Which Assessment Finding Could Indicate Hemorrhage In The Postpartum Patient?

Decreased blood pressure

.

Increased heart rate

.

Decrease in the red blood cell count (hematocrit) Swelling and pain in tissues

in the vaginal and perineal area, if bleeding is due to a hematoma.

What is the most frequent reason for postpartum hemorrhage?

Uterine atony

.

This is the most common cause of PPH. It happens when the muscles in your uterus don’t contract (tighten) well after birth. Uterine contractions after birth help stop bleeding from the place in the uterus where the placenta breaks away.

Which body system is most vulnerable to infection during the postpartum period?

You’re more vulnerable to developing a

urinary tract infection

after giving birth, particularly if you had a catheter in your bladder or an epidural.

Which relief measure would be most appropriate for a postpartum patient with superficial thrombophlebitis?

For superficial thrombophlebitis, your doctor might recommend applying heat to the painful area, elevating the affected leg, using an

over-the-counter nonsteroidal anti-inflammatory drug (NSAID)

and possibly wearing compression stockings.

Why is the nursing assessment vital to caring for the postpartum woman?

The postpartum nursing assessment is an important aspect of care in order to

identify early signs of complications in the woman

who has just given birth. Following pregnancy, the woman is at risk for infection, hemorrhage, and the development of a Deep Vein Thrombosis (DVT).

What lab values indicate postpartum hemorrhage?

PPH has been defined as “the amount

of blood loss over 500 ml in natural vaginal delivery

, or 1000 mL in cesarean section, within a period of 24 h postpartum”. However, this definition tends to be retrospective. Thus, PPH can only be diagnosed if the parturient has lost more than 500 mL or 1000 mL of blood.

Which of the following complications is most likely responsible for a postpartum hemorrhage?

Uterine atony

is the most common cause of postpartum hemorrhage.

Which medication may be used to treat postpartum hemorrhage?

The medications most commonly used in PPH management are uterotonic agents. These medications include

oxytocin (Pitocin

^®

)

, misoprostol (Cytotec

^®

), methylergonovine maleate (Methergine

^®

,), carboprost tromethamine (Hemabate

^®

), and dinoprostone (Prostin E2

^®

). All of these medications are available in the United States.

What are the complications of postpartum hemorrhage?

Complications include

sterility, uterine perforation, uterine synechiae (Asherman syndrome), urinary tract injury and genitourinary fistula, bowel injury and genitointestinal fistula, vascular injury, pelvic hematoma, and sepsis

.

How is postpartum infection diagnosed?

Postpartum infections can be diagnosed by

your doctor through a physical exam

. Your doctor may take a urine or a blood sample to test for bacteria or use a cotton swab to take a culture of your uterus.

What causes postpartum infections?

After delivery, the woman body is prone to postnatal infections which are caused by

bacteria and other microorganisms

. Infections can be caused by staphylococcus, a bacterial usually present in the oral cavity of the baby or within the abdominal and uterus lining of the mother.

What should the nurse teach regarding relief of breast engorgement?

• Soften your breasts before feedings. You can apply a warm compress for a couple of minutes before you breastfeed. …
• Try to breastfeed more often. …
• If your breasts still feel uncomfortable after nursing, try a cold compress to reduce swelling.

Which action would most make the nurse believe that a postpartum woman is accepting a child well?

Which action would most make the nurse believe that a postpartum woman is accepting a child well?

She turns her face to meet the infant’s eyes when she holds her.

What medication would the nurse administer to a client experiencing uterine Atony and bleeding leading to postpartum hemorrhage?

Medications used for postpartum hemorrhage secondary to Uterine atony include the following:

Oxytocin (Pitocin)

can be given IV 10 to 40 units per 1000 ml or 10 units intramuscularly (IM). The rapid undiluted infusion may cause hypotension. Methylergonovine (Methergine) given IM 0.2 mg.

Which measurement best describes postpartum hemorrhage?

2,3 The American College of Obstetricians and Gynecologists defines early postpartum hemorrhage as

at least 1,000 mL total

blood loss or loss of blood coinciding with signs and symptoms of hypovolemia within 24 hours after delivery of the fetus or intrapartum loss.

What should you assess during postpartum?

• BREASTS. The breasts are assessed for: …
• UTERUS. The fundus is assessed for: …
• BOWEL. Assessment of the bowel is important in all postpartum patients. …
• BLADDER. Assessment of urination and bladder function includes: …
• LOCHIA. Lochia is assessed during the postpartum period: …
• EPISIOTOMY/PERINEUM. …
• LOWER EXTREMITIES. …
• EMOTIONS.

What is postpartum nursing care?

Postpartum nurses

specialize in caring for patients after the birth has taken place

. They’re responsible for both the mother and the baby in their care and must make sure that they’re well taken care of until discharge, which may take anywhere from a few hours to a few days.

What happens to vital signs during postpartum hemorrhage?

Decreased blood pressure

.

Increased heart rate

.

Decrease in the red blood cell count

.

Swelling and pain in the vagina and nearby area

if bleeding is from a hematoma.

What is the appropriate way to assess the fundus of the postpartum patient?

The fundus (top portion of the uterus) should be felt at the level of your belly button or lower. You can attempt to feel your fundus

by gently pressing on your abdomen

.

What two lab findings are important for the postpartum nurse to review for all postpartum patients?

Complete blood count (CBC) with hemoglobin and hematocrit

.

Coagulation studies

.

Electrolytes

.

What is the role of lab tests in the workup of PPH?

Instead, history is relied on to uncover previous episodes suggesting

preexisting disorders of hemostasis

. Once the diagnosis of PPH has been made, a CBC and baseline coagulation studies should be performed. Initially, the hemoglobin value does not reflect the amount of blood loss.

Which of the following circumstance is most likely to cause uterine Atony and lead to postpartum hemorrhage?

The most common cause of PPH is uterine atony. Patients at increased risk for uterine atony include those with

high parity

, overdistended uterus (e.g., multiple gestation, polyhydramnios), prolonged or rapid labor, use of oxytocin for induction or augmentation, and use of magnesium sulfate.

Which of the following circumstances is most likely to cause uterine Atony and lead to postpartum hemorrhage *?

Uterine atony is

a failure of the uterine myometrial fibers to contract and retract

. This is the most important cause of PPH and usually occurs immediately following delivery of the baby, up to 4 hours after the delivery.

What will the nurse teach a nursing mother to do to reduce the risk of mastitis?

Switch back to the healthy breast and breastfeed until your baby has finished.

Pump or express milk from the affected breast

if pain prevents you from breastfeeding. Nipple pain can be caused by the baby latching on to sore nipples. For more information on pumping or expressing breast milk, see the topic Breastfeeding.

How is postpartum hemorrhage managed?

Management of post-partum haemorrhage (PPH) involves

the treatment of uterine atony, evacuation of retained placenta or placental fragments, surgery due to uterine or birth canal trauma

, balloon tamponade, effective volume replacement and transfusion therapy, and occasionally, selective arterial embolization.

Why is oxytocin given in postpartum haemorrhage?

Oxytocin

prevents excessive postpartum bleeding by helping the uterus to contract

. It is given to the mother by injection into a vein or into muscle during or immediately after the birth of her baby.

How is postpartum endometritis diagnosed?

Diagnosis and Treatment for Postpartum Endometritis

Your doctor can give

you a physical exam

and ask about your symptoms to diagnose you. They may perform a vaginal swab, blood test, or urine test to confirm the infection.

How do you diagnose endometritis?

1. taking samples, or cultures, from the cervix to test for bacteria that can cause an infection, such as chlamydia and gonococcus (the bacteria that causes gonorrhea)
2. removing a small amount of tissue from the lining of the uterus to test, which is called endometrial biopsy.

Which is the greatest risk factor for developing postpartum endometritis?

Caesarean delivery

is the most significant risk factor for postpartum endometritis, particularly if performed after labor has begun.

How do you prevent postpartum complications?

Prevention tips

Prioritize your postpartum health

. Start thinking about your postpartum care plan before you give birth. After childbirth, talk to your health care provider about your risk of a pregnancy-related complication and any special follow-up care you might need. Know the signs and symptoms of a problem.

Which of the following is the most common postpartum infection?

Endometritis

is the most common infection in the postpartum period.

What can nurses do to assist families that share concerns about a mother’s mental state?

• Assess the mental status, behavior, and mood.
• Educate the patient on postpartum depression.
• Encourage a healthy diet.
• Provide support and encourage self-care.
• Involve social worker who can provide support groups.
• Encourage the patient to speak up about help.
• Encourage patient to engage in social activities.

What postpartum means?

“Postpartum” means

the time after childbirth

. Most women get the “baby blues,” or feel sad or empty, within a few days of giving birth. For many women, the baby blues go away in 3 to 5 days. If your baby blues don’t go away or you feel sad, hopeless, or empty for longer than 2 weeks, you may have postpartum depression.

Which client should the postpartum nurse assess first after receiving Shift report?

1. Which client should the postpartum nurse assess first after receiving the a.m. shift report? 1.

The client who is complaining of perineal pain when urinating

.

What factors might predispose a postpartum client with the development of an infection?

• History of cesarean delivery.
• Premature rupture of membranes.
• Frequent cervical examination (Sterile gloves should be used in examinations. …
• Internal fetal monitoring.
• Preexisting pelvic infection including bacterial vaginosis.
• Diabetes.
• Nutritional status.
• Obesity.

When does postpartum infection occur?

Postpartum endometritis is an infection of the lining of the womb which can occur

up to six weeks after childbirth

. It is much more common after caesarean section births. It usually causes a temperature, tummy pain and heavier vaginal bleeding.

What are the 5 main causes of postpartum hemorrhage?

• Placental abruption. The early detachment of the placenta from the uterus.
• Placenta previa. The placenta covers or is near the cervical opening.
• Overdistended uterus. …
• Multiple pregnancy. …
• Gestational hypertension or preeclampsia. …
• Having many previous births.
• Prolonged labor.
• Infection.

How do you treat engorged breasts?

1. using a warm compress, or taking a warm shower to encourage milk let down.
2. feeding more regularly, or at least every one to three hours.
3. nursing for as long as the baby is hungry.
4. massaging your breasts while nursing.
5. applying a cold compress or ice pack to relieve pain and swelling.

Which of the following interventions would be helpful to a breastfeeding mother who is experiencing engorged breasts?

To treat engorgement, recommend that the mother

puts warm compresses on her breasts

or takes a warm shower and expresses enough milk to reduce discomfort which helps make attachment easier. After expressing milk she can use cold compresses to reduce the inflammation.

Should you pump to relieve engorgement?

Pumping shouldn’t make engorgement worse

—in fact, it might help alleviate engorgement. If your breast is engorged, it might become too firm for your baby to latch. Pumping a little bit before breastfeeding may help soften the areola and lengthen the nipple to make it easier for your infant to connect with your breast.