view all the answers

    How should nursing pads be managed according to breastfeeding guidelines?

    <p>Change nursing pads immediately when they are wet</p> Signup and view all the answers

    What is considered a proper approach for managing breast discomfort during breastfeeding?

    <p>Regularly emptying the breast to prevent fullness</p> Signup and view all the answers

    Which practice can worsen breast discomfort during nursing?

    <p>Using tight straps to secure nursing pads</p> Signup and view all the answers

    Under what condition should breastfeeding be completely discontinued on one side?

    <p>If a breast abscess ruptures into the breast duct</p> Signup and view all the answers

    What should be done to manage the affected side if breastfeeding is discontinued due to a ruptured abscess?

    <p>Use a manual breast pump to empty the affected side temporarily</p> Signup and view all the answers

    What should be the approach to breastfeeding if a mother has an abscess but it has not ruptured?

    <p>Continue breastfeeding as usual</p> Signup and view all the answers

    Which of the following statements is true regarding breastfeeding with a breast abscess?

    <p>Breastfeeding should be stopped on the affected side if an abscess ruptures</p> Signup and view all the answers

    What is the temporary solution for the affected breast when a rupture occurs?

    <p>Use a breast pump to express milk</p> Signup and view all the answers

    Study Notes

    Postnatal Infection (Puerperal Infection)

    • Puerperal infection is defined as a fever of 38°C or higher, occurring at least 2 days after the first 24 hours following childbirth.

    Etiology (Risk Factors)

    • History of previous infections (UTI, mastitis)
    • Cesarean birth
    • Trauma (large baby, vacuum extraction, laceration, episiotomy)
    • Catheterization
    • Prolonged rupture of membranes
    • Prolonged labor
    • Excessive vaginal examinations
    • Retained placental fragments
    • Hemorrhage
    • Poor nutrition (Vitamin C deficiency, anemia)
    • Poor hygiene
    • Poor general health
    • Medical conditions (e.g., diabetes)
    • Low socioeconomic status
    • Colonization of the lower genital tract with pathogenic organisms

    Pathophysiology

    • The reproductive system is interconnected.
    • Blood vessels carry infection to other parts of the body.
    • Vaginal discharge acidity decreases during labor.
    • Necrosis of the endometrial lining and presence of lochia occur.
    • Many small lacerations occur in the endometrium, cervix, and vagina.

    Endometritis (Metritis)

    • Definition: Infection of the uterus.
    • Also known as endometritis, endomyometritis, and endoparametritis.
    • Etiology: Normal vaginal inhabitants like group A and B streptococci and E. coli.

    Manifestations of Metritis

    • Fever, chills, malaise, anorexia, abdominal pain, and cramping.
    • Uterine tenderness
    • Foul-smelling, purulent lochia
    • Additional signs: tachycardia and subinvolution

    Laboratory Data

    • Increased white blood cell (WBC) count
    • Blood culture
    • Endocervix culture
    • Uterine cavity culture
    • Urine specimen

    Therapeutic Management of Metritis

    • Intravenous (IV) administration of broad-spectrum antibiotics (e.g., clindamycin, gentamicin).
    • Ampicillin, cephalosporins, metronidazole
    • Oral antibiotics are not needed after the IV antibiotics are completed.
    • Prophylactic antibiotics after cesarean section
    • Antipyretics for fever
    • Oxytocics (e.g., methargine) to increase lochia drainage

    Complications of Metritis

    • Salpingitis
    • Oophoritis (may lead to sterility)
    • Peritonitis (may lead to pelvic abscess)
    • Pelvic thrombophlebitis

    Nursing Considerations (Metritis)

    • Fowler's position to promote lochia drainage
    • Pain medication as needed
    • Monitor the woman for signs of improvement and complications
    • Assess vital signs every two hours if there is a fever, and every four hours otherwise

    Comfort Measures

    • Warm blanket
    • Cool compress
    • Cold or warm drinks
    • Heating pad
    • Food rich in vitamin C and protein

    Teaching

    • Signs/symptoms of complications
    • Side effects of therapy
    • Adherence to therapy
    • Breastfeeding and pumping if needed

    Mastitis

    • Definition: Breast infection, most common during the second and fourth weeks after childbirth.
    • Usually affects one breast.

    Etiology (Mastitis)

    • Staphylococcus aureus, originating from:
      • Cracks or sores on the nipple
      • Incomplete breast emptying
      • Milk engorgement and stasis
      • Breast constriction by bras
      • Stress (decreased immunity)

    Manifestations of Mastitis

    • Flu-like symptoms initially
    • Fatigue and muscle aches
    • Fever (38.4°C or higher)
    • Chills, malaise, headache
    • Localized, wedge-shaped, red, edematous, hot, and painful area.
    • Breast pain, swelling, redness, fever, breast enlargement, changes in nipple sensation, discharge, itching, tenderness, and/or a breast lump.

    Therapeutic Management of Mastitis

    • Antibiotics
    • Emptying the breast by feeding or pumping. Breastfeeding should continue unless an abscess ruptures into the breast duct.
    • Surgical drainage and antibiotics if an abscess develops.

    Supportive Measures (Mastitis)

    • Heat or ice packs
    • Breast support
    • Analgesics
    • Continuous breast emptying

    Additional Nursing Considerations (Mastitis)

    • Change nursing pads when they are wet.
    • Avoid continuous pressure on the breast from tight bras or carrying an infant.
    • Breast feeding should be continued unless an abscess ruptures into a duct. If this occurs, discontinue feeding from the affected side, and pump to empty the breast temporarily. Resume breastfeeding from the other breast.
    • Preventative measures: correct positioning of the infant, avoid nipple trauma, facilitate milk flow.

    If Mastitis occurs

    • Comfort measures and enhance lactation
    • Moist heat application
    • Shower or hot packs before feeding/pumping
    • Cold packs to reduce edema between feedings
    • Emptying the breast completely

    Additional Comfort Measures (Mastitis)

    • Massage the affected area before and during feeding to empty it completely.
    • Fluid intake of at least 2500-3000ml/day
    • Analgesics
    • Continue or resume breastfeeding from the other side.
    • Encourage the mother not to stop breastfeeding.
    • Engorgement during weaning can lead to abscess formation.

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    Postpartum Infection (PDF)

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    Test your knowledge on metritis, its symptoms, complications, and nursing considerations. Assess your understanding of puerperal infections and their management. This quiz will help reinforce important concepts related to maternal health.

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