Postpartum Hemorrhage and Trauma Management

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Questions and Answers

What is the primary characteristic of the Taking in Phase of maternal role attainment?

Being self-focused and passive (correct)

Increased independence in decision-making

Increased focus on infant care

Desire to socialize with family and friends

What are some effective methods to help siblings adapt to a new infant in the family?

Providing a doll for the preschool-aged sibling (correct)

Taking the sibling on solo trips

Ignoring the sibling's feelings about the infant

Restricting time with the baby

Which concept is critical to maternal-infant bonding?

Immediate return to work

Involvement of extended family members

Minimizing contact in the first days

Kangaroo care and skin-to-skin contact (correct)

What is an important factor for co-parenting adaptation after becoming a parent?

Expectations and intentions about parenting roles Signup and view all the answers

Which issue may LGBTQ families face regarding their new infant?

Legal concerns with the birth certificate Signup and view all the answers

Which factors can contribute to overdistention of the uterus?

Multiple gestation Signup and view all the answers

What is a sign that may indicate excessive bleeding after delivery?

Tachycardia and hypotension Signup and view all the answers

What nursing intervention should be prioritized for a patient showing signs of uterine atony?

Perform fundal massage Signup and view all the answers

Which medication is part of the oxytocic agents used in managing postpartum hemorrhage?

Methergine Signup and view all the answers

What assessment finding is indicative of prolonged lochia discharge?

Lochia rubra at day 4 post-delivery Signup and view all the answers

What are the primary needs a mother focuses on immediately following birth?

Nutrition and sleep Signup and view all the answers

In the 'Taking Hold Phase', what is a common emotional response a mother might experience?

Feeling demoralized when comparing skills Signup and view all the answers

Which phase of maternal attachment involves the mother verbally reacting to her infant's sounds?

Acquaintance Phase Signup and view all the answers

What is NOT a symptom of postpartum blues?

Increased appetite Signup and view all the answers

During the immediate postpartum assessment, which of the following is least likely to be a focus?

Assessment of family dynamics Signup and view all the answers

What is the expected descent of the fundus postpartum?

1 cm per day Signup and view all the answers

What could indicate excessive bleeding in the postpartum period?

Saturation of a perineal pad in 15 minutes Signup and view all the answers

What emotional concerns might a mother experience during the 'Letting Go Phase'?

Feeling anxious about family integration Signup and view all the answers

What would be an appropriate comfort measure during immediate postpartum care?

Frequent warm showers Signup and view all the answers

During the 'Phase of Mutual Regulation', what is a primary adjustment required?

Balancing the needs of both mother and infant Signup and view all the answers

What is a common cause of early postpartum hemorrhage?

Uterine atony Signup and view all the answers

What indicates a potential infection during a perineal assessment?

Foul odor and heat Signup and view all the answers

Which medication is NOT an uterine stimulant?

Ketorolac Signup and view all the answers

What is a key assessment during the intermediate care phase for new mothers?

Assessment of involution progress Signup and view all the answers

What is an important sign of postpartum hemorrhage?

Bright red bleeding saturating more than 1 pad per hour Signup and view all the answers

Which position is recommended to assess for hemorrhoids?

Side lying Signup and view all the answers

What should be monitored for potential post-operative complications in a cesarean section?

Signs of pulmonary infection Signup and view all the answers

What is a common emotional adjustment new mothers may experience postpartum?

Physical fatigue Signup and view all the answers

How should the discharge criteria evaluate the mother's ability?

Ability to perform self-care Signup and view all the answers

Which assessment finding would NOT indicate postpartum hemorrhage?

Suprapubic tenderness Signup and view all the answers

What is advised for a mother experiencing afterpains?

Use of analgesics Signup and view all the answers

What is a recommended approach for managing emotional support during home visits?

Providing emotional support and answering questions Signup and view all the answers

Which of the following indicates that a mother should seek immediate care postpartum?

Persistent unusual pelvic discomfort Signup and view all the answers

What is a common cause of late postpartum hemorrhage?

Retained placental fragments Signup and view all the answers

What degree of laceration involves the external anal sphincter?

3rd degree Signup and view all the answers

What symptom is indicative of a hematoma following trauma during birth?

Severe pain at the site Signup and view all the answers

Which of the following is a treatment option for endometritis?

Administration of broad antibiotics Signup and view all the answers

What is assessed in the nursing management of postpartum complications?

Frequent assessments of vital signs and bleeding Signup and view all the answers

Which risk factor is commonly associated with increased laceration during childbirth?

Epidural anesthesia Signup and view all the answers

The presence of boggy uterus is most commonly addressed with which nursing intervention?

Aggressive massage Signup and view all the answers

Which complication occurs when thrombi formed in deep veins dislodge and travel to the lungs?

Pulmonary embolism Signup and view all the answers

What is one classic sign of endometritis?

Sawtooth temperature spikes Signup and view all the answers

What should be monitored to assess the risk of postpartum hemorrhage?

Mental status changes Signup and view all the answers

What condition may occur as a result of an infection in the reproductive tract after childbirth?

Endometritis Signup and view all the answers

Which assessment could indicate the presence of a hematoma in a postpartum patient?

Bulging and discoloration of vulva Signup and view all the answers

Which characteristic does NOT describe a 1st degree laceration?

Involves external anal sphincter Signup and view all the answers

Study Notes

Postpartum Hemorrhage (PPH)

Occurs within 24 hours after birth
Most common cause is uterine atony
Treatment: Manual removal of retained placental fragments, D&C, uterine massage, administration of uterotonics
Late PPH: Occurs between 24 hours and 12 weeks after birth
Retained placental fragments are the most common cause of late PPH
Nursing management: Monitor for signs of shock, frequent assessments, pain assessment, monitor vital signs, maintain IV access, monitor urinary output, administer medications.
Risk factors for late PPH: Infection, Deficiency of immunologic factors, Faulty implantation in less vascular lower uterine segment

Trauma

Lacerations: Occur during labor and/or delivery, can be categorized from first to fourth degree.
Predisposing factors: Nulliparity, epidural anesthesia, precipitous birth, forceps or vacuum-assisted birth, macrosomia, oxytocin use
Hematoma: Bleeding into the tissues, usually vulva or vagina due to traumatic birth
Symptoms: Swelling, severe pain, inability to void, bulging and discoloration on vulva
Treatment: Ice packs, pain medications

Puerperal Infection

Infection of the reproductive tract associated with childbirth, occurs up to 6 weeks postpartum
Endometritis: Inflammation of the endometrium (most common)
Metritis: Inflammation of the myometrium (uterine wall)
Risk factors: C-section, especially extended labor with ruptured membranes, diabetes
Signs and Symptoms: Vaginal discharge (bloody, scant or profuse, may have odor), uterine tenderness, pelvic pain, fever.
Treatment: Obtain history and physical exam, blood cultures, lochia cultures, UA, administer antibiotics (penicillins or cephalosporins).
Nursing Management: Perineum, lochia, incision assessment q 8 hours, administer medications, VS, adequate fluid intake, evaluate labs, instruct on perineal care, proper hand washing, promote comfort

Thromboembolic Disease

Venous thrombosis: Can be superficial or deep vein, usually in legs
Thrombophlebitis: Thrombus formed in response to inflammation in vein wall
Pulmonary embolus: Rare, life-threatening condition that occurs when thrombi dislodges from deep vein and travels to pulmonary artery

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Description

This quiz covers important aspects of postpartum hemorrhage, including its causes, treatments, and nursing management. Additionally, it delves into the trauma associated with childbirth, particularly lacerations and hematomas, along with their predisposing factors. Test your knowledge on these crucial topics related to maternal care.