Postpartum Infections Study Guide

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Questions and Answers

What is the AAP's recommendation regarding breastfeeding duration?

Exclusive breastfeeding for 12 months and solid foods at 9 months.

Combination feeding for the first 6 months and exclusive breastfeeding thereafter.

Exclusive breastfeeding for at least 6 months and continued for at least 12 months. (correct)

Immediate introduction of solid foods within the first month after birth.

Which factor has influenced the increase in U.S. breastfeeding rates over the past decade?

Government mandates on infant nutrition.

Increased awareness of personal and sociocultural factors. (correct)

Availability of formula alternatives.

Higher disposable incomes.

What primarily initiates bilirubin metabolism in newborns?

The intestines.

The reticuloendothelial system, mainly the liver and spleen. (correct)

The spleen.

The kidneys.

What is the primary action to take when managing postpartum hemorrhage (PPH)?

Perform bimanual massage of the uterus Signup and view all the answers

What is the Apgar score used to evaluate?

A newborn baby's health immediately after birth. Signup and view all the answers

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

Abdominal cramping Signup and view all the answers

What is an appropriate measure to prevent infection postpartum?

Strict adherence to aseptic techniques Signup and view all the answers

Which method of heat loss is NOT one of the four main types identified for neonates?

Diffusion Signup and view all the answers

What is a predisposing factor for developing mastitis?

Cracked nipples Signup and view all the answers

What is the typical bilirubin production rate in newborns compared to adults?

2 to 2.5 times that of adults. Signup and view all the answers

When experiencing signs of mastitis, what should a patient do?

Promptly contact a healthcare provider Signup and view all the answers

Which of the following medications is commonly used to treat mastitis?

Dicloxacillin Signup and view all the answers

What should be addressed to manage postpartum hemorrhage effectively?

Address the underlying cause of bleeding Signup and view all the answers

What role does IV access play in managing PPH?

To administer isotonic fluids Signup and view all the answers

What is defined as the presence of a fever of 38° C (100.4° F) in the first 10 postpartum days?

Postpartum infection Signup and view all the answers

Which of the following is the most common postpartum infection?

Endometritis Signup and view all the answers

What is the most appropriate management for endometritis after a cesarean birth?

IV broad-spectrum antibiotic therapy Signup and view all the answers

Which condition can be distinguished from mastitis by the absence of flu-like symptoms?

Transient fever from Misoprostol Signup and view all the answers

What can make someone more susceptible to wound infections postpartum?

Manual introduction of bacteria Signup and view all the answers

What symptoms would likely indicate a urinary tract infection (UTI) in a postpartum woman?

Dysuria and suprapubic pain Signup and view all the answers

What is a typical rate of wound infections following cesarean births?

3% to 5% Signup and view all the answers

Which of the following is NOT a potential cause of fever in the postpartum period?

Routine postpartum assessments Signup and view all the answers

Which of the following is a complication that can arise from breastfeeding?

Breast abscess Signup and view all the answers

In which scenario is breastfeeding contraindicated?

Newborn has galactosemia Signup and view all the answers

Which breastfeeding position may help prevent pain associated with improper positioning?

Football or clutch hold Signup and view all the answers

What is the recommended intervention for treating engorgement?

Applying ice packs Signup and view all the answers

What should mothers with COVID-19 do while breastfeeding?

Wear a mask and practice hand hygiene Signup and view all the answers

Which of the following is NOT a factor that contributes to pain during breastfeeding?

Adequate fluid intake Signup and view all the answers

What time frame is typically associated with engorgement after birth?

Around 3 days after birth Signup and view all the answers

In which circumstance do the benefits of breastfeeding outweigh the risks of HIV transmission?

In developing countries with high HIV prevalence Signup and view all the answers

Which sign is NOT commonly associated with neonatal hypoglycemia?

Bradycardia Signup and view all the answers

What is the most significant cause of neonatal morbidity and mortality related to infections?

Systemic Inflammatory Response Syndrome (SIRS) Signup and view all the answers

What characteristic of neonates contributes to their susceptibility to infections?

Compromised integumentary system Signup and view all the answers

What condition is primarily caused by a lack of pulmonary surfactant in neonates?

Respiratory Distress Syndrome (RDS) Signup and view all the answers

True apnea in neonates is defined as a pause in breathing for how long?

20 seconds or more Signup and view all the answers

Which of the following infections does NOT represent a risk for neonatal health?

Common cold Signup and view all the answers

What is the potential impact of maternal hyperglycemia on fetal lung maturity?

Delay fetal lung maturity significantly Signup and view all the answers

A significant characteristic of congenital cardiac conditions in neonates is that they may present as what?

Irregular heart murmur Signup and view all the answers

Study Notes

Postpartum

Postpartum infections, also known as puerperal infections, occur within 28 days after miscarriage, abortion, or birth.
Defined by a fever of 38°C (100.4°F) within the first 10 days postpartum, excluding the first 24 hours after birth.
Endometritis, the most common postpartum infection, is marked by fundal tenderness and fever, typically following prolonged rupture of membranes.
Treatment for endometritis involves IV broad-spectrum antibiotics such as Gentamicin and Clindamycin, given until the patient is afebrile for 24 hours.

Wound and Urinary Tract Infections

Wound infections often develop post-discharge; rates after cesarean section range from 3% to 5%.
Symptoms of urinary tract infections (UTIs) include dysuria, burning, frequency, and suprapubic pain, with occurrence rates of 2% to 4% postpartum.
Use of thorough evaluations, such as urinalyses, is critical for diagnosing UTIs and other infections.

Postpartum Hemorrhage (PPH)

A major cause of obstetric morbidity and mortality, often leading to ICU admissions.
Management includes firm fundal massages, calling for hemorrhage assistance, and immediate IV access for isotonic fluids.
Administration of uterotonics, such as Pitocin and Cytotec, is essential; surgical options may be required for severe cases.

Infection Prevention

Aseptic techniques during childbirth and postpartum are vital for infection prevention and cost-effective care.

Mastitis

Mastitis presents with flu-like symptoms (fever, chills, malaise) and localized breast pain, typically occurring 2-4 weeks postpartum.
Predisposing factors include inadequate breast emptying and sore, cracked nipples which allow bacterial entry.
Early detection and treatment can prevent complications, such as breast abscess.

Breastfeeding Considerations

Breastfeeding is contraindicated for newborns with galactosemia and mothers with certain infections (e.g., active tuberculosis, HIV).
AAP recommends exclusive breastfeeding for the first 6 months and continued breastfeeding for at least 12 months.

Neonatal Health

Newborns have a higher bilirubin production than adults, leading to a risk of jaundice due to a shorter RBC lifespan.
Signs of neonatal hypoglycemia include jitteriness and apnea; metabolic abnormalities must be monitored closely.
Neonates are particularly susceptible to infections given their immature immune systems, necessitating vigilance for conditions like sepsis.

Respiratory and Cardiac Considerations

Respiratory distress syndrome (RDS) in neonates is primarily caused by surfactant deficiency, significantly influenced by maternal hyperglycemia.
Normal findings can include sinus dysrhythmia; any abnormal murmurs require further assessment for potential congenital conditions.

Engorgement and Breastfeeding Positions

Engorgement occurs 3 days postpartum due to congestion and can be addressed with ice packs and cabbage leaves.
Various breastfeeding positions can alleviate discomfort; common positions include football, cradle, and side-lying holds.

Key Points on Jaundice and Neonatal Care

Acute bilirubin encephalopathy poses risks, and monitoring is essential post-delivery.
Neonates require adequate warmth management to prevent heat loss through conduction, convection, evaporation, and radiation.
Skin-to-skin care is encouraged to bolster bonding and breastfeeding success.

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Description

This study guide covers essential information regarding postpartum infections, also known as puerperal infections. It defines clinical infections of the genital tract that occur within 28 days post-miscarriage, abortion, or birth, highlighting the critical symptoms such as fever and increased heart rate. Prepare yourself with key insights for Exam #3.