Questions and Answers
What is the AAP's recommendation regarding breastfeeding duration?
Which factor has influenced the increase in U.S. breastfeeding rates over the past decade?
What primarily initiates bilirubin metabolism in newborns?
What is the primary action to take when managing postpartum hemorrhage (PPH)?
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What is the Apgar score used to evaluate?
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Which of the following is NOT a common symptom of mastitis?
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What is an appropriate measure to prevent infection postpartum?
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Which method of heat loss is NOT one of the four main types identified for neonates?
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What is a predisposing factor for developing mastitis?
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What is the typical bilirubin production rate in newborns compared to adults?
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When experiencing signs of mastitis, what should a patient do?
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Which of the following medications is commonly used to treat mastitis?
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What should be addressed to manage postpartum hemorrhage effectively?
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What role does IV access play in managing PPH?
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What is defined as the presence of a fever of 38° C (100.4° F) in the first 10 postpartum days?
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Which of the following is the most common postpartum infection?
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What is the most appropriate management for endometritis after a cesarean birth?
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Which condition can be distinguished from mastitis by the absence of flu-like symptoms?
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What can make someone more susceptible to wound infections postpartum?
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What symptoms would likely indicate a urinary tract infection (UTI) in a postpartum woman?
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What is a typical rate of wound infections following cesarean births?
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Which of the following is NOT a potential cause of fever in the postpartum period?
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Which of the following is a complication that can arise from breastfeeding?
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In which scenario is breastfeeding contraindicated?
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Which breastfeeding position may help prevent pain associated with improper positioning?
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What is the recommended intervention for treating engorgement?
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What should mothers with COVID-19 do while breastfeeding?
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Which of the following is NOT a factor that contributes to pain during breastfeeding?
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What time frame is typically associated with engorgement after birth?
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In which circumstance do the benefits of breastfeeding outweigh the risks of HIV transmission?
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Which sign is NOT commonly associated with neonatal hypoglycemia?
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What is the most significant cause of neonatal morbidity and mortality related to infections?
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What characteristic of neonates contributes to their susceptibility to infections?
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What condition is primarily caused by a lack of pulmonary surfactant in neonates?
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True apnea in neonates is defined as a pause in breathing for how long?
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Which of the following infections does NOT represent a risk for neonatal health?
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What is the potential impact of maternal hyperglycemia on fetal lung maturity?
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A significant characteristic of congenital cardiac conditions in neonates is that they may present as what?
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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.
