NURM 2 OB EXAM 2 54 C0RRECT QUESTIONS AND ANSWERS

NURM 2 OB EXAM 2

54 C0RRECT QUESTIONS AND ANSWERS

Postpartum Complications

1.      What is Mastitis?

●       Is an infection of the breast; cracked nipples allow bacteria in, hard with a lump Signs and symptoms: Breast will have a hard localized lump or wedge-shaped area of pain, tenderness, warmth, and enlarged axillary lymph nodes, flulike symptoms; achy muscles, high temp, chills, malaise, headache.

Interventions: (#1) hand washing, antibiotics, analgesics, continued emptying of the breast, drainage if abscess forms, moist warm compress, patient education for prevention; recognize signs and symptoms

2.      Postpartum patient with Increased Temperature, only a few hours after she’s delivered, what would be contributing to her high temps (outside of infection)?

●       Dehydration can cause a client who is postpartum to have a temperature up to 38° C 100.4° F during the first 24 hrs. following delivery

3.      What would consider a patient to have Postpartum Hemorrhage?

●       Early Causes: blood loss of 500 ml or more after vaginal delivery, 1000 ml or more after c-section

What causes Postpartum Hemorrhage?

●       (#1) Uterine atony is lack of muscle tone, failure of uterine muscle fibers to contract around blood vessels when placenta separate

Signs and Symptoms: uterus is “boggy” not firm, hard to find fundus, uterus stays firm only when messaged, fundus is above expected level, excessive lochia (bright red), excessive clots

Interventions: if uterus is not contracted massage fundus until firm (one hand is cupped to massage and gently compress the fundus towards the lower uterine segment, the other hand remains cupped against the uterus at the level of the symphysis pubis to support uterus)

●       (#2) Trauma to birth canal during labor or birth, hematomas, retention of placenta fragments, coagulation abnormalities

Interventions: IV of Lactated Ringers or NS with 10 to 40 units of oxytocin, face mask 8-10 L, lower head of the bed, Cytotec (rectal), Hemabate or Carboprost (contradicted in pts with asthma), Methylergonovine (contradicted in pts with HTN)