Postpartum Complications: Mastitis Quiz
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Questions and Answers

Which condition is NOT typically screened for during a postpartum visit?

  • Preeclampsia
  • Thyroiditis
  • Gestational diabetes
  • Hypertension (correct)

What is the recommended timing for a postpartum visit if there are no complications?

  • 4-6 weeks
  • 10-12 weeks
  • 2-4 weeks
  • 6-8 weeks (correct)

During which time frame postpartum are breastfeeding complications like mastitis most commonly observed?

  • Within the first 2 weeks
  • Throughout the entire breastfeeding duration
  • After 6 months
  • Within the first 3 months (correct)

Which of the following represents the expected lochia rubra type?

<p>Dark red/red-brown (A)</p> Signup and view all the answers

What is the focus of health promotion and education during the postpartum period?

<p>Improving maternal attachment and infant care (A)</p> Signup and view all the answers

What is the primary bacterial cause of infective lactational mastitis?

<p>Staphylococcus aureus (B)</p> Signup and view all the answers

Which diagnostic test is advised especially for someone with a history of gestational diabetes?

<p>2-hour glucose tolerance test (GTT) (C)</p> Signup and view all the answers

Which of the following is NOT a risk factor for developing mastitis?

<p>High-intensity exercise (B)</p> Signup and view all the answers

Which symptom is specifically associated with infective lactational mastitis?

<p>Fever greater than 38.3°C (D)</p> Signup and view all the answers

What common challenge might breastfeeding mothers face that necessitates care?

<p>Breast engorgement or mastitis (B)</p> Signup and view all the answers

Which physical examination finding is commonly associated with mastitis?

<p>Axillary lymphadenopathy (A)</p> Signup and view all the answers

What should be included when assessing a new mother during her postpartum visit?

<p>Review of social history and mental health (D)</p> Signup and view all the answers

Which complications typically warrant immediate attention in postpartum care?

<p>Continuous bleeding or infection signs (D)</p> Signup and view all the answers

What is an appropriate initial treatment recommendation for mastitis?

<p>Pain management and continued breastfeeding (C)</p> Signup and view all the answers

What is one common approach to manage mastitis in breastfeeding mothers?

<p>Frequent breastfeeding or milk expression (A)</p> Signup and view all the answers

In managing a case of infective lactational mastitis, which antibiotic is commonly prescribed?

<p>Dicloxacillin 500 mg PO QID (D)</p> Signup and view all the answers

Which method is suggested for improving sleep hygiene in postpartum women?

<p>Adopting a sleep schedule and creating a calming environment (A)</p> Signup and view all the answers

Which condition should be considered if a breast condition does not resolve and presents with 'peau d' orange' appearance?

<p>Inflammatory breast cancer (A)</p> Signup and view all the answers

What distinguishing feature would indicate a plugged duct, rather than mastitis?

<p>No systemic findings (C)</p> Signup and view all the answers

Which of the following should be avoided to minimize the risk of mastitis?

<p>Using breast pump frequently (A)</p> Signup and view all the answers

What is a primary indication for performing an ultrasound in a patient with suspected breast abscess?

<p>Failure to respond to treatment within 48-72 hours (D)</p> Signup and view all the answers

Which treatment option is appropriate for a patient with a beta-lactam allergy and MRSA risk?

<p>Bactrim (A)</p> Signup and view all the answers

What symptom is most characteristic of nipple candidiasis in breastfeeding mothers?

<p>Bilateral burning or stabbing pain in both nipples (D)</p> Signup and view all the answers

Which intervention should be prioritized when a patient has mastitis and is unable to breastfeed from the affected breast?

<p>Hand expression or pumping of milk (C)</p> Signup and view all the answers

What is the most common organism responsible for nipple candidiasis in breastfeeding women?

<p>Candida albicans (A)</p> Signup and view all the answers

What is the proper initial management of a breast abscess in a breastfeeding mother?

<p>Needle aspiration or incision and drainage (A)</p> Signup and view all the answers

Which of the following findings suggests that mastitis may have progressed to an abscess?

<p>A fluctuating mass upon examination (C)</p> Signup and view all the answers

When should milk culture be considered in a patient with mastitis?

<p>If ultrasound shows no evidence of abscess (C)</p> Signup and view all the answers

What condition should be monitored in infants when a mother with G6PD deficiency receives Bactrim?

<p>Hemolytic anemia (A)</p> Signup and view all the answers

What is the recommended action for a breastfeeding mother diagnosed with nipple candidiasis?

<p>Continue breastfeeding while managing symptoms (D)</p> Signup and view all the answers

What is the primary treatment option for a mother experiencing breast pain associated with a fungal infection?

<p>Topical miconazole or clotrimazole after feedings (D)</p> Signup and view all the answers

What condition should be considered when a postpartum patient shows symptoms of fatigue, shortness of breath, and pale gums?

<p>Anemia of chronic inflammatory disease (C)</p> Signup and view all the answers

In cases of secondary postpartum hemorrhage occurring 24 hours to 2-3 weeks post-delivery, what initial management step is critical?

<p>Immediate ultrasound and consultation with OB/GYN (B)</p> Signup and view all the answers

What lab tests are recommended to evaluate for preeclampsia in a postpartum patient with suspected new-onset hypertension?

<p>CBC with differential, CMP, and urine protein analysis (A)</p> Signup and view all the answers

Which of the following is a sign that a urinary tract infection (UTI) may be leading to a more serious condition such as pyelonephritis?

<p>Presence of fever, chills, and back pain (B)</p> Signup and view all the answers

During which time frame is postpartum thyroiditis typically diagnosed?

<p>1-4 months postpartum (C)</p> Signup and view all the answers

Which symptom would most likely differentiate postpartum depression from baby blues?

<p>Sleep disturbances lasting over two weeks (C)</p> Signup and view all the answers

What is the initial treatment recommendation for a mother who has been diagnosed with mastitis?

<p>Effective drainage via breast massage and continuing breastfeeding (D)</p> Signup and view all the answers

When treating postpartum urinary incontinence, what is a recommended intervention?

<p>Referral for pelvic floor physical therapy (B)</p> Signup and view all the answers

Which condition may be suggested if a postpartum patient experiences persistent heavy bleeding and hypovolemic shock?

<p>Retained placenta fragments (D)</p> Signup and view all the answers

Study Notes

Postpartum Complications

Breastfeeding Complications

  • Mastitis: Occurs in 2-20% of breastfeeding patients within the first 3 months.

  • Symptoms: Unilateral erythema, tenderness, warmth, persistent for over 12-24 hours, typically caused by S. aureus.

  • Risk Factors: Include breastfeeding difficulties, previous mastitis, stress, cracked nipples, engorgement, and infrequent feedings.

  • Treatments: Continue breastfeeding, manage pain with ibuprofen or Tylenol, and antibiotics if infected (Dicloxacillin or Cephalexin). Follow-up after 48-72 hours if no improvement.

  • Breast Abscess: A complication of mastitis characterized by a fluctuant mass when mastitis fails to improve.

  • Treatment: Incision and drainage or needle aspiration. Culture is necessary for antibiotic guidance.

  • Nipple Candidiasis: Most commonly caused by C. albicans, presents with bilateral burning pain during breastfeeding, shiny or flaky skin on nipples.

Postpartum Care

  • Error refers to a postpartum visit typically scheduled at 6 weeks but may be moved to 3 weeks.

  • Comprehensive visit includes labor and delivery history, complications, recovery, and bleeding patterns (lochia stages).

  • Lochia Stages:

    • Rubra: Dark red, days 2-4
    • Serosa: Pinkish-brown, days 7-22
    • Alba: White, weeks 2-6.
  • Sexual activity post-delivery can typically resume after 1 month, most women return to normal by 2 months.

Hematologic Complications

  • Anemia: Considered in the context of early postpartum hemorrhage. Symptoms include fatigue and pallor. Treat with iron supplements or transfusions as needed.

  • Thrombosis: DVT symptoms include leg pain and swelling; PE presents with chest pain and shortness of breath. Treat DVT with 6 months of anticoagulation.

Secondary Postpartum Hemorrhage

  • Defined as excessive bleeding over 24 hours after delivery. Causes include uterine atony and retained placenta. Symptoms feature heavy bleeding and may require hospitalization.

  • Endometritis: Can occur 24 hours to 2-3 weeks postpartum. Risk factors include C-section and prolonged ROM. Symptoms: fever, uterine tenderness, and malodorous lochia. Requires hospitalization and IV antibiotics.

Endocrine Complications

  • Thyroiditis: May lead to hypo- or hyperthyroidism within 1-4 months postpartum, diagnosed using TSH and Free T4.

  • Diabetes: Monitor A1C for pre-existing diabetes; screen for GDM at 6 weeks postpartum.

Cardiac Complications

  • Hypertension: Peaks 3-6 days postpartum with 20% of patients at risk for stroke. Monitor blood pressure and treat severe cases in the emergency department.

  • Preeclampsia: Can manifest postpartum. Symptoms: headache, vision changes, and upper abdominal pain. Requires emergency care.

GU Complications

  • Urinary Complications: Stress incontinence and fistula may arise, with pelvic floor therapy as a treatment option.

GI Complications

  • Constipation: Managed with dietary changes and stool softeners. Hemorrhoids present with pain and bleeding, treated with topical medications.

Postpartum Mood and Anxiety Disorders

  • Baby Blues: Affecting 80% of women, transient and resolving within 2 weeks.

  • Postpartum Depression: Symptoms last longer than 2 weeks. First-line treatments include Zuranolone or SSRIs like sertraline.

  • Postpartum Psychosis: Abrupt onset, typically within the first month, requires immediate mental health intervention.

Abnormal Uterine Bleeding and Dysmenorrhea

  • Normal menstrual patterns and clinical management should also be assessed postpartum, ensuring appropriate follow-up care.

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Week 4.docx

Description

Test your knowledge on postpartum complications, specifically focusing on breastfeeding issues like mastitis. This quiz covers symptoms, risk factors, and prevalence among breastfeeding mothers. Perfect for healthcare students and professionals.

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