Term
What PPH?
Occurs in first 24 hours after childbirth
More common
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Definition
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Term
| Do deaths from PPH occur from lots of blood loss or slow and steady blood loss? |
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Definition
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Term
| Do Vital signs change a lot if there is blood loss? |
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Definition
| VS dont change much unless a GREAT blood loss |
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Term
| What are some implications for over distention of uterus? |
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Definition
| Multi-gestational births, LGAs, and Hydraminos |
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Term
| What position should the woman be in for episitomy? |
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Definition
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Term
| What is the most common cause of late hemorrhage? |
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Definition
Retained placental fragments |
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Term
| Why do some placenta fragments get retained? |
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Definition
| Due to partial separation of placenta |
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Term
| What test can be done to see if any placental fragments were left over? |
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Definition
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Term
| What type of anesthesia (risk factor) can cause hematomas? |
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Definition
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Term
| What are some risk factors for hematoma? |
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Definition
| Preeclampsia, first full term birth, precipitious labor, prolonged second stage of labor, and macrosomnia, and forceps vaccum assisted birth |
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Term
| How long does it take for a small hematoma to heal? |
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Definition
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Term
| What size (and under) can hematomas be managed with ice and analgesia? |
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Definition
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Term
| For larger hematomas, what may be required? |
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Definition
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Term
| What may be brought to traumatize implantation site which increases bleeding and potential for uterine secretions? |
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Definition
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Term
| What is an uterine inversion? |
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Definition
| Prolapse of fundus so uterus is inside out |
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Term
| Is uterine inversion rare or life threatening cause of PPH? |
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Definition
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Term
| How do you fix uterine inversion? |
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Definition
| Managed by immediately repositioning of uterus within pelvis by HCP under IV tocolysis or General Anesthesia |
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Term
| What are some clinical therapies for PPH? |
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Definition
| Stop hemorrhage, correct hypovolemia, |
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Term
| What do you do after explusion of placenta? |
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Definition
Massage fundus until firm and contracted. Make sure you educate women on why you are doing it.
Regional anesthesia may be used because it may be uncomfortable
Bi manual massage may be firm |
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Term
| If uterine massage isnt effective, what may be administered to contract atonic musculature? |
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Definition
| Uterine Stimulants such as Oxytocin, Prostaglandin Analog, Erogtamine, and Misoprostol |
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Term
| What is common in OB to treat uterine atony after failed attempts with oxytocics? |
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Definition
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Term
| What are some surgical procedures to correct uterine atony? |
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Definition
| Tamponade Balloon and maybe ending in hysterectomy |
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Term
What PPH occurs from 24 hours until 6 weeks after birth?
Less common and most likely due to subinvolution (failure of uterus to return to nromal size) |
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Definition
LATE PPH
AKA Secondary or Delayed |
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Term
| If Lochia rubra lasts longer than 2 weeks.... what is this a sign of? |
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Definition
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Term
| Subinvolution normally is diagnosed _________ weeks |
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Definition
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Term
| Subinvolution normally is diagnosed _________ weeks |
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Definition
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Term
| An enlarged, softer than normal uteurs palpated bimanualy is an objective indication of ________ |
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Definition
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Term
| How do you treat subinvolution? |
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Definition
Oral Methergine
if infection present, administer ATB |
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Term
| If there is a large amount of blood loss, what position should you put mom in? |
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Definition
| Legs elevated 30 degrees because it facilitates venous return and promotes oxygenation |
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Term
| What kind of diet for postpartum mom to prevent infection? |
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Definition
| Diet high in protein and Vitamin C |
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Term
| How often should you advise mom to pee? |
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Definition
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Term
| Masitis.... Should you get a culture? |
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Definition
| Yes to test for culture and sensitivity |
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Term
What is Virchow triad?
What is it associated with? |
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Definition
Hypercoaguability of the blood, venous stasis, and injury to epilthelium of the blood vessel
Thrombophelbitis |
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Term
| What are some risk factors for thrombophlebitis? |
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Definition
| C section, Immobility, obesity, smoking, trauma, varicose veins, dm, advanced maternal age, DVT |
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Term
| How can you assess for thrombophelbitis? |
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Definition
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Term
| Where is the pain for thrombophelbitis? |
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Definition
Pain in leg, inguinal area, or lower abdomen
May be edema, temperature change, and pain with palpation as well |
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Term
| How to prevent thrombphlebitis? |
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Definition
| Avoid prolonged sitting or standing. Avoid crossing legs. Take frequent trips while on car trips. Early ambulation will help after birth. Fluids to avoid dehydration. No Smoking. Stockings. Elevating legs |
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