1
Q
This is the infection of the breasts
A
Mastitis
2
Q
Mastitis may occur as early as how many days?
or not until when?
A
As early as the seventh postpartum day
Not until the baby is weeks or month old
3
Q
What is the primary cause of mastitis?
A
Milk stasis
4
Q
Because of mastitis it can lead to __ which can also lead to a lack of flow of breastmilk plugged ducts, and the growth of bacteria
A
Engorgement
Are the overfilling of the best with milk blood, and other fluids
5
Q
To prevent mastitis, it is important to?
A
It is important to prevent nipples from cracking
6
Q
To prevent mastitis, it’s important to prevent nipples from cracking through measures such as
A
Making certain the baby is positioned correctly and grasps the nipple properly
Helping the baby release a grasp on the nipple before removing the baby from the breast
Washing hands between handling perennial pads, and touching breasts
Exposing nipple to air for at least part of every day
Possibly using vitamin E ointment daily to soften nipples
Encouraging birthing parents to begin breast-feeding on an unaffected nipple
7
Q
Occasionally, the organisms that cause mastitis comes from where?
A
Nasal-oral cavity of the infant
8
Q
What type of organisms are found in mastitis?
A
Staphylococcus aureus, methicillin resistance, Staphylococcus aureus, streptococcus
8
Q
Mastitis
How does the infant introduce the organism to the mother?
A
The infant introduces the organism into the milk ducts by sucking
9
Q
Mastitis is usually
Choices
Unilateral
Bilateral
A
Unilateral
Although its usually unilateral, because it originates with the infant, it may also be bilateral
10
Q
What are the symptoms of mastitis?
A
Painful and swollen and reddened breast
Fever
Breastmilk become scant
11
Q
Mastitis treatment consist of what type of antibiotics?
A
Antibiotics effective against Penicillin resistant staphylococci such as
Dicloxacillin
cephalosporin
12
Q
Mastitis
True or false
After treating a patient with antibiotics, breast-feeding should be continued if possible
A
True
Because keeping the breast emptied of milk helps to prevent the growth of bacteria
13
Q
Mastitis
How long does antibiotics usually take affect?
A
Three days
14
Q
Mastitis
What can help with pain relief until the process improves?
A
Cold or ice compress
Good supportive bra
warm compress because this reduces inflammation and edema
15
Q
Mastitis
What happens if the infection is unrecognized?
A
This can spread to involve a large portion of the breast and even ruptured through skin
16
Q
Mastitis
True or false
Encourage patients to continue to pump breast milk, if possible until the abscess has resolved
A
True
17
Q
What can be an acceptable alternative for breast-feeding?
A
Formula feeding
18
Q
Mastitis
True or false
Neither mastitis nor breast abscesses, leave any permanent breast disease
A
True
19
Q
Mastitis
True or false
A patient can be assured that such an incident such as mastitis is not associated with the development of breast cancer and does not interfere with future breast-feeding potential
A
True
20
Q
What causes severe urinary tract disorder to occur?
A
Person’s bladder compressed by the infant head
21
Q
This occurs when the bladder is unable to empty completely
A
Urinary retention
22
Q
After childbirth bladder sensation for avoiding his decreased, why is that?
A
Because of bladder edema caused by the pressure of birth
23
Q
Urinary retention
When the person does void after childbirth, why does it quickly become over distended again?
A
Because instead of emptying completely, the bladder empties only a small portion of its contents
24
Urinary retention
True or false
Over distention can cause permanent damage to bladder tone leading to permanent incontinence
True
25
Urinary retention
What happens in primary over distention?
Person does not void at all
26
voiding is less than how many ML then you should suspect urinary retention
Less than 100 ML
27
Why can catheterizing a patient during the early postpartum period Be difficult
Because of vulvar edema the position and appearance of the urinary meatus
28
What is an a non invasive way to measure residual urine
Bladder ultrasound
29
There is a suggestion that removing more than how many ML of urine at once make your eighth such an extreme pressure change in the lower abdomen they can cause blood flow into the area causing supine hypotension
750 to 1000 ML of urine
Although there is little evidence of this actually happening
30
always use what type of catheter rather than a temporary or straight catheter therefore to categorize for residual urine so this can be inflated and left in place
Indwelling Foley catheter
31
What do you call the amount of urine left in the bladder after avoiding
Residual
32
After how many hours is the indwelling catheter are usually removed
24 hours
33
what would you do if a patient has not voided by eight hours after a catheter removal
ReInsert the indwelling catheter for an additional 24 hours
34
Encourage a patient to void by the end of how many hours after removal of the catheter
Encouraged to the patient to avoid by the end of six hours
35
Give me the common symptoms of urinary tract infection
Burning on urination
Hematuria
Feeling of frequency or that they always have to void
Low-grade fever
Discomfort from lower abdominal pain
36
What do you need to get from a patient with symptoms of urinary tract infection?
Clean, catch urine specimen as an independent nursing action
37
What type of drugs are usually prescribed for urinary tract infection but is contraindicated while breast-feeding?
Sulfa
38
UTI
Are sulfa drugs contraindicated while breast-feeding and if so, why or why not?
Yes, they are contraindicated while breast-feeding because they can cause neonatal jaundice
39
UTI in addition to antibiotics encourage the patient to drink large amounts of fluid how many glass every hour to help flush the infection from the bladder?
A glass every hour
40
UTI
They may need an oral analgesic such as?
To reduce the pain of urination for the next few times they void
Acetaminophen (Tylenol)
41
UTI
How many days usually does it take for the patient to take the prescribed antibiotic?
5 to 7 days to eradicate the infection completely
42
UTI
True or false
If a patient stops taking the antibiotic, the bacteria in the urine will begin to multiply again in another week
true
Symptoms and active infection will re-occur
43
What are the cardinal symptoms of a postpartum preeclampsia?
Proteinuria
Edema
Increased blood pressure
44
What is one reason that postpartum preeclampsia could occur?
When some placental material is retained in the uterus
45
Postpartum preeclampsia
If there is still placental material retained the patient may be taken to surgery to have what
To have a D&C to be certain that all placental fragments have been removed from the uterus
46
If sulfa drugs are contraindicated while breast-feeding, what are the drug drugs prescribed to treat postpartum urinary tract infection?
Broad spectrum antibiotics such as
Nitrofurantoin
Amoxicillin
Ampicillin
47
Postpartum preeclampsia
True or false
Hypertensive therapy can be administered in a higher dose than during pregnancy
True
Because there is no longer any risk of injury to the fetus
48
Postpartum preeclampsia
How many hours does a seizure (which is a symptom of a eclampsia) typically occur in the postpartum period?
Six to 24 hours after birth
49
Postpartum preeclampsia
Seizures occurring more than how many hours after birth may not be a result of eclampsia, but the result of some other cause
More than 72 hours after birth
50
Postpartum preeclampsia
True or false
Since preeclampsia is a symptom of pregnancy, the symptoms will fade quickly after birth
True
51
Pregnancy has a potential to leave reproductive system or organs weekend or displaced, especially in people with?
Grand multiparity
Instrument birth
52
Reproductive tract displacement
What is the main concern if the ligaments of the uterus are weekend because of pregnancy?
Prolapse of the uterus
53
Reproductive tract displacement
If the vagina walls are weakened, what can occur
Cystocele (outpouching of the bladder into the vagina wall)
Rectocele (out poaching of the rectum into the vagina wall)
54
Reproductive tract displacement
How are cystocele or rectocele identified?
Pelvic exam or sonogram
55
Reproductive tract displacement
If stress incontinence occurs what may be done?
Kegels exercise to strengthen the perennial muscles
Pelvic floor physical therapy
Injection of bulking agents
Botox
56
During pregnancy, why do many people feel discomfort at the symphesis pubis?
Because of relaxation of the joint preparatory for birth
57
What can cause the ligaments of the symphesis pubis to tear?
Unusually large fetus
Fetal position may not be optimal
58
Separation of the symphesis pubis
After birth, the patient experiences acute pain on turning or walking their legs to rotate externally, giving them what kind of gait
Waddling gait
59
Separation of the symphesis pubis
True or false
A defect over the symphesis pubis can be palpated
True
the area is swollen and feels tender to the touch
60
Separation of the symphesis pubis
Bedrest and application of __ can help immobilize the joint and may be necessary to relieve the pain and allow healing
Snug pelvic binder
61
Separation of the symphesis pubis
As with ligament injuries, how many weeks is necessary for healing to be complete
4 to 6 weeks
62
Separation of the symphesis pubis
True or false
They may need to be advised to consider cesarean birth for future pregnancy
True
63
Postpartum depression
How many days after birth do birthing parents notice immediate feeling of sadness or postpartum blues?
1 to 10 days postpartum
64
Postpartum depression
What causes an anti-climatic feeling after birth
Hormonal shifts as the level of
estrogen, progesterone and gonadotropin releasing hormone in the body decrease
65
And many is 10% of birthing parents reflect a serious problem more than the usual baby blues and can continue beyond the immediate postpartum period. Possibly as long as one year.
Postpartum depression
66
How long is it considered a postpartum depression
possibly as long as one year
67
Postpartum depression
True or false
Depression of this type manifested by overwhelming sad sadness can occur in both new birthing parents and non-birthing parents
True
68
Risk factors of postpartum depression include
History of depression
Troubled childhood
Low self-esteem
Stress in home or work
Lack of effective support
Different expectations between partners
Feeling of disappointment related to the birth or child rearing
69
Postpartum depression
True or false
It is difficult to predict who will develop postpartum depression
True
because childbirth can result in many varied reactions
70
Postpartum depression
Discovery of the problem as soon as symptoms develop is a nursing priority a number of depression scales, help, detect, postpartum depression
Questionnaire nine (PHQ –9)
Edinburgh postnatal depression scale (EPDS)
71
Postpartum depression
What may the patient need to integrate the experience of childbirth into their life?
Antidepressant therapy and counseling
72
How many birthing parents has enough symptoms during the year after the birth of a child to be considered psychiatric ill?
1 in 500 birthing parents
73
When mental illness coincides with the postpartum period or occurs during the following year, what is it?
Postpartum psychosis
74
Postpartum psychosis
Rather than being a response to physical aspects of child bearing it is probably a response to?
Crisis of child bearing
75
Postpartum psychosis
True or false
A person with postpartum psychosis usually appears exceptionally sad
True
76
Postpartum psychosis
True or false
A parent may insist that they were never pregnant, even when the child has brought to them
True
By definition psychosis exists to when a person has lost contact with reality
77
Postpartum psychosis
What are the measures that you can do?
Referral to a professional psychiatric counselor
Probably antipsychotic medication
78
Postpartum psychosis
Can you leave the patient alone with their baby?
No, you cannot because they’re distorted perception may lead to harm of the infant as well as themselves
79
Postpartal blues
During postpartum period as many as __ of patience, experienced some feeling of overwhelming sadness or baby blues
50%
80
What can cause Postpartal blues
Hormonal changes particularly the decrease in estrogen and progesterone that occur occurred in the delivery of the placenta
81
What has been shown to help elevate baby blues and counteract the effects of the hormonal drop that occurs after birth?
Breast-feeding
82
Postpartal blues
In addition to crying, the syndrome is evidenced by
Feeling of inadequacy
Mood lability
Anorexia
Sleep disturbance
83
Postpartal blues
What can you do and how can you help?
Anticipatory guidance and individualized support to help parents understand that this is normal
Giving parents a chance to verbalize their feelings
Empowering breathing parent in particular to make as many decisions as they want to help gain a sense of control
84
Postpartal blues
Birthing parents are at a greater risk (how many percent?) to lead to moderate to severe post partal depression after childbirth.
19 to 48% more likely
85
Give me the onset of postpartum blues
1 to 10 days after birth
86
Give me the onset of postpartum depression
1 to 12 months after birth
87
Give me the onset of postpartum psychosis
Within the first year after birth
88
How many percent of all births have postpartum blues?
70% of all birth
89
How many percent of all births have postpartum depression?
10% of all births
90
How many percent of all births have postpartum psychosis?
1 to 2% of all births
91
Parents may notice extreme fatigue, an inability to stop crying, increased anxiety about their own infant health, insecurity psychosomatic symptoms, and either depressive or extreme mood fluctuations
Postpartum depression
92
Postpartum preeclampsia
True or false
Mild pre-existing hypertension may increase in severity during the first few hours or days after birth
True
93
UTI
True or false
During urinary tract infection, having blood in the urine is a contraindication to obtaining a clean catcher and specimen
False
94
Urinary retention
In a postpartum patient, what may be difficult to detect than primary or simple overdistention?
Urinary retention with overflow
95
Urinary retention
In a postpartum patient urinary retention with overflow may be difficult to detect than what?
primary or simple overdistention
96
Urinary retention
How many hours after birth is considered abnormally long if a person has not voided or if there is a prolonged interval between voids?
Eight hours
97
Urinary retention
Always measure the amount of a patient first void after birth because with __ occurring, this should be large
Diuresis
98
Urinary retention
Catheterization for residual urine. if this is greater than how many ML leave the catheter in place
100 ML
99
Urinary retention
Use strict __ technique to prevent introducing pathogens bacteria into the sterile, urinary and causing a urinary tract infection
Antiseptic technique
100
Urinary retention
Why is having a Difficulty with a bladder function after childbirth is becoming less of a problem?
Because of the use of anesthesia and forceps is less common, thus decreasing bladder and Vulvar pressure
101
Urinary retention
Fortunately, they are not present for no longer than how many hours
48 hours
102
Urinary retention
True or false
They most likely do not reoccur
True
103
What are the symptoms of postpartum blues?
Sadness and tears
104
What is the etiology of postpartum blue?
Due to hormonal changes and stress of life changes
105
What is the therapy of postpartum blues?
Support and empathy
106
What is the nursing role of postpartum blues?
Offer compassion and understanding
107
What are the symptoms of postpartum depression?
Anxiety and feeling of loss
108
What are the etiology of postpartum depression?
History of previous depression and hormonal response
109
What is the therapy for postpartum depression?
Counseling
110
What is the nursing role for postpartum depression?
Screening for depression and refer for counseling
111
What is the symptoms for postpartum psychosis?
Delusions or hallucinations of harming, infant or self
112
What are the etiology of postpartum psychosis?
Possible activation of previous mental illness
113
What is the therapy for postpartum psychosis?
Psychotherapy
114
What is the nursing role for postpartum psychosis?
Referred to psychiatric care and safeguard patient from injury to self and newborn
115
Mastitis
True or false
If an abscess forms breast-feeding on that breast should be continued as the abscess may need to be drained
False
It is discontinued as the abscess made incision and drainage
116
Urinary retention
Assessment by percussion or palpation reveals that the bladder is?
Bladder is distended
117
Urinary retention
When do you leave the indwelling catheter in the patient?
If the amount of urine left in the bladder of voiding is greater than 100 ML
118
When catheterizing a patient during the early postpartum period make sure to use __ technique, remembering that the perineum is able to feel tender to touch
Gentle technique
119
Urinary retention
True or false
The amount of urine removed from an overdistended bladder is often debated
True
120
Urinary retention
What are time-tested solutions that can help with letting the patient void
Running water at the sink
Letting the patient hold their hand under while running, Water
121
Postpartum preeclampsia
When does mild preexisting hypertension increase in severity
First few hours or days after birth
122
Postpartum preeclampsia
what can you administer?
Magnesium sulfate
123
urinary retention
True or false
Bladder ultrasound can be used by those not trained in ultrasound, including the nursing stuff
True
NCM 109
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