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Questions and Answers
What is the definition of postpartum infection?
What is the definition of postpartum infection?
Which symptom is most characteristic of endometritis?
Which symptom is most characteristic of endometritis?
What is the recommended management for endometritis?
What is the recommended management for endometritis?
What percentage of postpartum women typically experience urinary tract infections (UTIs)?
What percentage of postpartum women typically experience urinary tract infections (UTIs)?
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What is NOT a common reason for fever or infection symptoms in postpartum women?
What is NOT a common reason for fever or infection symptoms in postpartum women?
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What is the primary cause of postpartum hemorrhage?
What is the primary cause of postpartum hemorrhage?
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What is true regarding wound infections following childbirth?
What is true regarding wound infections following childbirth?
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Which factor can cause mastitis in postpartum women?
Which factor can cause mastitis in postpartum women?
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What is the primary cause of hemorrhagic (hypovolemic) shock?
What is the primary cause of hemorrhagic (hypovolemic) shock?
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Which intervention is NOT part of the standardized management protocols for hemorrhagic shock?
Which intervention is NOT part of the standardized management protocols for hemorrhagic shock?
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What is a common complication following childbirth that can lead to morbidity and mortality?
What is a common complication following childbirth that can lead to morbidity and mortality?
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Which factor is significant in the prevention of postpartum infections?
Which factor is significant in the prevention of postpartum infections?
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What does postpartum UTI commonly result from?
What does postpartum UTI commonly result from?
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Which key component is essential for managing hemorrhagic shock effectively?
Which key component is essential for managing hemorrhagic shock effectively?
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Which condition is caused by increased glucose stimulating fetal insulin release in infants of diabetic mothers?
Which condition is caused by increased glucose stimulating fetal insulin release in infants of diabetic mothers?
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Which of the following is a risk associated with macrosomia in infants of diabetic mothers?
Which of the following is a risk associated with macrosomia in infants of diabetic mothers?
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What characterizes cephalhematoma in newborns?
What characterizes cephalhematoma in newborns?
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What is a potential complication of hyperbilirubinemia in neonates?
What is a potential complication of hyperbilirubinemia in neonates?
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Which of the following is true about subgaleal hemorrhage in neonates?
Which of the following is true about subgaleal hemorrhage in neonates?
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What is the likely outcome for a neonate experiencing hypoglycemia after birth?
What is the likely outcome for a neonate experiencing hypoglycemia after birth?
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What is the recommended duration for exclusive breastfeeding according to AAP guidelines?
What is the recommended duration for exclusive breastfeeding according to AAP guidelines?
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What is the primary cause of jaundice in newborns as compared to adults?
What is the primary cause of jaundice in newborns as compared to adults?
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What does the Apgar score measure in a newborn?
What does the Apgar score measure in a newborn?
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When should solid foods be introduced to an infant's diet?
When should solid foods be introduced to an infant's diet?
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Which method does NOT contribute to neonatal heat loss?
Which method does NOT contribute to neonatal heat loss?
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Which statement about bilirubin metabolism in newborns is accurate?
Which statement about bilirubin metabolism in newborns is accurate?
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What is a significant sign of neonatal hypoglycemia?
What is a significant sign of neonatal hypoglycemia?
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Which factor contributes to a preterm neonate's susceptibility to infections?
Which factor contributes to a preterm neonate's susceptibility to infections?
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What type of infection is most closely associated with Systemic Inflammatory Response Syndrome (SIRS) in neonates?
What type of infection is most closely associated with Systemic Inflammatory Response Syndrome (SIRS) in neonates?
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In the context of respiratory distress syndrome (RDS), what is primarily lacking in preterm neonates that causes atelectasis?
In the context of respiratory distress syndrome (RDS), what is primarily lacking in preterm neonates that causes atelectasis?
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What should be investigated when a baby arrives at the NICU to consider a potential infection?
What should be investigated when a baby arrives at the NICU to consider a potential infection?
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What is a typical characteristic of a cardiac murmur in a neonate?
What is a typical characteristic of a cardiac murmur in a neonate?
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Which type of immunity is compromised in preterm neonates?
Which type of immunity is compromised in preterm neonates?
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What is the definition of true apnea in neonates?
What is the definition of true apnea in neonates?
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Study Notes
Postpartum Infections
- Also known as puerperal infection, occurs within 28 days after miscarriage, abortion, or birth.
- Diagnosed by a fever of 38° C (100.4° F) during the first ten postpartum days; excludes the first 24 hours after birth.
- Common symptoms include increased heart rate, fatigue, and elevated blood pressure.
Endometritis
- Infection of the uterine lining and the most prevalent postpartum infection.
- Symptoms include fundal tenderness and fever.
- Risk factors include prolonged rupture of membranes and manual introduction of bacteria.
- Treatment involves IV broad-spectrum antibiotics like Gentamicin and Clindamycin; no routine cultures are taken.
Wound and Urinary Tract Infections
- Wound infections often surface post-discharge, particularly after cesarean birth (3% to 5% infection rate).
- UTIs manifest as dysuria, burning sensation, frequency, and suprapubic pain; occur in 2% to 4% of postpartum women.
Other Causes of Fever
- Potential causes for fever/infection symptoms include pneumonia, flu, DVT/PE, and mastitis.
- Mastitis symptoms include fever and flu-like symptoms; treatable with dicloxacillin.
- Misoprostol can cause transient fever without additional symptoms.
Postpartum Hemorrhage and Shock
- Major cause of obstetric morbidity/mortality globally and primary reason for ICUs admissions.
- Hemorrhagic shock compromises organ perfusion and can be life-threatening.
- Management includes fluid/blood replacement and restoring oxygen delivery to tissues.
- Uterine massage recommended for managing hemorrhage.
Breastfeeding Recommendations
- Follow-up examination for breastfeeding infants should occur 48 to 72 hours post-discharge.
- AAP endorses exclusive breastfeeding of human milk for the first six months, continuing for at least 12 months.
- Solid foods introduction recommended after six months.
Neonatal Jaundice
- Newborn bilirubin production is 2-2.5 times greater than adults due to a shorter RBC lifespan.
- Bilirubin binding to albumin facilitates liver processing for excretion.
- Acute bilirubin encephalopathy, or kernicterus, can result from high bilirubin levels.
Neonatal Heat Loss
- Four methods: conduction, convection, evaporation, and radiation.
Apgar Score
- A quick health evaluation of newborns right after birth; measures appearance, pulse, grimace, activity, and respiration.
- A score of 7 or above is generally considered good.
Infant of a Diabetic Mother
- Hyperinsulinemia leads to increased glucose via the placenta, stimulating fetal insulin production.
- Potential complications: macrosomia, birth trauma, respiratory distress syndrome, hypoglycemia, and hyperbilirubinemia.
- Congenital anomalies risk increases with pregestational diabetes.
Neonate Head Assessment
- Caput succedaneum shows as edema over the presenting part; due to pressure during birth.
- Cephalhematoma is a subperiosteal blood collection that does not cross suture lines; more serious subgaleal hemorrhage can occur.
Neonatal Hypoglycemia
- Signs include jitteriness, apnea, tachypnea, decreased activity, and cyanosis.
Neonatal Infection Risks
- Neonates are susceptible to infections due to immature immune systems.
- Major causes of neonatal morbidity/mortality include early-late onset sepsis and various viral/bacterial infections.
- Common pathogens include GBS, E. coli, chlamydia, and rubella, among others.
Neonatal Immunity
- Limited maternal immunoglobulin stores and inability to produce antibodies puts neonates at risk.
Respiratory Distress in Neonates
- True apnea is defined as a pause in breathing of 20 seconds or more.
- Signs of respiratory distress include: labored breathing and abnormal lung sounds.
- Respiratory distress syndrome arises from lack of pulmonary surfactant, impacting lung function.
- Maternal hyperglycemia impedes fetal lung maturity significantly.
Cardiac Findings in Neonates
- Sinus dysrhythmia is a normal finding; murmurs require further evaluation to rule out congenital issues.
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Description
This study guide focuses on postpartum infections, also known as puerperal infections, that can occur within 28 days following childbirth, miscarriage, or induced abortion. It outlines the definition, symptoms, and significance of fever as a clinical marker within the first ten postpartum days. Understand the key concepts to prepare effectively for your exam.
