Term
|
Definition
| From the delivery of the placenta and membranes to the return of the woman's reproductive system to its non-pregnant state |
|
|
Term
|
Definition
| Hourly assessment X18 hours to monitor for adverse effects: respirations, pain, sedation, itching
**NO narcotic pain medications can be given until Duramorph assessment is complete...and they shouldn't have pain until 24H |
|
|
Term
| ABO Incompatability causes what in infants? |
|
Definition
| Fetus experiences hemolysis, RBC destruction leads to hyperbilirubinemia
Treat with phototherapy- cuases the bilirubin to be bound and excreted through meconium |
|
|
Term
|
Definition
| Staining of the brain and necrosis of neurons.....
due to elevated bilirubin crossing the blood brain barrier |
|
|
Term
|
Definition
| Needs a 1:8 titer to be considered immune.
If not immune post partum give MMR, and birth control for at least 1 month.
If mom had rubella, you need to get a level on the baby |
|
|
Term
| Quantifications for Hemorrhage |
|
Definition
| >1000 cc reguardless of delivery type
>500 cc loss in the first 24 hours
Unresponsive to massage or medication
Decrease in Hct 10%
ACTION: locate the bleed; administer meds |
|
|
Term
|
Definition
| Normal range 36-48, but a in pregnancy a woman is lucky to have one at 37 or 38 due to physiologic anema.
Watch the Hct to make sure patients do not lose 10%. If so: ACTION: administer volume replacement (usually lactated ringers), blood products and meds as ordered (usually give Fe without active bleeds) |
|
|
Term
|
Definition
| Will be increased because the body is "working hard"
Not a reliable sign of infection. Look at temp or for a left shift
ACTION: assess for S/S of infection; administer meds; hygeine! |
|
|
Term
|
Definition
| Will be firm in 3-5 days after birth. For soreness: If breastfeeding, apply heat; if bottle feeding apply cold and avoid heat (wear a tight bra)
Engorgement will regress in 2-3 days if not breast feeding |
|
|
Term
|
Definition
| If uterine fundus is pushed to the side, think that the woman has a full bladder. (During labor there is rapid diuresis, and they should void within 2-3 hours)
We measure teh first three urine outputs |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| Excessive bleeding- using a pad per hour
There should be no foul smell to lochia! Need evaluation if this is present
Clot larger thana plumb |
|
|
Term
|
Definition
| REEDA
R-redness--there should be none
E-edema--there is always edema
E-ecchymosis--shouldn't be brusing. Document!
Discharge: lochia
A-approximation of skin edgets. Should see normal, no raw edges, no jaggedy suture stuff |
|
|
Term
| Causes of postpartum hemorrhage |
|
Definition
| "The 4 T's"
Tone: Uterine atony
Trauma: Trauma to the genital tract
Thrombin: Clotting disorders
Tissue: Retained Placenta**most common cause of late hemorrhage |
|
|
Term
|
Definition
| Uterus fails to contract despite being empty
Causes:
Uterus is too tired to contract r/t multiple gestations, poly hydroamnios, macrosomia (>4500g) distention with clots, traumatic birth. Also precipitous labor, MgSO4, pitocin use, infeciton, retianed fragemtns, high parity |
|
|
Term
|
Definition
| Firm massage
Manual clot expression
Eliminate bladder distention
Pitocin and LS or NS; If tha fails use methergine; if hypertension or if that fails use prostaglandin F2
Bimanual compression (give Abs after) |
|
|
Term
|
Definition
| Uterus flips inside out partially or completely. Happens with fundal pressure ***NEVER PUSH ON TOP OF UTERUS TO GET FETUS OUT***
Results in instant shock. Also hemorrhage and pain.
Treatment LR, blood products. Funus repositioned, oxytocic meds; bimaual compression. ANTIBIOTICS---hand in uterus is a huge risk for infection |
|
|
Term
|
Definition
| Idiopathic Thrombocytopenic Purppura
Auto immune platlet killing disorder.
Thrombocytopenia, capillary fragility (many bruises, petechiae), increased bleeding time
Tx: Goal--prevent bleeding problems.
Give glucorticoids to beef up platlets. Can do spleenectomy. IV Gammaglobulins or danzol (danzol is a male hormone and only given PP) |
|
|
Term
|
Definition
| Disseminated Intravascular Coagulation (DIC)
Overactivation of clotting and anti-clotting processes. Overstimulation of fibrinolysis by primary disorder. Inital hypercoaguability is followed by hypocoag and hemorrhage. Also eats RBCS--which decreases O2 carrying capabilities
S/S: Internal and external bleeding: gums nose, petechiae aroudn pressure and trauma site.
Tx: FIND THE ROOT OF THE PROBLEM IT'S ALWAYS CAUSED BY SOMETHING ELSE. Good assessments (VS); Monitor U/O (want 30cc/hour) Fluid replacement, give O2 |
|
|
Term
|
Definition
| Implantation of the placenta into the myometrium |
|
|
Term
|
Definition
| Implatation of the placenta all the way into the uterine muscle |
|
|
Term
|
Definition
| Implantation of the placenta all the way through the muscle of the uterus. Requires hysterectomy. |
|
|
Term
|
Definition
| Delayed return of enlarged uterus to normal size and function
S/S: prolonged, irregular or excessive vaginal bleeding; enlarged uterus by exam; boggy uterus (needs constant massage to remain firm)
Tx: Methergine, antibiotics with lochia smell, D&C if placenta is retained. |
|
|
Term
|
Definition
| Soaking a pad/hour
Clot larger than a plum
Fever and Chills >4hours
Dizziness/Fainting |
|
|
Term
|
Definition
| (Metritis) Infection of the uterine cavity or muscle
S/S: **Subinvolution and **Scanty odorous lochi or mod heavy floul smelling bloody seropurulent lochi; Tachcardia, jagged temp elevation, uternine tenderness
Tx: Antibiotics, analgesia |
|
|
Term
|
Definition
| Infection of the bladder
Huge risk with a history of UTI. TELL THEM TO DRINK!!
s/s: frequency, urgency, burning; suprapubic discomforta, CVA tenderness and fever with kidneys, tachycardia, N/V
Tx: Antibiotics, alangelsis, encourage fluid intake, encourage frequent voiding **** Routine Pericare**** |
|
|
Term
|
Definition
| INfection of the breast tissue; typically from organisms on maternal skin (or in baby's mouth)
Starts with a crack or bloster; pain swelling and tenderness, HIGH FEVER 103!!, breast feels hot, possible purulant drainage
Tx: **Encourage breast emptying! Keep breast feeding or pumping!** Antibiotics, incision and draininage, analgesics |
|
|
Term
|
Definition
| Almost everyone cries non-stop for 24-48 hours when they get home (day 4-8). Mom's are tearful, worried and very concerned about infant care. *They have VALID concerns.
**Praise mom on feeding, assessing needs***Encourage rest while baby is sleeping*** Let mom know that these are normal.Monitor bonding. Educate: what's normal and what's not! |
|
|
Term
|
Definition
| Depression. May want to kill themselves or their babies. Have excessive worry about bad things happening.
**Greatest risk is during the first month of delivery
s/s: insomnia; feeling devistated, poor concentration and difficulty with decisions, obsessive thoughts, decline in personal hygeine, suicidal or homosidal ideation.
Reponds to meds VERY quickly and once you're through it you can get off the meds. |
|
|
Term
|
Definition
| Includes delusions and hallucinations which PPD does not have.
Other s/s: agitation, confusion, irrational statements or behaviros, insomnia or hyperativity. |
|
|
