1
Q
What is the primary risk associated with a deep-vein thrombosis (DVT) in a postpartum client?
A
A DVT can lead to a pulmonary embolism.
2
Q
What is the term for a thrombus that is associated with inflammation?
A
Thrombophlebitis.
3
Q
Cesarean birth _____ the risk for deep-vein thrombosis.
A
doubles
4
Q
What is a primary physical assessment finding for a client with a deep-vein thrombosis (DVT)?
A
A unilateral area of swelling, warmth, and redness in the leg.
5
Q
What noninvasive diagnostic procedure is commonly used to identify a deep-vein thrombosis (DVT)?
A
Doppler ultrasound scanning.
6
Q
To prevent thrombophlebitis, how long should a sequential compression device be maintained?
A
It should be maintained until ambulation is established.
7
Q
What is the recommended daily fluid intake to help prevent thrombophlebitis by avoiding sluggish circulation?
A
2 to 3 liters each day from food and beverage sources.
8
Q
In managing thrombophlebitis, how should the client’s affected extremity be positioned during bed rest?
A
It should be elevated above the level of the heart.
9
Q
Why is it contraindicated to massage the affected limb of a client with thrombophlebitis?
A
To prevent the thrombus from dislodging and becoming an embolus.
10
Q
What is the therapeutic intent of administering IV Heparin for DVT?
A
To prevent the formation of other clots and to prevent enlargement of the existing clot.
11
Q
What laboratory value is monitored for a client receiving a continuous IV infusion of Heparin?
A
The activated partial thromboplastin time (aPTT).
12
Q
What is the antidote for Heparin?
A
Protamine sulfate.
13
Q
What is the antidote for Warfarin?
A
Phytonadione (Vitamin K).
14
Q
What types of contraception are contraindicated for a client taking Warfarin and why?
A
Oral contraceptives are contraindicated because of the increased risk for thrombosis.
15
Q
A client on anticoagulant therapy should be educated to avoid taking aspirin or _____.
A
ibuprofen
16
Q
What is a pulmonary embolism?
A
A complication of DVT where an embolus lodges in the pulmonary artery, obstructing blood flow to the lungs.
17
Q
What is a common expected finding in a client experiencing a pulmonary embolus, related to their emotional state?
A
Apprehension.
18
Q
What is the priority nursing intervention for positioning a client with a pulmonary embolus?
A
Place the client in a semi-Fowler’s position with the head of the bed elevated.
19
Q
What class of medication, such as alteplase or streptokinase, can be prescribed to break up blood clots in a pulmonary embolus?
A
Thrombolytic therapy.
20
Q
What is idiopathic thrombocytopenic purpura (ITP)?
A
An autoimmune disorder where the life span of platelets is decreased by antiplatelet antibodies.
21
Q
What is disseminated intravascular coagulation (DIC)?
A
A coagulopathy in which clotting and anticlotting mechanisms occur at the same time.
22
Q
What is the most common cause of disseminated intravascular coagulation (DIC) in pregnant clients?
A
Abruptio placentae.
23
Q
A specific fibrin degradation fragment test used to help diagnose DIC is the _____ test.
A
D-dimer
24
Q
In a client with DIC, what is the expected finding for platelet levels and fibrinogen levels?
A
Both platelet and fibrinogen levels are decreased.
25
What is the primary focus of nursing care for a client with disseminated intravascular coagulation (DIC)?
Assessing for and correcting the underlying cause.
26
What surgical intervention might be necessary if idiopathic thrombocytopenic purpura (ITP) does not respond to medical management?
A splenectomy.
27
According to ACOG, what is the definition of postpartum hemorrhage (PPH)?
A cumulative blood loss of 1,000 mL or greater, or blood loss with findings of hypovolemia within 24 hours of birth.
28
What are two major complications that can occur following postpartum hemorrhage?
Hypovolemic shock and anemia.
29
What is a common physical assessment finding of the uterine fundus in a client with postpartum hemorrhage?
Uterine atony (hypotonic or boggy).
30
Perineal pad saturation in _____ or less is a physical assessment finding indicating postpartum hemorrhage.
15 minutes
31
What is the first nursing action when postpartum hemorrhage is suspected?
Firmly massage the uterine fundus.
32
To increase circulation to essential organs during postpartum hemorrhage, how should the nurse position the client's legs?
Elevate the client's legs to a 20° to 30° angle.
33
What is the therapeutic intent of administering Oxytocin for postpartum hemorrhage?
It promotes uterine contractions.
34
Methylergonovine, a uterine stimulant, should not be administered to clients who have what condition?
Hypertension.
35
What is the classification of Tranexamic Acid, used to improve blood clotting in postpartum hemorrhage?
Antifibrinolytic.
36
What is uterine atony?
The inability of the uterine muscle to contract adequately after birth.
37
One risk factor for uterine atony is the administration of _____ as a tocolytic.
magnesium sulfate
38
When is it appropriate to express clots from the uterus of a client with uterine atony?
Only after the uterus is firmly contracted.
39
What is subinvolution of the uterus?
When the uterus remains enlarged with continued lochial discharge.
40
What are the two primary risk factors for subinvolution of the uterus?
Pelvic infection (endometritis) and retained placental fragments.
41
What is an inversion of the uterus?
The turning inside out of the uterus, which can be partial or complete.
42
Vigorous fundal pressure is a risk factor for what postpartum complication?
Inversion of the uterus.
43
What type of medication, such as Terbutaline, is administered to relax the uterus before a provider attempts manual replacement of an inverted uterus?
A tocolytic.
44
A placenta that has not been delivered within _____ minutes of birth is considered a retained placenta.
30
45
What is the distinguishing clinical finding of a hematoma in the postpartum period?
Pain, rather than noticeable bleeding.
46
What physical finding suggests a laceration as the cause of postpartum bleeding, even when the uterus is firm and contracted?
A continuous slow trickle of bright red blood from the vagina.
47
A fever of _____ or higher after the first 24 hours postpartum, or for 2 days during the first 10 days, is indicative of a postpartum infection.
38° C (100.4° F)
48
What is the major complication of a puerperal (postpartum) infection?
Septicemia.
49
What is the most frequently occurring puerperal infection?
Endometritis, an infection of the uterine lining.
50
Endometritis usually begins on the _____ postpartum day.
third to fourth
51
What is mastitis?
An infection of the breast involving the interlobular connective tissue, usually unilateral.
52
What is the most common infecting organism in mastitis?
Staphylococcus aureus.
53
A characteristic physical finding of endometritis is dark, profuse lochia that may be _____ or purulent.
malodorous
54
What are the key physical assessment findings of a wound infection?
Wound warmth, erythema, tenderness, pain, edema, and seropurulent drainage.
55
What are the characteristic findings of mastitis?
A painful or tender localized hard mass and reddened area, usually on one breast, with influenza-like manifestations.
56
What is the recommended client education for a breastfeeding client with mastitis?
Continue breastfeeding frequently (every 2-4 hours), especially on the affected side.
57
To manage discomfort from mastitis, a client can use _____ or _____ packs on the affected breast.
ice; warm
58
What is a potential complication of a postpartum urinary tract infection (UTI)?
Progression to pyelonephritis with permanent kidney damage.
59
Pain at the costovertebral angle in a client with a UTI is an indication of what condition?
Pyelonephritis.
60
How should a client be taught to perform perineal hygiene to prevent UTIs?
Wipe from front to back.
61
What is postpartum blues?
A condition characterized by mood swings, anxiety, and sadness that occurs in the first few days after birth and resolves within 10 days without intervention.
62
What is postpartum depression (PPD)?
A condition occurring within 12 months of birth characterized by persistent feelings of sadness and intense mood swings that usually does not resolve without intervention.
63
What is postpartum psychosis?
A severe condition developing within the first 2-3 weeks postpartum with findings like confusion, hallucinations, delusions, and paranoia.
64
Clients who have a history of _____ are at a higher risk for developing postpartum psychosis.
bipolar disorder
65
What are some characteristic findings of postpartum depression that distinguish it from postpartum blues?
Feelings of guilt, flat affect, rejection of the newborn, and thoughts of harming self or the newborn.
66
What is the priority action for a nurse caring for a client with postpartum psychosis?
Ask the client if they have thoughts of harming themselves or their infant.
67
What is the term for the quantification of blood loss measured with every birth, as recommended by AWHONN?
QBL (Quantification of Blood Loss).
68
What is the therapeutic intent of Carboprost tromethamine?
To control postpartum hemorrhage.
69
A nurse should monitor for adverse reactions like fever, hypertension, and chills when a client is receiving what uterine stimulant?
Carboprost tromethamine.
70
Pushing on an uncontracted uterus can cause what emergency situation?
It can invert the uterus and result in extensive hemorrhage.
71
What is uterine tamponage?
An intrauterine balloon that is placed inside the uterus to treat postpartum hemorrhage.
72
A prolapsed uterine inversion is evidenced by a large, red, rounded mass that protrudes _____ outside the introitus.
20 to 30 cm
73
What is the nurse's immediate action regarding oxytocin if a uterine inversion occurs?
Stop the oxytocin infusion if it is being administered.
74
What is the term for a collection of clotted blood within tissues that can appear as a bulging bluish mass?
Hematoma.
75
A client on anticoagulant therapy should be educated to report spontaneous bleeding from the _____ or _____.
gums; nose
76
Operative vaginal birth (forceps or vacuum-assisted) is a risk factor for which two postpartum bleeding disorders?
Lacerations and hematomas.
77
According to AWHONN, perinatal mood disorders (PMDs) can occur anytime during pregnancy and during the _____ postpartum.
first year
78
What condition should a nurse monitor for in a newborn whose parent has a postpartum mental health disorder?
Failure to thrive secondary to an inability of the parent to provide care.
79
According to ACOG, when should postpartum depression screening occur?
Screening should occur during the postpartum period before discharge and then be reassessed four weeks after birth.
80
Milk stasis, nipple trauma, and poor breastfeeding technique are all risk factors for what postpartum infection?
Mastitis.
81
What is the definition of thrombophlebitis in the postpartum period?
It refers to a thrombus that is associated with inflammation.
82
A postpartum client is at the greatest risk for a deep-vein thrombosis (DVT) that can lead to what serious complication?
A pulmonary embolism.
83
Cesarean birth _____ the risk for developing a deep-vein thrombosis (DVT).
doubles
84
What is a key physical assessment finding for deep-vein thrombosis (DVT)?
A unilateral area of swelling, warmth, and redness.
85
What noninvasive diagnostic procedure is commonly used to identify a deep-vein thrombosis (DVT)?
Doppler ultrasound scanning.
86
For a postpartum client on bed rest longer than 8 hours, what nursing intervention helps prevent thrombophlebitis?
Use active and passive range of motion to promote circulation in the legs.
87
What client education should a nurse provide regarding leg position to prevent thrombophlebitis?
Elevate both legs when sitting and avoid crossing the legs.
88
In managing thrombophlebitis, the client's affected extremity should be elevated above the level of the _____.
heart
89
Why is it critical to NOT massage the affected limb of a client with deep-vein thrombosis (DVT)?
To prevent the thrombus from dislodging and becoming an embolus.
90
What is the therapeutic intent of administering Heparin IV for a DVT?
To prevent the formation of other clots and the enlargement of the existing clot.
91
What laboratory value must be monitored for a client receiving a continuous IV infusion of Heparin?
aPTT (activated partial thromboplastin time).
92
What is the antidote for Heparin that should be readily available?
Protamine sulfate.
93
What two laboratory values are monitored for a client taking Warfarin?
PT (prothrombin time) and INR (international normalized ratio).
94
What is the antidote for Warfarin?
Phytonadione (Vitamin K).
95
Clients on Warfarin should use birth control because the drug has _____ effects, but oral contraceptives are contraindicated due to increased thrombosis risk.
teratogenic
96
What complication of DVT occurs if an embolus lodges in the pulmonary artery, obstructing blood flow to the lungs?
A pulmonary embolism.
97
What are the classic expected findings for a client experiencing a pulmonary embolus?
Apprehension, pleuritic chest pain, and dyspnea.
98
What is the priority nursing intervention for a client with a suspected pulmonary embolus?
Place the client in a semi-Fowler’s position and administer oxygen by mask.
99
What is Idiopathic Thrombocytopenic Purpura (ITP)?
An autoimmune disorder where the lifespan of platelets is decreased by antiplatelet antibodies, risking severe hemorrhage.
100
What is Disseminated Intravascular Coagulation (DIC)?
A coagulopathy where clotting and anti-clotting mechanisms occur at the same time, putting the client at risk for both bleeding and ischemia.
101
What is the most common cause of Disseminated Intravascular Coagulation (DIC) in pregnant clients?
Abruptio placentae.
102
A key finding in coagulopathies like DIC is unusual spontaneous bleeding from the _____ and nose.
gums
103
In a client with DIC, platelet and fibrinogen levels are expected to be _____.
decreased
104
In a client with DIC, fibrin split product levels and the D-dimer test are expected to be _____.
increased
105
What is the primary focus of care for a client with Disseminated Intravascular Coagulation (DIC)?
To assess for and correct the underlying cause.
106
According to ACOG, what is the definition of postpartum hemorrhage (PPH)?
A cumulative blood loss of 1,000 mL or greater, or blood loss with findings of hypovolemia within 24 hours of birth.
107
What is an early indicator of hypovolemia caused by hemorrhage?
Increasing pulse and decreasing blood pressure.
108
Saturation of a perineal pad in _____ or less is a physical assessment finding indicating postpartum hemorrhage.
15 minutes
109
What is the immediate nursing action for a boggy uterine fundus?
Firmly massage the uterine fundus.
110
To increase circulation to essential organs during postpartum hemorrhage, the nurse should elevate the client's legs to a _____ to _____ degree angle.
20 to 30
111
What is a potential adverse reaction of Oxytocin administration that can progress to cerebral edema and coma?
Water intoxication.
112
Methylergonovine, a uterine stimulant, should not be administered to clients who have _____.
hypertension
113
What condition results from the inability of the uterine muscle to contract adequately after birth and can lead to postpartum hemorrhage?
Uterine atony.
114
One risk factor for uterine atony is the administration of _____ _____ as a tocolytic.
magnesium sulfate
115
A nurse should only express clots from the uterus after it is _____ contracted.
firmly
116
What is subinvolution of the uterus?
A condition where the uterus remains enlarged with continued lochial discharge, potentially causing postpartum hemorrhage.
117
The two main risk factors for subinvolution of the uterus are pelvic infection and _____ _____ _____.
retained placental fragments
118
What is inversion of the uterus?
The turning inside out of the uterus, which can be partial or complete.
119
What medication class, including Terbutaline, is administered to relax the uterus before a provider attempts to manually replace an inverted uterus?
Tocolytics.
120
After an inverted uterus is replaced, the nurse should avoid _____ fundal massage.
aggressive
121
A placenta that has not been delivered within _____ of the birth is considered a retained placenta.
30 minutes
122
What is the distinguishable clinical finding of a postpartum hematoma, as opposed to a laceration?
Pain, rather than noticeable bleeding.
123
A continuous slow trickle of bright red blood from the vagina when the uterus is firm and contracted suggests what complication?
A laceration.
124
What is a non-pharmacological nursing intervention for a small postpartum hematoma?
Use ice packs to treat the area.
125
A postpartum infection is indicated by a fever of _____°C (_____°F) or higher after the first 24 hours, or for 2 days during the first 10 days postpartum.
38°C (100.4°F)
126
What is the most frequently occurring puerperal (postpartum) infection?
Endometritis, an infection of the uterine lining.
127
When does endometritis typically begin postpartum?
On the third to fourth postpartum day.
128
What is mastitis?
An infection of the breast involving the interlobular connective tissue, which is usually unilateral.
129
What is the most common infecting organism that causes mastitis?
Staphylococcus aureus.
130
What are two risk factors for mastitis related to breastfeeding practices?
Milk stasis and nipple trauma from poor latching.
131
A client with endometritis is likely to have uterine tenderness and dark, profuse lochia that is either _____ or _____.
malodorous or purulent
132
What is a key physical finding in mastitis?
A painful or tender localized hard mass and reddened area, usually on one breast.
133
What client education should be provided about breastfeeding to a client with mastitis?
Continue breastfeeding frequently, at least every 2 to 4 hours, especially on the affected side.
134
A client with mastitis should wear a well-fitting bra but avoid one with an _____ because it increases the risk for infection.
underwire
135
A potential complication of a postpartum urinary tract infection (UTI) is the progression to _____.
pyelonephritis
136
Postpartum clients should be encouraged to increase their fluid intake to _____ mL/day to help prevent or treat a UTI.
3000
137
What condition is characterized by mood swings, anxiety, and crying, occurs in the first few days after birth, and generally resolves within 10 days without intervention?
Postpartum blues.
138
What postpartum mental health disorder occurs within 12 months of birth and is characterized by persistent feelings of sadness and intense mood swings that do not resolve without intervention?
Postpartum depression (PPD).
139
What severe postpartum mental health disorder develops within the first 2 to 3 weeks, with clients who have a history of bipolar disorder being at higher risk?
Postpartum psychosis.
140
A client with postpartum psychosis may exhibit severe clinical findings, including confusion, disorientation, hallucinations, and _____.
delusions
141
What is the priority nursing action when caring for a client with postpartum psychosis?
Ask the client if they have thoughts of harming themselves or their infant.
142
What physical assessment finding is common in both postpartum blues and postpartum depression?
Crying.
143
A client with postpartum depression may exhibit a _____ affect and rejection of the newborn.
flat
144
What medications may be prescribed for postpartum psychosis?
Antipsychotics, benzodiazepines, and mood stabilizers.
145
In addition to pregnancy and immobility, what are two other risk factors for deep-vein thrombosis (DVT)?
Obesity and smoking.
146
What is the recommended daily fluid intake to help prevent DVT by avoiding sluggish circulation?
2 to 3 liters each day from food and beverage sources.
147
Besides anticoagulants, what type of analgesic medication is typically administered for thrombophlebitis?
Nonsteroidal anti-inflammatory agents (NSAIDs).
148
A client taking anticoagulants should be educated to avoid taking _____ or _____ because they increase bleeding tendencies.
aspirin or ibuprofen
149
A client with a pulmonary embolus might exhibit hemoptysis, which is the _____ of blood.
coughing up
150
A surgical procedure to remove an embolus from the lungs is called an _____.
embolectomy
151
If ITP does not respond to medical management, a _____ may be performed.
splenectomy
152
Two complications that can occur following postpartum hemorrhage are _____ shock and anemia.
hypovolemic
153
The administration of what uterine stimulant helps control postpartum hemorrhage by improving blood clotting?
Tranexamic Acid.
154
An intrauterine balloon placed inside the uterus to treat postpartum hemorrhage is known as uterine _____.
tamponage
155
What is a therapeutic procedure performed by a provider to remove retained placental fragments?
Dilation and curettage (D&C).
156
Excessive traction applied to the _____ _____ is a risk factor for uterine inversion.
umbilical cord
157
A complete uterine inversion is evidenced by the fundus presenting as a _____ in the vagina.
mass
158
A major complication of any puerperal infection is _____, a life-threatening condition.
septicemia
159
What hygiene practice can help prevent mastitis?
Thoroughly washing hands prior to breastfeeding and allowing nipples to air-dry.
160
A nurse teaching a client about UTI prevention should instruct them to perform perineal hygiene by wiping from _____ to _____.
front to back
161
A postpartum client who had premature rupture of membranes and _____ labor is at the greatest risk for developing a postpartum infection.
prolonged
162
Feelings of guilt and inadequacies, intense mood swings, and thoughts of harming the newborn are characteristic of postpartum _____.
depression
163
A nurse should reinforce to a client with postpartum blues that the condition is normal and _____-_____.
self-limiting
164
What is thrombophlebitis?
It refers to a thrombus that is associated with inflammation.
165
The postpartum client is at the greatest risk for a deep-vein thrombosis (DVT) that can lead to a _____.
pulmonary embolism
166
What type of birth doubles the risk for deep-vein thrombosis (DVT)?
Cesarean birth.
167
What is a key physical assessment finding for deep-vein thrombosis (DVT)?
A unilateral area of swelling, warmth, and redness in the leg.
168
What noninvasive diagnostic procedure is commonly used to identify a DVT?
Doppler ultrasound scanning.
169
For a postpartum client on bed rest longer than 8 hours, what nursing intervention helps prevent thrombophlebitis?
Using active and passive range of motion to promote circulation in the legs.
170
What client education should be provided regarding leg position to prevent DVT?
Elevate both legs when sitting and avoid crossing the legs.
171
In managing thrombophlebitis, how should the client's affected extremity be positioned?
Elevated above the level of the heart on bed rest.
172
Why is it contraindicated to massage the affected limb of a client with DVT?
To prevent the thrombus from dislodging and becoming an embolus.
173
What is the therapeutic intent of administering Heparin IV for DVT?
To prevent the formation of other clots and the enlargement of the existing clot.
174
What laboratory value is monitored for a client on a continuous IV infusion of Heparin?
The aPTT (activated partial thromboplastin time).
175
What is the antidote for Heparin?
Protamine sulfate.
176
What is the antidote for Warfarin?
Phytonadione (Vitamin K).
177
What two laboratory values are monitored for a client taking Warfarin?
PT (prothrombin time) and INR (international normalized ratio).
178
Why are oral contraceptives contraindicated for a client taking Warfarin?
Because of the increased risk for thrombosis.
179
A pulmonary embolism occurs when an embolus lodges in the pulmonary artery, obstructing blood flow to the _____.
lungs
180
What are the expected findings for a client experiencing a pulmonary embolus?
Apprehension, pleuritic chest pain, dyspnea, and tachypnea.
181
What is the priority nursing action for a client with a suspected pulmonary embolus?
Place the client in a semi-Fowler’s position and administer oxygen by mask.
182
What is Idiopathic Thrombocytopenic Purpura (ITP)?
An autoimmune disorder where the life span of platelets is decreased by antiplatelet antibodies, risking severe hemorrhage.
183
What is Disseminated Intravascular Coagulation (DIC)?
A coagulopathy where clotting and anti-clotting mechanisms occur at the same time, putting the client at risk for both bleeding and ischemia.
184
What is the most common cause of Disseminated Intravascular Coagulation (DIC) in the postpartum period?
Abruptio placentae.
185
What physical assessment finding is common in coagulopathies like ITP and DIC?
Unusual spontaneous bleeding from the gums and nose (epistaxis).
186
In a client with DIC, what would you expect the platelet and fibrinogen levels to be?
Decreased.
187
In DIC, the D-dimer test, which measures a specific fibrin degradation fragment, would show an _____ level.
increased
188
The primary nursing focus in managing DIC is to assess for and correct the _____ cause.
underlying
189
What is the ACOG definition of a postpartum hemorrhage?
A cumulative blood loss of 1,000 mL or greater, or blood loss with findings of hypovolemia within 24 hours of birth.
190
What is an early indicator of hypovolemia caused by hemorrhage?
Increasing pulse and decreasing blood pressure.
191
What is the first nursing intervention for a postpartum hemorrhage caused by uterine atony?
Firmly massage the uterine fundus.
192
To increase circulation to essential organs during a postpartum hemorrhage, how should the nurse position the client's legs?
Elevate the legs to a 20° to 30° angle.
193
What is the primary therapeutic intent of administering Oxytocin for postpartum hemorrhage?
It promotes uterine contractions.
194
What is a major contraindication for the administration of Methylergonovine?
Hypertension.
195
Carboprost tromethamine, a uterine stimulant, has what common adverse reactions?
Fever, hypertension, chills, headache, nausea, vomiting, and diarrhea.
196
Uterine atony results from the inability of the uterine muscle to _____ adequately after birth.
contract
197
What physical assessment finding indicates uterine atony?
A uterus that is larger than normal and boggy.
198
When is it appropriate to express clots from the uterus in a client with uterine atony?
Only after the uterus is firmly contracted.
199
What is subinvolution of the uterus?
When the uterus remains enlarged with continued lochial discharge.
200
What are the two main risk factors for subinvolution of the uterus?
Pelvic infection (endometritis) and retained placental fragments.
201
What therapeutic procedure is performed to remove retained placental fragments causing subinvolution?
Dilation and curettage (D&C).
202
What is an inversion of the uterus?
The turning inside out of the uterus, which can be partial or complete.
203
A prolapsed uterine inversion is evidenced by a large, red, rounded mass that protrudes 20 to 30 cm outside the _____.
introitus
204
What is the therapeutic purpose of administering Terbutaline for a uterine inversion?
To relax the uterus prior to the provider’s attempt at replacement.
205
A placenta that has not been delivered within _____ minutes of the birth is considered a retained placenta.
30
206
What is the distinguishable clinical finding of a hematoma in the perineal area?
Pain, rather than noticeable bleeding.
207
What assessment finding suggests a perineal laceration rather than uterine atony?
A continuous slow trickle of bright red blood from the vagina while the uterus is firm and contracted.
208
A postpartum fever of _____°C (100.4°F) or higher for 2 consecutive days during the first 10 days indicates a possible infection.
38
209
What is endometritis?
An infection of the uterine lining or endometrium, and it is the most frequently occurring puerperal infection.
210
What is mastitis?
An infection of the breast involving the interlobular connective tissue, which is usually unilateral.
211
What is the most common infecting organism in mastitis?
Staphylococcus aureus.
212
What are the characteristic findings of lochia in a client with endometritis?
Dark, profuse lochia that is either malodorous or purulent.
213
What are the influenza-like manifestations associated with mastitis?
Chills, fever, headache, and body ache.
214
What is a key physical finding on the affected breast of a client with mastitis?
A painful or tender localized hard mass and reddened area.
215
What is a crucial piece of client education for managing mastitis regarding breastfeeding?
Continue breastfeeding frequently (every 2-4 hours), especially on the affected side.
216
What type of bra should a client with mastitis avoid?
A bra with an underwire, as it increases the risk for infection.
217
A potential complication of an untreated postpartum UTI is progression to _____ with permanent kidney damage.
pyelonephritis
218
Pain at the costovertebral angle in a client with a UTI suggests what condition?
Pyelonephritis.
219
What is the recommended daily fluid intake for a client with a UTI?
At least 3,000 mL per day to dilute bacteria and flush the bladder.
220
Postpartum blues are characterized by mood swings and crying, typically resolving within _____ days without intervention.
10
221
Postpartum depression (PPD) occurs within _____ months of birth and is characterized by persistent feelings of sadness and intense mood swings.
12
222
Postpartum psychosis, which can develop in the first 2-3 weeks postpartum, is a severe disorder, and clients with a history of _____ are at a higher risk.
bipolar disorder
223
What are the severe clinical findings associated with postpartum psychosis?
Confusion, disorientation, hallucinations, delusions, obsessive behaviors, and paranoia.
224
What is the priority nursing action when caring for a client with postpartum psychosis?
Ask the client if they have thoughts of harming themselves or their infant.
225
What is a distinguishing feature between postpartum blues and postpartum depression?
Postpartum blues resolve within about 10 days without intervention, whereas PPD is persistent and usually requires intervention.
226
What physical assessment finding might be observed in a client with postpartum depression?
Crying, weight loss, flat affect, and irritability.
227
A key client education point for managing PPD is to get plenty of rest and nap when the _____ sleeps.
newborn
228
What class of medication is typically prescribed for postpartum depression?
Antidepressants.
229
What types of medications may be prescribed for clients who have postpartum psychosis?
Antipsychotics, benzodiazepines, and mood stabilizers.
230
Perinatal depression, one of the most common medical conditions during pregnancy and postpartum, affects one in _____ clients.
seven
231
What does QBL stand for in the context of postpartum care?
Quantification of blood loss.
232
What is the therapeutic intent of Tranexamic Acid in treating postpartum hemorrhage?
It works to improve blood clotting (as an antifibrinolytic).
233
A client with an overdistended uterus due to multiple gestations or a macrosomic fetus is at high risk for what postpartum complication?
Uterine atony.
234
What is a uterine tamponade?
An intrauterine balloon placed inside the uterus to treat postpartum hemorrhage.
235
According to the source, what is the proper hygiene technique for changing perineal pads to prevent infection?
Change the pad from front to back.
236
Painful urination, urgency, and frequency are expected findings for what common postpartum infection?
Urinary tract infection (UTI).
OB Proctor Exam ATI
flashcards
Decks in class (11)
# Cards
