Postpartum Shock in Childbearing

What is the definition of postpartum shock?

What is a common cause of hypovolemic shock related to childbearing?

When does late postpartum hemorrhage occur?

What is the major risk associated with postpartum hemorrhage?

How much blood loss defines postpartum hemorrhage traditionally?

Which type of shock can be caused by an allergic reaction to drugs administered during childbearing?

What is the leading cause of postpartum death around the world?

Which of the following is the first sign of inadequate blood volume (hypovolemia)?

What action is taken to assess oxygen saturation of the blood?

What may indicate a blood clotting problem?

Which sign may indicate that a large hematoma is the cause of hypovolemia despite normal lochia and firm uterus?

How should intake and output be monitored in early postpartum hemorrhage care?

What is a key nursing role in providing care for postpartum hemorrhage?

What is the first blood pressure change seen in hypovolemic shock?

What is used to assess urine output and kidney function in patients with postpartum hemorrhage?

What may be required for high-risk patients with postpartum hemorrhage to allow invasive hemodynamic monitoring?

What is the most common cause of early postpartum hemorrhage?

Which drug is commonly used to control uterine atony?

What can cause uterine atony according to the text?

How should the uterus feel when a woman is experiencing uterine atony?

What is the expected fundal height after the expulsion of the placenta?

What may worsen uterine atony and postpartum hemorrhage according to the text?

How is a woman with uterine atony usually positioned?

'Lochia rubra' should be of what color?

What may lead to uterine atony if not corrected according to the text?

What can help stimulate uterine contraction postpartum?

What is the treatment for retained placental fragments?

What is subinvolution of the uterus?

What is a common sign of subinvolution?

How does involution prevent postpartum bleeding?

What may increase the risk of venous thrombosis in pregnant women?

What may cause subinvolution of the uterus?

What might be a sign that a woman is experiencing subinvolution?

How does ultrasonography assist in postpartum care?

Why do pregnant women face an increased risk of venous thrombosis?

What is an appropriate medical treatment for subinvolution?

What is the fourth leading cause of maternal mortality in the United States?

Which of the following is a risk factor for postpartum infection?

How is puerperal fever defined after childbirth?

What is the estimated normal range of white blood cells during the early postpartum period?

Why should the nurse promptly report and document any hardening of a C-section or episiotomy wound?

What can happen if a localized infection in the perineum ascends the reproductive tract?

What medication can be used to inhibit the breakup of clots that form, supporting the developing blood clot necessary to control hemorrhage?

In what timeframe must tranexamic acid be administered for postpartum hemorrhage?

Which intervention is typically sufficient for most small perineal hematomas?

What long-term effects can genital trauma after childbirth cause?

What is the primary purpose of intravenous calcium gluconate in the context of postpartum hemorrhage?

What might be the cause of late postpartum hemorrhage (occurs 24 hours to 6 weeks after childbirth)?

What is the main reason pregnant women are at an increased risk of blood clot formation?

Which symptom characterizes Deep Venous Thrombosis (DVT)?

What is the appropriate treatment for Superficial Venous Thrombosis?

Which practice should pregnant women avoid to prevent thrombus formation?

What should pregnant women be taught regarding antiembolic stockings?

What is the main sign of possible Pulmonary Embolism (PE)?

Which scenario may necessitate prophylactic heparin use for pregnant women?

What should be reported promptly when looking for signs of Deep Venous Thrombosis?

Which practice should be continued both during and after birth to prevent thrombus formation?

What is important when using stirrups during birth or episiotomy repair?

Postpartum shock is a condition in which the cardiovascular system fails to provide essential oxygen and nutrients to the cells due to ________

Hypovolemic shock is caused by postpartum hemorrhage or blood clotting disorders, leading to low blood volume or ________

Anaphylactic shock is caused by allergic responses to drugs administered during childbearing, resulting in an ________ reaction

Septic shock is caused by puerperal infection, which leads to a systemic ________ response

Postpartum hemorrhage is traditionally defined as blood loss greater than 500 mL after vaginal birth or 1000 mL after cesarean birth, resulting in signs or symptoms of ________

Early (primary) postpartum hemorrhage occurs within 24 hours of birth, while late postpartum hemorrhage occurs after 24 hours and within 6 weeks after birth, posing a risk of ________ shock

Uterine atony is characterized by a lack of normal ______ tone

After the placenta detaches, the uterus normally ______ to compress bleeding vessels

Excessive bleeding in postpartum hemorrhage may be managed by providing a uterine ______

The woman's uterus is difficult to feel and feels boggy (soft) in cases of uterine ______

The infant suckling at the breast stimulates the woman’s posterior pituitary gland to secrete ______, which causes uterine contraction

A dilute oxytocin (Pitocin) IV infusion is commonly ordered to control uterine ______

Methylergonovine increases blood pressure and should not be given to a woman with ______

Lochia rubra should be of a dark ______ color

Pressing towards the vagina should expel any clots or blood pooled in the vagina after the uterus is ______

A full bladder interferes with the ability of the uterus to contract and may eventually lead to uterine ______

Treatment for retention of placental fragments may include the administration of drugs such as oxytocin, methylergonovine, or prostaglandins to contract the ______

If bleeding continues after ultrasonography is used to identify placental fragments, curettage (scraping or vacuuming of the inner surface of the uterus) is performed to remove small blood clots and placental fragments. This procedure is known as dilation and ______

Subinvolution is a slower than expected return of the uterus to its nonpregnant condition. Infection and retained fragments of the placenta are the most common causes. Typical signs of subinvolution include fundal height greater than expected for the amount of time since birth, persistence of lochia rubra or a slowed progression through the three phases, pelvic pain, heaviness, and ______

Medical treatment for subinvolution may include methylergonovine (Methergine) to maintain firm uterine contraction, antibiotics for infection, and dilation of the cervix and curettage to remove fragments of the placenta from the uterine ______

Puerperal sepsis is an infection or septicemia after ______ and is the fourth leading cause of maternal mortality in the United States

A venous thrombosis is a blood clot within a ______

Tissue trauma during labor, the open wound of the placental insertion site, surgical incisions, cracks in the nipples of the breasts, and the increased pH of the vagina after ______ are all risk factors for the postpartum woman

Blood vessel injury during cesarean section can cause a ______

The fever is most often caused by ______, an inflammation of the inner lining of the uterus

Blockage of the lochial flow because of retained placenta or clots increases susceptibility to ______

The pregnant woman is at increased risk for venous thrombosis because of the venous stasis that can occur from compression of the blood vessels by the heavy uterus or by pressure behind the knees when the legs are placed in stirrup leg supports for episiotomy ______

A venous thrombosis occurs in 1 in 1500 pregnancies. The size of the clot can increase as circulating blood passes over it and deposits more platelets, fibrin, and ______

Fever, pain, a foul odor, or abnormal findings on routine postpartum assessment must be reported to the health care ______

Women should report fever, persistent pain, persistent red lochia, or return of bleeding after it has changed. The woman should be taught how to palpate the fundus and what normal changes to ______

Leukocyte counts in the upper limits are more likely to be associated with infection than lower ______

Nursing care for subinvolution involves assisting with medical therapy, providing analgesics, and other comfort measures. Specific nursing care depends on whether the subinvolution results from infection or ______

The body responds to a reduction in blood volume with increased heart and respiratory rates to increase the oxygen content of each ____________.

Tachycardia is usually the first sign of inadequate blood volume in ____________ shock.

The first blood pressure change in hypovolemic shock is a narrow pulse pressure with a falling systolic pressure and a rising diastolic pressure as the blood pressure continues falling and eventually cannot be ____________.

Blood flow to nonessential organs gradually stops to make more blood available for vital organs, specifically the ____________ and brain.

As blood loss continues, flow to the brain decreases, resulting in mental changes such as anxiety, confusion, restlessness, and ____________.

In the first hours postpartum, the perineal pad should be weighed to determine the output amount: 1 g equals 1 ____________.

Decreased blood pressure may be a late sign of ____________ shock.

The body initially responds to a reduction in blood volume with increased heart and respiratory rates to cause faster circulation of the remaining ____________.

Medical management of hypovolemic shock resulting from hemorrhage may include giving ____________ to increase the saturation of remaining blood cells.

Nursing Care Plan 10.1 specifies interventions for the woman at high risk for altered tissue perfusion related to ____________.

Intravenous calcium gluconate may be used to counteract a tocolytic drug that may have been administered to relax the ______ during labor.

The health care provider may examine the woman in the delivery or operating room to determine the source of her bleeding and to correct it. Rarely, a hysterectomy is needed to remove the bleeding ______ that does not respond to any other measures.

Lacerations of the perineum, vagina, cervix, or area around the ______ (periurethral lacerations) can cause postpartum bleeding.

Blood lost in lacerations is usually a brighter red than ______ and flows in a continuous trickle.

The woman with a hematoma usually has severe, unrelenting pain that analgesics do not relieve. Depending on the amount of blood in the tissues, she also may describe pressure in the vulva, pelvis, or ______.

Small hematomas usually resolve without treatment. Larger ones may require incision and drainage of the clots. The bleeding vessel is ligated or the area packed with a ______ material to stop the bleeding.

Depending on the amount of blood in the tissues, she also may describe pressure in the vulva, pelvis, or ______. She may be unable to urinate because of the pressure.

The woman does not have unusual amounts of lochia, but she may develop signs of concealed blood loss if the hematoma is large. Her pulse and respiratory rates rise, and her blood pressure falls. She may develop other signs of ______ shock if blood loss into the tissues is substantial.

An ice pack to the perineum is sufficient for most small perineal hematomas and requires no physician prescription. The nurse should observe for and report the classic symptom – excessive, poorly relieved ______.

In addition to the specific interventions for specific causes of postpartum hemorrhage, the medication tranexamic acid can be used to inhibit the breakup of clots that form; this supports the developing blood clot that is necessary to control hemorrhage. However, the drug must be administered within 3 hours of ______.

The levels of ______ and other clotting factors normally increase during pregnancy

A state of hypercoagulability results in an increased susceptibility to developing ______

Preventive measures for thrombus formation include the use of pneumatic compression devices on the lower extremities or prophylactic ______

Superficial venous thrombosis (SVT) involves the ______ vein of the lower leg

Deep venous thrombosis (DVT) can involve veins from the feet to the ______ area

Pulmonary embolism (PE) occurs when the pulmonary artery is obstructed by a ______ clot

Superficial venous thrombosis is treated with administration of analgesics, local application of heat, and elevation of the legs to promote ______ drainage

Deep venous thrombosis is treated similarly, with the addition of subcutaneous or IV ______ drugs

Low-molecular-weight heparin (LMWH) may be used to treat thrombosis because it is long acting and requires less frequent doses and lab ______

The woman undergoing anticoagulant therapy at home should be taught how to give herself the drug and about signs of excess ______