ATONY
What is Uterine Atony
muscles are not contracting
Oxytocin/Pitocin for:
Boggy uterus
4 primary causes of PP hemorrhage:
Tone (uterine atony)
Trauma (lacerations or hematoma)
Tissue (retained products of conception)
Thrombin (DIC)
Endometriosis:
Fever, foul smelling lochia, chills, abdominal pain, cramping, uterine tenderness
Heparin (aPTT) is used _____
warfarin (PT & INR) is used ____
DURING pregancy
After birth
Predisposing factors: (5)
- overdistention
-multiparity
-obesity
-prolonged or induced/augmented labor
- retained placental fragments
Misoprostol (Cytotec) is for___
major SE ___
- Medical abortion & after placenta is delivered
- SE: Fever- tell other nurses so they dont suspect infection
Nursing actions for hypovolemic shock:
-Assess Vitals, Fundus, Lochia, Review the Four T’s
Monitor UOP, labs, IV fluids, Comfort, Watch for water intoxication w oxytocin!
& lots more
Wound infections:
Redness, warmth, tenderness, pain, drainage, fever
Most common signs of pulmonary embolus or amniotic fluid embolus:
Dyspnea, chest pain, tachycardia, tachypnea, hemoptysis
- Pulse Ox DROPS
What does it look like?
Fundus difficult to locate, soft or boggy
higher than expected
excessive lochai & excessive/large clots
Dont give Methylergonovine (Methergine) if...
mom has HTN
Most crucial nursing intervention for PP depression
anticipatory guidance
UTIs
Burning, urgency, frequency, pain (flank), hematuria, fever
What to do for this:
Notify provider & Provide oxygen
IV access & Elevate HOB
CPR if needed
managing uterine atony:
- early administration of oxytocin
- fundal massage
-empty bladder
-maybe misoprostal, methergine
Carboprost helps ____
Dont give if___
SE ___
- helps uterine contract
- Don’t give to moms with asthma (causes bronchoconstriction)
- diarrhea
Operations for hypovolemic shock: (2)
hysterectomy & blood vessel litigation/cautery
Mastitis
Flu-like symptoms, fever, chills, breast lump, pain, redness, heat, inflammation
Prevention for DVT:
SCD, early ambulation, compression stockings
major preventitive factors of infection: