Podcast
Questions and Answers
What is the primary characteristic of uterine atony that contributes to early postpartum hemorrhage (PPH)?
What is the primary characteristic of uterine atony that contributes to early postpartum hemorrhage (PPH)?
- A soft, boggy uterus (correct)
- A uterus with multiple fibroids
- An inverted uterus
- A rigid, contracted uterus
Which of the following factors increases the risk of retained placental fragments leading to late postpartum hemorrhage?
Which of the following factors increases the risk of retained placental fragments leading to late postpartum hemorrhage?
- Spontaneous vaginal delivery
- Manual removal of the placenta (correct)
- Elective induction of labor
- Use of vacuum extraction during delivery
A postpartum patient is experiencing excessive bleeding. After uterine massage and initial uterotonic administration, what is the next most appropriate intervention a nurse should anticipate?
A postpartum patient is experiencing excessive bleeding. After uterine massage and initial uterotonic administration, what is the next most appropriate intervention a nurse should anticipate?
- Preparing for immediate hysterectomy
- Initiating blood transfusions
- Administering a second dose of the same uterotonic
- Bimanual compression of the uterus (correct)
What condition is most associated with triggering disseminated intravascular coagulation (DIC) as a cause of postpartum hemorrhage?
What condition is most associated with triggering disseminated intravascular coagulation (DIC) as a cause of postpartum hemorrhage?
Which of the following findings would be most indicative of endometritis in a postpartum patient?
Which of the following findings would be most indicative of endometritis in a postpartum patient?
A postpartum patient develops a wound infection after a cesarean birth. What factor in her history most likely contributed to this complication?
A postpartum patient develops a wound infection after a cesarean birth. What factor in her history most likely contributed to this complication?
What intervention is most important for a breastfeeding mother diagnosed with mastitis?
What intervention is most important for a breastfeeding mother diagnosed with mastitis?
A patient is diagnosed with a postpartum UTI. Which of the following antepartum factors most likely contributed to its development?
A patient is diagnosed with a postpartum UTI. Which of the following antepartum factors most likely contributed to its development?
A postpartum patient reports pain, swelling, and redness in her left calf. Which condition should the nurse suspect?
A postpartum patient reports pain, swelling, and redness in her left calf. Which condition should the nurse suspect?
A postpartum patient suddenly experiences dyspnea, chest pain, and hemoptysis. What immediate intervention should the nurse prepare for?
A postpartum patient suddenly experiences dyspnea, chest pain, and hemoptysis. What immediate intervention should the nurse prepare for?
Which factor is most responsible for the increased risk of thromboembolic disorders in the postpartum period?
Which factor is most responsible for the increased risk of thromboembolic disorders in the postpartum period?
Besides pharmacological interventions, what non-pharmacological intervention can improve venous return in a postpartum patient diagnosed with DVT?
Besides pharmacological interventions, what non-pharmacological intervention can improve venous return in a postpartum patient diagnosed with DVT?
A postpartum patient reports feeling tearful, anxious, and irritable two days after delivery. What condition is she most likely experiencing?
A postpartum patient reports feeling tearful, anxious, and irritable two days after delivery. What condition is she most likely experiencing?
Which symptom is most indicative of postpartum depression (PPD) rather than postpartum blues?
Which symptom is most indicative of postpartum depression (PPD) rather than postpartum blues?
Which pre-existing condition places a woman at the highest risk for developing postpartum psychosis?
Which pre-existing condition places a woman at the highest risk for developing postpartum psychosis?
What is the priority nursing intervention for a postpartum patient exhibiting signs of postpartum psychosis?
What is the priority nursing intervention for a postpartum patient exhibiting signs of postpartum psychosis?
What does maternal role attainment primarily refer to in the context of postpartum psychological adaptation?
What does maternal role attainment primarily refer to in the context of postpartum psychological adaptation?
Which intervention best supports the development of attachment between a mother and her newborn infant?
Which intervention best supports the development of attachment between a mother and her newborn infant?
What is a key aspect of psychological adaptation to the postpartum period?
What is a key aspect of psychological adaptation to the postpartum period?
A first-time mother expresses anxiety about caring for her newborn. What intervention would best promote her confidence and competence?
A first-time mother expresses anxiety about caring for her newborn. What intervention would best promote her confidence and competence?
Following a vaginal delivery complicated by a third-degree perineal laceration, which of the following nursing interventions is most important in preventing infection?
Following a vaginal delivery complicated by a third-degree perineal laceration, which of the following nursing interventions is most important in preventing infection?
A postpartum client who had a cesarean birth reports increasing pain, redness, and purulent drainage at the incision site four days postpartum. Her temperature is 101.5°F (38.6°C). Which of the following interventions should the nurse implement first?
A postpartum client who had a cesarean birth reports increasing pain, redness, and purulent drainage at the incision site four days postpartum. Her temperature is 101.5°F (38.6°C). Which of the following interventions should the nurse implement first?
A breastfeeding mother develops mastitis. She is concerned about the safety of breastfeeding while having an infection. Which of the following statements is the most appropriate response by the nurse?
A breastfeeding mother develops mastitis. She is concerned about the safety of breastfeeding while having an infection. Which of the following statements is the most appropriate response by the nurse?
A postpartum client, who is 12 hours post-delivery, reports severe pain and swelling in her left calf. What initial action should the nurse take?
A postpartum client, who is 12 hours post-delivery, reports severe pain and swelling in her left calf. What initial action should the nurse take?
A postpartum woman, 3 days after delivery, reports feeling overwhelmed, sad, and anxious. She states, "I don't know why I'm crying all the time." Which of the following nursing interventions is most appropriate?
A postpartum woman, 3 days after delivery, reports feeling overwhelmed, sad, and anxious. She states, "I don't know why I'm crying all the time." Which of the following nursing interventions is most appropriate?
A postpartum patient is being discharged after a cesarean section. Which of the following instructions is most important to include in her discharge teaching to prevent complications related to thromboembolism?
A postpartum patient is being discharged after a cesarean section. Which of the following instructions is most important to include in her discharge teaching to prevent complications related to thromboembolism?
A postpartum client with a history of postpartum depression (PPD) is being seen in the clinic for her 6-week follow-up visit. She reports feeling increasingly hopeless and having thoughts of harming herself. What is the priority nursing action?
A postpartum client with a history of postpartum depression (PPD) is being seen in the clinic for her 6-week follow-up visit. She reports feeling increasingly hopeless and having thoughts of harming herself. What is the priority nursing action?
A nurse is caring for a postpartum client experiencing heavy vaginal bleeding. After notifying the healthcare provider, which of the following actions should the nurse take first?
A nurse is caring for a postpartum client experiencing heavy vaginal bleeding. After notifying the healthcare provider, which of the following actions should the nurse take first?
A postpartum client who delivered vaginally 24 hours ago reports intense perineal pain despite the use of ice packs and analgesics. On assessment, the nurse notes a firm, hot, and exquisitely tender mass on the client’s perineum. Which of the following conditions should the nurse suspect?
A postpartum client who delivered vaginally 24 hours ago reports intense perineal pain despite the use of ice packs and analgesics. On assessment, the nurse notes a firm, hot, and exquisitely tender mass on the client’s perineum. Which of the following conditions should the nurse suspect?
A nurse is providing discharge teaching to a postpartum client who had a cesarean section. Which of the following instructions is most important to prevent wound infection?
A nurse is providing discharge teaching to a postpartum client who had a cesarean section. Which of the following instructions is most important to prevent wound infection?
A postpartum client develops a urinary tract infection (UTI). Which of the following factors in her history is most likely associated with the development of a UTI?
A postpartum client develops a urinary tract infection (UTI). Which of the following factors in her history is most likely associated with the development of a UTI?
A nurse is assessing a postpartum client and notes the following: temperature of 101.0°F (38.3°C), tachycardia, uterine tenderness, and foul-smelling lochia. Which postpartum complication is most likely indicated by these findings?
A nurse is assessing a postpartum client and notes the following: temperature of 101.0°F (38.3°C), tachycardia, uterine tenderness, and foul-smelling lochia. Which postpartum complication is most likely indicated by these findings?
A postpartum client reports feeling increasingly anxious, irritable, and having difficulty sleeping, three weeks after delivery. Which of the following conditions should the nurse suspect?
A postpartum client reports feeling increasingly anxious, irritable, and having difficulty sleeping, three weeks after delivery. Which of the following conditions should the nurse suspect?
A postpartum patient is prescribed methylergonovine for postpartum hemorrhage. Which condition in the patient's history would be a contraindication for the administration of methylergonovine?
A postpartum patient is prescribed methylergonovine for postpartum hemorrhage. Which condition in the patient's history would be a contraindication for the administration of methylergonovine?
A postpartum client is diagnosed with postpartum psychosis. Which intervention is the highest priority for this client?
A postpartum client is diagnosed with postpartum psychosis. Which intervention is the highest priority for this client?
Which of the following is the most important factor in promoting early attachment between a mother and her newborn?
Which of the following is the most important factor in promoting early attachment between a mother and her newborn?
After a difficult and prolonged labor, a multiparous woman develops a postpartum hemorrhage. Despite fundal massage and administration of oxytocin, the bleeding continues. What should the nurse do next?
After a difficult and prolonged labor, a multiparous woman develops a postpartum hemorrhage. Despite fundal massage and administration of oxytocin, the bleeding continues. What should the nurse do next?
A postpartum woman who is breastfeeding reports a sudden onset of flu-like symptoms, along with localized breast pain, redness, and warmth. Which of the following interventions is most appropriate?
A postpartum woman who is breastfeeding reports a sudden onset of flu-like symptoms, along with localized breast pain, redness, and warmth. Which of the following interventions is most appropriate?
A client is 24 hours postpartum and complains of severe perineal pain. Assessment reveals significant swelling and bruising of the perineum. The client's hemoglobin level is 9 g/dL, and she reports feeling dizzy when she stands. What intervention is the priority?
A client is 24 hours postpartum and complains of severe perineal pain. Assessment reveals significant swelling and bruising of the perineum. The client's hemoglobin level is 9 g/dL, and she reports feeling dizzy when she stands. What intervention is the priority?
During a postpartum home visit, a nurse finds the new mother tearful and anxious. She states, "I don't feel like myself, and I'm so tired all the time." Her infant is healthy and feeding well. What action should the nurse take first?
During a postpartum home visit, a nurse finds the new mother tearful and anxious. She states, "I don't feel like myself, and I'm so tired all the time." Her infant is healthy and feeding well. What action should the nurse take first?
A postpartum client who delivered by cesarean section is at increased risk for developing which of the following complications?
A postpartum client who delivered by cesarean section is at increased risk for developing which of the following complications?
A postpartum client is diagnosed with deep vein thrombosis (DVT). Which of the following medications should the nurse anticipate administering?
A postpartum client is diagnosed with deep vein thrombosis (DVT). Which of the following medications should the nurse anticipate administering?
Flashcards
Postpartum complications
Postpartum complications
Physical and psychological issues after childbirth impacting maternal health.
Postpartum Hemorrhage (PPH)
Postpartum Hemorrhage (PPH)
Blood loss >500 mL after vaginal birth or >1,000 mL after cesarean.
Uterine atony
Uterine atony
Soft, boggy uterus after delivery.
Risk factors for uterine atony
Risk factors for uterine atony
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Genital tract lacerations
Genital tract lacerations
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Risk factors for genital lacerations
Risk factors for genital lacerations
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Retained placental fragments
Retained placental fragments
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Risk factors for retained fragments
Risk factors for retained fragments
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Coagulation disorders
Coagulation disorders
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Interventions for PPH
Interventions for PPH
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Postpartum Infections
Postpartum Infections
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Endometritis
Endometritis
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Risk factors for endometritis
Risk factors for endometritis
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Cesarean wound infection
Cesarean wound infection
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Risk factors for mastitis
Risk factors for mastitis
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Interventions for postpartum infections
Interventions for postpartum infections
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Thromboembolic Disorders
Thromboembolic Disorders
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Risk factors for thromboembolism
Risk factors for thromboembolism
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Symptoms of DVT
Symptoms of DVT
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Symptoms of PE
Symptoms of PE
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Interventions for thromboembolism
Interventions for thromboembolism
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Postpartum Psychiatric Disorders
Postpartum Psychiatric Disorders
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Postpartum blues
Postpartum blues
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Postpartum Depression (PPD)
Postpartum Depression (PPD)
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Postpartum psychosis
Postpartum psychosis
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Risk factors for postpartum psychiatric disorders
Risk factors for postpartum psychiatric disorders
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Interventions for postpartum psychiatric disorders
Interventions for postpartum psychiatric disorders
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Psychological adaptation
Psychological adaptation
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Attachment
Attachment
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Maternal role attainment
Maternal role attainment
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Interventions for psychological adaptation
Interventions for psychological adaptation
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Study Notes
- Postpartum complications encompass physical and psychological challenges that can arise after childbirth.
- These complications impact the mother's health and well-being.
- Prompt identification and management of complications ensures positive maternal outcomes.
Postpartum Hemorrhage (PPH)
- PPH is blood loss of more than 500 mL after a vaginal birth, or more than 1,000 mL after a cesarean birth.
- Early PPH occurs within the first 24 hours postpartum.
- Late PPH occurs from 24 hours to 12 weeks postpartum.
- Uterine atony, characterized by a soft, boggy uterus, is a primary cause of early PPH.
- Risk factors for uterine atony include: overdistended uterus, multiparity, prolonged or rapid labor, and medications like magnesium sulfate or oxytocin.
- Lacerations of the genital tract, including the cervix, vagina, or perineum, can lead to PPH.
- Rapid or precipitous labor, operative vaginal delivery, and fetal macrosomia increase the risk of lacerations.
- Retained placental fragments can interfere with uterine contraction and cause late PPH.
- Manual removal of the placenta, placenta accreta, and succenturiate lobe of the placenta increase the risk of retained placental fragments.
- Coagulation disorders like disseminated intravascular coagulation (DIC) or pre-existing conditions like Von Willebrand disease can contribute to PPH.
- DIC can be triggered by placental abruption, amniotic fluid embolism, or severe preeclampsia.
- PPH detection involves monitoring vital signs, assessing uterine tone, and estimating blood loss.
- Interventions for PPH aim to control bleeding and restore hemodynamic stability.
- Uterine massage, uterotonic medications (oxytocin, misoprostol, methylergonovine, carboprost), and bimanual compression can help contract the uterus.
- Laceration repair may be necessary to control bleeding from tears.
- Manual exploration of the uterus or dilation and curettage (D&C) may be required for retained placental fragments.
- Blood transfusions and clotting factors may be necessary for blood loss and coagulation abnormalities.
Postpartum Infections
- Postpartum infections can affect the uterus (endometritis), perineum, wound (cesarean incision or episiotomy), urinary tract (UTI), and breasts (mastitis).
- Endometritis, a uterine lining infection, is more common after cesarean birth.
- Prolonged labor, prolonged rupture of membranes, and multiple vaginal examinations increase endometritis risk.
- Perineal wound infections can occur after episiotomy or laceration repair.
- Risk factors include poor perineal hygiene, trauma during delivery, and compromised immune status.
- Cesarean wound infections manifest as redness, swelling, drainage, and pain at the incision site.
- Obesity, diabetes, and prolonged labor increase the risk of cesarean wound infections.
- UTIs are common postpartum due to urinary catheterization, bladder trauma, and postpartum diuresis.
- Mastitis, a breast tissue infection, usually occurs in breastfeeding mothers.
- Risk factors include nipple trauma, infrequent emptying of the breasts, and blocked milk ducts.
- Assess for infection signs/symptoms: fever, chills, pain, redness, swelling, drainage, and foul-smelling lochia.
- Interventions for postpartum infections include: Antibiotic therapy, wound care, pain management, and comfort measures.
- Wound care includes cleansing, irrigation, and dressing changes.
- Comfort measures include sitz baths, ice packs, and breast support.
- Education on hygiene practices helps prevent further infection.
- For mastitis, encourage frequent breastfeeding or pumping; consider antibiotics if symptoms persist.
Thromboembolic Disorders
- Thromboembolic disorders, including deep vein thrombosis (DVT) and pulmonary embolism (PE), are potential postpartum complications.
- Pregnancy-related hypercoagulability, venous stasis, and vascular damage during delivery increase thromboembolism risk.
- DVT typically affects the deep veins of the legs or pelvis.
- DVT symptoms include pain, swelling, redness, and warmth in the affected extremity.
- PE occurs when a blood clot travels to the lungs, obstructing pulmonary blood flow.
- PE symptoms include sudden dyspnea, chest pain, cough, and hemoptysis.
- Risk factors for thromboembolic disorders: cesarean birth, obesity, immobility, history of thromboembolism, and certain medical conditions.
- Assess for signs/symptoms of DVT and PE.
- Interventions include: Anticoagulation therapy, thrombolytic therapy, compression stockings, and elevation of the affected extremity.
- Anticoagulation therapy uses heparin or low-molecular-weight heparin (LMWH) to prevent clot formation.
- Thrombolytic therapy may be necessary in severe PE cases.
- Compression stockings promote venous return.
- Elevating the affected extremity reduces swelling.
- Monitor for bleeding complications associated with anticoagulation therapy.
Postpartum Psychiatric Disorders
- Postpartum psychiatric disorders include postpartum blues, postpartum depression (PPD), and postpartum psychosis.
- Postpartum blues involve mood lability, tearfulness, and anxiety, typically resolving within a few weeks postpartum.
- Hormonal changes, sleep deprivation, and adjustment to new motherhood contribute to postpartum blues.
- Postpartum depression (PPD) is a more severe and persistent mood disorder that can interfere with function.
- PPD symptoms include: depressed mood, loss of interest, changes in appetite/sleep, fatigue, worthlessness/guilt, difficulty concentrating, and suicidal ideation.
- Postpartum psychosis is a rare but serious psychiatric emergency with hallucinations, delusions, disorganized thinking, and bizarre behavior.
- Women with a history of bipolar disorder or psychosis are at higher risk for postpartum psychosis.
- Risk factors for postpartum psychiatric disorders: history of mental illness, previous PPD, stressful life events, lack of social support, and complications during pregnancy/childbirth.
- Assess for symptoms of mood and anxiety disorders.
- Interventions include: emotional support, rest, nutrition, exercise, and referral to mental health professionals.
- Mental health referrals are for counseling, therapy, and medication management.
- Monitoring for suicidal ideation and ensuring safety is crucial.
- Hospitalization may be necessary for severe PPD or postpartum psychosis.
Psychological adaptation
- Psychological adaptation to the postpartum period involves emotional, social, and cognitive adjustments.
- Becoming a mother brings changes in identity, roles, and relationships.
- Adaptation to new responsibilities and expectations is required.
- Attachment is the process by which a mother develops a strong emotional bond.
- Attachment fosters a sense of love and connection.
- Factors influencing attachment include maternal-infant interaction, temperament, and cultural beliefs.
- Maternal role attainment refers to confidence and competence in the role of a mother.
- Factors influencing maternal role attainment include social support, self-esteem, and previous experience with childcare.
- Assessment includes maternal adaptation, attachment behaviors, and maternal role attainment
- Interventions include: education, support, skin-to-skin contact, early breastfeeding, and opportunities for bonding.
- Guidance is offered on infant care, feeding, and sleep patterns.
- Connecting mothers with support groups and resources addresses challenges and promotes well-being.
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