OB4 CH34 postpartum hemorrhage

  1. mother has post partum hemorrhage after a vaginal birth. how much blood is she expected to lose?
  2. mother has post partum hemorrhage after a C/S. how much blood is she expected to lose?
  3. early, acute or primary hemorrhage happens how long after the delivery?
    within 24 hours
  4. late or secondary hemorrhage happens how long after a delivery?
  5. A physician orders methylergonovine (Methergine) 0.2 mg intramuscularly for
    a postpartum client. Which of the following interventions should the nurse take
    before administering this medication

    a. Obtain the client’s blood

      b. Determine the client’s blood glucose level.

      c. Take the client’s pulse.

      d. Have the client urinate.
    Blood pressure. (SE is HTN)
  6. a mother has been on mag. why is she at risk for uterine atony?
    muscle relaxant. uterine needs to contract.
  7. what is the leading cause of PPH?
    uterine atony
  8. what is the second most common cause of PPH?
    retained placenta
  9. at what point (primary or secondary) can we see the signs of a retained placenta?
  10. one of the PPH causes is a retained placenta. what is the difference between placenta accreta, increta, percreta?
    • accreta - slight penetration into the wall
    • increta - medium
    • percreta - deep, all the way penetrated
  11. when would we see the signs of an inverted uterus?
    late PPH
  12. a woman is diagnosed with ITP (idiopathic thrombrcytopenic purpura). what is she most likely being treated with?
    • corticosteroids or IV immunoglobin
    • if that doesn't work, platelet transfusions
    • if that doesn't work, splenectomy.
  13. what is Von Willebrand Disease? how does it work? what is used to treat it.
    hemophilia. no clotting factor VIII, platelet dysfunction. 

    tx: desmopressin .
  14. patient is complaining of pain and tenderness in her lower leg. there is no swelling, warm to the touch. what are you thinking? what are you going to do?
    • superficial venous thrombosis. give analgesics. 
    • elevate the leg. elastic stockings
  15. patient is complaining of pain in the lower leg. it's warm to the touch, red and you can see swelling. there is a positive homan's sign. what do you do?
    DVT. IV Heparin. rest elevated leg. analgesics. elastics stockings.
  16. you have a post partum mother that has is presenting with dyspnea, tachy, coughing, elevated temp. what are you thinking? what are you most likely going to do?
    pulmonary embolism. IV Hep until symptoms are gone.
  17. you have a post partum patient that is presenting with a fever, the chills, uterine tenderness and foul smelling lochia. what is going on? how are you going to treat it?
    endometritis. infection of uterus. give IV broad-spec antibx.
  18. your mother has a UTI. what do you do to tx it?
    antibx, analgesia, hydration
  19. your patient has mastitis. what is it? how what is the tx?
    infected breast. IV antibx. hydration. analgesics.
  20. what is the most effective and least expensive tx of postpartum infection?
  21. what is the first symptom of a PP infection?
    fever greater than 38 Celsius on 2 straight days within the first 10 days.
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OB4 CH34 postpartum hemorrhage
OB4 CH34 postpartum hemorrhage