Postoartum Disorders

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Questions and Answers

What is a common first sign of Deep-Vein Thrombosis (DVT)?

Chest pain

Leg pain (correct)

Nausea

Increased heart rate

Which condition is associated with significant blood loss more than 500 mL after vaginal birth?

Uterine atony (correct)

Pulmonary embolism

Deep-vein thrombosis

Coagulopathies

What is the therapeutic range for aPTT when treating DVT?

30 to 40 seconds

25 to 35 seconds

1.5 to 2.5 times the control level (correct)

20 to 30 seconds

Which of the following is NOT a risk factor for Deep-Vein Thrombosis (DVT)?

Regular exercise Signup and view all the answers

Which medication is commonly used to manage postpartum hemorrhage?

Oxytocin Signup and view all the answers

What is the antidote for Warfarin?

Phytonadione Signup and view all the answers

Which assessment technique is most appropriate for diagnosing DVT?

Doppler ultrasound Signup and view all the answers

Which of the following is a sign of postpartum hemorrhage?

Tachycardia Signup and view all the answers

What is the primary complication associated with Deep Vein Thrombosis (DVT)?

Pulmonary embolism Signup and view all the answers

Which of the following causes postpartum hemorrhage due to inadequate uterine contractions?

Uterine atony Signup and view all the answers

What characterizes coagulopathies like Idiopathic Thrombocytopenic Purpura (ITP) and Disseminated Intravascular Coagulation (DIC)?

Simultaneous clotting and bleeding Signup and view all the answers

What condition can be triggered by retained placental fragments after childbirth?

Subinvolution of the uterus Signup and view all the answers

In which of the following scenarios would postpartum hemorrhage be defined as excessive bleeding?

More than 500 mL after vaginal birth Signup and view all the answers

What are the lower extremities primarily affected by in the case of Deep Vein Thrombosis?

Inflammation associated with a thrombus Signup and view all the answers

What major risk does DIC pose to a patient regarding their blood condition?

Increased risk of hemorrhage Signup and view all the answers

What can be a direct effect of a dislodged thrombus from DVT?

Obstruction of blood flow to the lungs Signup and view all the answers

Study Notes

Key Complications

Deep-Vein Thrombosis (DVT): Thrombus formation in deep veins, especially in the legs, potentially leading to pulmonary embolism.
Pulmonary Embolism (PE): A clot from a DVT traveling to the lungs, blocking blood flow and causing respiratory distress.
Coagulopathies: Disorders affecting blood clotting, including ITP and DIC, leading to abnormal bleeding or clotting.
Postpartum Hemorrhage: Significant blood loss after childbirth, requiring immediate intervention (caused by uterine atony, failure of the uterus to contract effectively).
Uterine Atony: Failure of the uterus to contract effectively, increasing risk of postpartum hemorrhage.

Key Assessment Techniques

Physical assessment: Monitor for signs of DVT (leg pain, swelling, warmth) and postpartum hemorrhage (uterine tone, lochia).
Diagnostic procedures: Use Doppler ultrasound for DVT and complete blood count (CBC) for coagulopathy assessment.
Vital signs monitoring: Regularly check for tachycardia and hypotension, indicators of hemorrhage or shock.

Key Risk Factors

Deep-Vein Thrombosis (DVT): Pregnancy, cesarean birth, immobility, obesity, smoking, age over 35, history of thromboembolism.
Postpartum Hemorrhage: Uterine atony, overdistended uterus, prolonged labor, high parity, retained placental fragments, genetic factors (ITP), abruptio placentae, severe preeclampsia, infection, and hemorrhage.

Facts to Memorize

Postpartum hemorrhage: Defined as losing more than 500 mL blood after vaginal birth or more than 1,000 mL after cesarean birth.
Heparin antidote: Protamine sulfate.
Warfarin antidote: Phytonadione.
Normal aPTT range: 30 to 40 seconds (therapeutic range for DVT: 1.5 to 2.5 times the control level).
Normal PT range: 11 to 13.5 seconds (therapeutic range for warfarin: INR 2.0 to 3.0).

Reference Information

Risk factors for DVT: Pregnancy, cesarean birth, immobility, obesity, smoking, and age over 35
Common medications for postpartum hemorrhage: Oxytocin, Methylergonovine, Misoprostol, and Carboprost tromethamine.

Concept Comparisons

Deep Vein Thrombosis: A thrombus associated with inflammation, primarily in the deep veins.

Cause and Effect

Uterine Atony: Leads to postpartum hemorrhage due to inadequate uterine contractions.
Retained placental fragments: Can cause subinvolution of the uterus and prolonged bleeding, increasing the risk of hemorrhage.
Coagulopathies: Increase risk of both simultaneous clotting and bleeding, leading to hemorrhage.

Key Terms/Concepts

Postpartum Disorders: Unexpected events or occurrences during the postpartum period requiring nursing intervention.
Deep-Vein Thrombosis (DVT): A thrombus associated with inflammation, primarily occurring in the lower extremities.
Pulmonary Embolism: A clot dislodges and obstructs blood flow to the lungs, a complication of DVT.
Coagulopathies: Disorders affecting blood coagulation (including ITP and DIC).
Postpartum Hemorrhage: Excessive bleeding after childbirth (defined as more than 500 mL after vaginal birth or more than 1000 mL after cesarean birth).

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Description

This quiz covers key complications such as Deep-Vein Thrombosis and Pulmonary Embolism, along with their assessment techniques. It also explores conditions like coagulopathies and postpartum hemorrhage, emphasizing physical assessment and diagnostic procedures. Test your understanding of these critical topics in obstetric care.