Postpartum Hemorrhage and Fundal Assessment

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Questions and Answers

What is the blood loss threshold for diagnosing vaginal postpartum hemorrhage?

  • 800mL
  • 500mL (correct)
  • 300mL
  • 1000mL

Which of the following is NOT a recognized cause of postpartum hemorrhage?

  • Overdistended uterus
  • Low placental implantation
  • Rapid labor
  • Mild dehydration (correct)

Which medication is commonly given intravenously after birth to stimulate uterine contractions?

  • Oxytocin (Pitocin) (correct)
  • Methylergonovine (Methergine)
  • Prostaglandin E1
  • Calcium gluconate

What should be done if a boggy fundus is detected during assessment?

<p>Massage the fundus and check for bladder distention (A)</p> Signup and view all the answers

Which factor would most likely increase the risk of postpartum hemorrhage due to an overdistended uterus?

<p>Multiple births (five or more) (A)</p> Signup and view all the answers

What indicates a poor latch while breastfeeding?

<p>Dimpled cheeks during sucking (A)</p> Signup and view all the answers

What should formula feeding mothers specifically do to ensure proper care?

<p>Avoid warm water on the breasts (C)</p> Signup and view all the answers

Which of the following is NOT a common symptom of mastitis?

<p>Intense itching and rash on the breast (A)</p> Signup and view all the answers

How should a mother manage discomfort related to mastitis?

<p>Apply heat packs and take mild analgesics (D)</p> Signup and view all the answers

When experiencing mastitis, which nursing intervention is advisable?

<p>Expose nipples to air when possible (C)</p> Signup and view all the answers

Flashcards

Postpartum Hemorrhage

Loss of blood exceeding 500mL after vaginal delivery or 1000mL after Cesarean section.

Boggy Fundus

A uterus that feels soft and relaxed instead of firm and contracted.

Fundal Assessment

The top of the uterus, located in the middle of the abdomen, should be firm and centered.

Oxytocin (Pitocin)

A medication used intravenously after birth to stimulate uterine contractions and reduce bleeding.

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Methylergonovine (Methergine)

A medication given intramuscularly or orally to stimulate uterine contractions and reduce postpartum bleeding.

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Mastitis

A painful condition in the breast that typically happens 2-3 weeks after birth, characterized by redness, tenderness, swelling, and possible pus discharge.

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Breastfeeding

The process of a baby feeding from the breast.

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Good Latch

A poor latch can lead to pain for the mother and inadequate feeding for the baby.

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Poor Latch

When a baby's mouth is not properly positioned on the nipple, it can lead to painful breastfeeding and inadequate feeding.

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Dimpled Cheeks

A medical condition where a baby's cheeks appear dimpled during breastfeeding.

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Study Notes

Postpartum Hemorrhage

  • Definition: Blood loss greater than 500mL (vaginal) or 1000mL (cesarean).
  • Causes:
    • Bladder distention
    • Abnormal or prolonged labor
    • Overdistended uterus
    • Multiparity (five or more births)
    • Use of oxytocin during labor
    • Medications that relax the uterus
    • Operative birth (e.g., Cesarean section)
    • Low placental implantation
    • Rapid labor
    • Use of instruments (e.g., forceps, vacuum) during birth
    • Prolonged or rapid labor
    • Large infant (macrosomnia)
    • Use of forceps or vacuum extractor

Fundal Assessment

  • Expected finding: Midline and firm.
  • Abnormal finding: Boggy/deviated fundus.
  • Actions:
    • Massage fundus
    • Palpate bladder (if distended)
    • Monitor bleeding and change pad as needed
    • If bleeding persists, notify physician immediately
    • Administer medications as needed (e.g., oxytocin, methylergonovine) to stimulate uterine contraction.
    • Change the patient's pad frequently
    • Change to a larger pad if needed
    • Observe for any signs of infection
    • Monitor vital signs regularly

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