PPH
>500ml
>1000ml
What is uterine atony and treatments
Uterus does not contract
massage the fundus
blood/fluid transfusion
Bakri Balloon
ligation of uterine arteries
bimanual compression
What is Endometritis and what is the treatment
Inflammation/infection of the inner uterine lining
antibiotics, antipyretics, pitocin
How to avoid thromboembolic disorders in pp?
Encourage ambulation, assess lower extremities, avoid being sedentary
Medications for hemmorhage
Oxytocin
Methylergonovine
Carboprost
Misoprostol
Tranexamic acid
Reasons for early PPH
Uterine atony
Lacerations
Retained Placental Fragments
Hematoma
Uterine inversion
Uterine rupture
Coagulation disorders
Macrosomia
Rapid Birth
induction/augmentation
vacuums/foreceps
repair( surgery/stitches), packing
What to do for wound infections
antibiotics, aseptic technique, monitor site
Risk factors for thromboembolic disorders
obesity, advanced maternal age, anesthesia, previous history, endometritis, heart disease, smoking, inactivity bed rest
Tocolytics and when to use them for PPR
Magnesium sulfate, indomethacin, terbutaline, nifedipine
Uterine inversion
Reasons for late PPH
Subinvolusion
retained placental fragments
infection
Signs of and treatment for hematoma
blue/black bulging mass, vital sign changes (hypovolemic shock, high HR, low BP), extreme pain/pressure, firm fundus, normal lochia
Ice/Analgesics if <3cm and not expanding
surgery if >3cm and expanding
What to do for a UTI
Void every 2-3 hours
Change pads regularly, wipe from front to back
cranberry juice
antibiotics/antipyretics
Signs of Superficial venous thrombosis
tenderness in portion of vein, local heat/redness, normal-low grade fever, palpable cord
Signs of post partum blues
mild depression, occurs first few days lasts around 2 weeks, overwhelmed, tearful, loss of appetite
low BP
High HR
High RR
dizziness
fatigue
weak pulses
decreased urine output
Causes of and treatment for retained placental fragments
manual removal of placenta, previous c-section, early attempt to deliver placenta
INSPECT PLACENTA FOR INTACTNESS AFTER BIRTH
manual extraction, D/C, antibiotics
What is and what to do for Mastitis
Infection of the breast tissue
frequent breastfeeding, fluids, warm compress, antibiotics, analgesics
Patient is complaining of leg pain in one leg, redness and swelling. Patient also has a low grade fever. What could this be a sign of and what is the treatment?
DVT
IV heparin/warfarin, elevation, bedrest, ted hose, pain meds
Signs of PPD
Greatest risk around 4th week
depressed mood or loss of interest in activities for at least 2 weeks
Signs of hemorrhage
Saturating a pad in 1 hour
boggy fundus
large clots
high temp
high hr/ low BP
backache/pelvic discomfort
firm uterus with bleeding
rise in fundus level
hematoma
lowered LOC
Causes of and treatment for Uterine inversion
vigorous removal of placenta (pulling on cord), abnormal placenta placement, weak uterine muscles, nulliparity, macrosomia, uterine relaxation (MAG. SULF.), accreta
Surgery, tocolytics(stops contractions), manual repositioning
Antibiotic preferred for mastitis
Dicloxacillin for 2 weeks
Signs of a PE and treatment
dyspnea, tachypnea, tachycardia
chest pain, cough, cyanosis, diminished breath sounds
bedrest, heparin, coumadin, o2, elevate head of bed
Signs of PPP
hyperactivity, agitation, confusion, poor judgment, delusion, hallucinations, sleep disturbances