Monroe College NURSING 812. HW: Study Guide chapter 28. Cult Comp't Care of Child- Bearing. The Woman with a Postpartum Complication

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  Monroe College NURSING 812 Cult Comp't Care of Child- Bearing 14 July 2021 HW: Study Guide chapter 28 The Woman with a Postpartum Complication Matching Key Terms 1. ___c____ Atony 2. _... __b____ Embolus 3. __e_____ Hematoma 4. ___d____ Hypovolemia 5. __f_____ Psychosis 6. ___a____ Thrombus a. Blood clot within a vessel b. A clot, usually a thrombus, forced into smaller vessels by the blood circulation c. Lack of muscle tone d. Decreased volume of circulating fluid e. Localized collection of blood f. Mental state in which a person’s ability to recognize reality is impaired Key Concepts 1. What is the time difference between an early and late postpartum hemorrhage? What quantity of blood loss constitutes a postpartum hemorrhage?   2. What is the most common cause of an early postpartum hemorrhage? Describe the pathophysiology of this cause of a hemorrhage.   3. How will the nurse recognize uterine atony?   4. What are the correct nursing actions if uterine atony is discovered?   5. What signs typically distinguish a postpartum hemorrhage caused by uterine atony from that caused by lacerations of the birth canal?   6. How do the signs and symptoms of a hematoma differ from those of uterine atony or a bleeding laceration?   7. Describe the body’s reaction to hypovolemia and the clinical signs that the nurse might detect. a. Compensatory   b. Failure of compensatory mechanisms   8. What discharge teaching related to a late postpartum hemorrhage is essential?   9. Why are pregnant and postpartum women prone to developing venous thrombosis?   10. Complete the following chart on venous thrombosis. Include the preventive measures. Signs and Symptoms Medical and Nursing Management Superficial venous thrombosis Swelling of the involved extremity as well as redness, tenderness, and warmth. Palpation of an enlarged, hardened, cord-like vein may be possible.       11. What laboratory studies should the nurse expect if the woman is administered heparin anticoagulation or if she is administered warfarin anticoagulation?   12. List the patient teaching related to long-term anticoagulation.   13. What are the signs and symptoms of a pulmonary embolism?   14. Define puerperal infection.   15. What anatomic features of the woman’s reproductive tract make an infection in this location potentially serious?   16. What changes in uncomplicated childbirth further increase the woman’s risk for a reproductive tract infection? What are her protective factors?   17. What is the significance of a distended, painful abdomen in the woman who has endometritis? Are other assessments needed? What action should the nurse take?   18. List the signs and symptoms of a wound infection.   19. What liquids can help acidify urine? Why is this helpful in preventing or treating a urinary tract infection?   20. Why is it important that the breastfeeding mother with mastitis empty her breasts completely?   21. How does septic pelvic thrombophlebitis differ from thrombophlebitis?   22. What is the key difference between postpartum “blues” and postpartum depression?   23. Describe the characteristics of each category of postpartum psychosis.   Case Study Jana is a gravida 1, para 1, who had a vaginal birth of a 9-pound baby 1.5 hours ago. Her fundus has remained firm, midline, and one fingerbreadth below the umbilicus. She has not yet voided. Her vital signs are stable, and she is afebrile. She received two tablets of hydrocodone with acetaminophen (Vicodin) for perineal pain 30 minutes after the birth. She now requests “something stronger” for the pain because the previous analgesic has been ineffective. 1. What are some possible explanations for the ineffectiveness of the analgesic?   2. Does the nurse need more information? If so, what?   The nurse checks Jana’s vital signs 30 minutes later. Her blood pressure is near its previous levels, but her pulse is slightly higher. Her fundal height, firmness, and amount of lochia are unchanged. Her perineum is intact and has a small amount of edema. The nurse replaces the ice pack on the perineum that has been in place since Jana’s recovery period began. 3. Are any other interventions warranted? If so, what are they and why are they appropriate?   Review Questions 1. The nurse notes that the woman has excess lochia at 2 hours after the vaginal birth of an 8-pound baby. The priority nursing action is to:   2. Choose the signs and symptoms that suggest a concealed postpartum hemorrhage.   3. One hour after the woman gives birth vaginally, the nurse notes that her fundus is firm, two fingerbreadths above the umbilicus, and deviated to the right. The lochia rubra is moderate. Her perineum is slightly edematous, with no bruising; an ice pack is in place. The priority nursing action is to:   4. What drug should be readily available when the woman is receiving heparin therapy?   5. The nurse’s initial response to a suspected pulmonary embolism should be to:   6. The woman has an 8-pound 9-ounce baby after an 18-hour labor that required a low-forceps delivery. Her membranes were ruptured for 15 hours. Based on these facts, patient teaching should emphasize:   7. Postpartum teaching related to urinary health should emphasize:   8. The best position for the woman who has postpartum endometritis is:   9. A breastfeeding woman develops mastitis. She tells the nurse that she will just feed her baby formula instead of breastfeeding. The best nursing response is that:   10. The woman who has a postpartum bipolar psychosis is most likely to demonstrate:   [Show More]

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