Questions and Answers
What is a critical consequence of hemorrhagic (hypovolemic) shock?
What is an effective strategy for managing postpartum infections?
Which of the following is NOT a part of the interprofessional care management for hemorrhagic shock?
What is a common maternal morbidity related to postpartum complications?
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Which factor can exacerbate the condition of a woman with a hemorrhagic disorder?
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What is a primary goal in managing hypovolemic shock?
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What is the recommended duration for exclusive breastfeeding according to AAP guidelines?
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Which of the following statements about jaundice in newborns is correct?
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What is the primary purpose of the Apgar score?
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At what age does the AAP recommend introducing solid foods to infants?
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Which of the following methods does NOT contribute to neonatal heat loss?
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What is the term for the serious condition caused by excessive bilirubin in newborns?
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What is defined as the presence of a fever of 38° C (100.4° F) within the first 10 postpartum days?
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Which is the most common postpartum infection characterized by fundal tenderness and fever?
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Which treatment is commonly used for endometritis during the postpartum period?
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What percentage of postpartum women are likely to develop urinary tract infections?
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Which of the following symptoms is NOT typically associated with mastitis?
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What is a significant reason for postpartum fever aside from infections?
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What is the incidence rate of wound infections after cesarean birth?
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What is a potential complication of prolonged rupture of membranes during the postpartum period?
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Which of the following are considered contraindications to breastfeeding?
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What safe practices should infected mothers follow while breastfeeding?
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Which breastfeeding position involves holding the baby under the arm?
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What is a common physiological change that occurs around 3 days after birth?
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Which of the following can be a factor contributing to pain associated with breastfeeding?
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Which complication is preventable with early treatment during breastfeeding?
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What intervention is appropriate for treating engorgement?
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For mothers with HIV infection, what is generally recommended in the United States?
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Which of these signs is indicative of neonatal hypoglycemia?
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What is the most significant cause of neonatal morbidity and mortality associated with infection?
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Which type of infection can result from congenital means?
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What is a primary characteristic of true apnea in neonates?
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How does maternal hyperglycemia affect fetal lung maturity?
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What is a common characteristic of congenital cardiac conditions in neonates?
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What factor associated with maternal diabetes significantly affects neonatal lung development?
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What deficiency contributes to compromised neonatal immunity?
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Study Notes
Postpartum Infection
- Postpartum infections, or 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 postpartum days (excluding the first 24 hours).
- Symptoms may include increased heart rate, fatigue, and elevated blood pressure.
Endometritis
- Most common postpartum infection, affecting the uterine lining.
- Characterized by fundal tenderness and fever; risks include prolonged membrane rupture and bacterial introduction.
- Management typically involves IV broad-spectrum antibiotics such as Gentamicin and Clindamycin.
Wound Infections
- May develop post-discharge, with infection rates of 3% to 5% after cesarean delivery.
- Commonly presents as cellulitis or abscess at the wound site.
Urinary Tract Infections (UTIs)
- Symptoms include dysuria, burning, frequency, and suprapubic pain.
- Occurs in 2% to 4% of postpartum women, often requiring urinalysis (UA) for confirmation.
Other Causes of Fever
- Consider pneumonia, flu, DVT/PE, and mastitis (infection of milk ducts).
- Mastitis presents with flu-like symptoms and requires treatment with dicloxacillin.
Postpartum Hemorrhage
- Major cause of obstetric morbidity and mortality; leading reason for ICU admissions.
- Hemorrhagic shock compromises organ perfusion and can lead to death.
- Key management includes restoring blood volume, fluid or blood replenishment, and maintaining cardiac output.
Breastfeeding and Illness
- Generally safe even when the mother is ill; COVID-19 is not transmitted through breast milk.
- Infected mothers advised to wear masks and practice hand hygiene.
Contraindications of Breastfeeding
- Includes conditions like galactosemia in newborns, HIV positive status, untreated brucellosis, active tuberculosis, and herpes simplex lesions on breasts.
Breastfeeding Positions
- Pain may result from improper positioning.
- Common positions include football hold, modified cradle, cradling, and side-lying.
Engorgement
- Physiological engorgement occurs around 3 days postpartum due to venous and lymphatic congestion.
- Treatment includes ice packs and cabbage leaves, with resolution typically within 24 hours.
AAP Breastfeeding Recommendations
- Exclusive breastfeeding recommended for the first 6 months; continue for at least 12 months.
- Solid foods should be introduced after 6 months.
Neonate Overview
- The U.S. has seen a steady increase in breastfeeding rates due to personal and sociocultural influences.
Jaundice in Newborns
- Newborns produce bilirubin at 2-2.5 times the adult rate due to shorter RBC lifespan.
- Bilirubin is processed primarily in the liver and spleen.
Neonatal Withdrawal & Heat Loss
- Neonatal heat loss occurs via conduction, convection, evaporation, and radiation.
Apgar Score
- Evaluates newborn's immediate health post-birth across five criteria: appearance, pulse, grimace, activity, and respiration.
Neonatal Hypoglycemia
- Signs include jitteriness, apnea, tachypnea, decreased activity, and cyanosis.
Neonatal Infection
- Newborns are susceptible due to an immature immune system; infections include viral, bacterial, protozoal, and fungal.
- Early- and late-onset sepsis are significant causes of neonatal morbidity and mortality.
Neonatal Immunity
- Newborns face challenges like low maternal IgG, impaired antibody production, and vulnerable skin.
Respiratory Distress in Neonates
- True apnea defined as a pause in breathing lasting 20 seconds or more.
- Respiratory Distress Syndrome (RDS) results from a lack of pulmonary surfactant.
Cardiac Murmurs in Neonates
- Sinus dysrhythmia can be normal; all murmurs require follow-up assessment to rule out congenital conditions.
Newborn Vital Signs
- Monitoring is crucial in the early postpartum period to ensure the health of the neonate.
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Description
Prepare for Exam #3 with this study guide focused on postpartum infections. Learn about definitions, symptoms, and clinical details related to infections that can occur after childbirth. This resource is essential for understanding puerperal infections and how they can affect new mothers.
