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Caring for the Woman Experiencing Complications During the Postpartal Period

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Chapter 16 Caring for the Woman Experiencing Complications During the Postpartal Period * Refer to Tables 16-7 & 16-8 for Risk factors for intimate partner abuse ... – PowerPoint PPT presentation

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Title: Caring for the Woman Experiencing Complications During the Postpartal Period


1
Chapter 16
  • Caring for the Woman Experiencing Complications
    During the Postpartal Period

2
Postpartum Hemorrhage
  • Definition
  • Accurately estimating blood loss
  • Early vs. late
  • LARRY
  • 4 Ts

3
Postpartum Hemorrhage
  • Uterine atony
  • Hallmarksoft uterus filled with clots and blood
  • Genital tract trauma
  • Uterus firm
  • Tissue
  • Thrombin

4
Postpartum Hemorrhage
  • Late postpartum hemorrhage
  • Retained placental fragments
  • Ergonovine medication, antibiotics, and possible
    DC
  • Hypovolemic shock

5
Collaborative Management
  • Frequent vital signs and fundal massage
  • Note patients behavior
  • Medical management depends on cause
  • Administer oxygen
  • Obtain laboratory tests
  • Accurate I/O

6
Hematoma
  • Definition
  • Signs and symptoms
  • Unremitting pain and pressure
  • Collaborative management
  • Careful assessment
  • Implement pain relief measures

7
Puerperal Infections
  • Definition
  • Types of puerperal infections
  • Endometritis
  • Mastitis
  • Operative wound
  • Urinary tract
  • Careful assessment

8
Collaborative Management
  • Antibiotics
  • Encourage rest, increased fluids, proper
    nutrition
  • Comfort measures
  • NSAIDs
  • Educate patient and family

9
Thrombophlebitis and Thrombosis
  • Definition
  • Pathophysiologyhypercoagulable state, venous
    stasis and vein injury
  • Signs/symptomspain, tenderness may be
    asymptomatic
  • Diagnostic tests

10
Collaborative Management
  • Analgesics elevate extremity TED hose increase
    fluids apply moist, warm packs
  • Complete bedrest with bathroom privileges
  • Anticoagulation therapy
  • Measure leg circumference

11
Complication Pulmonary Embolism
  • Abrupt onset chest pain, dyspnea, diaphoresis,
    syncope, anxiety
  • ABC response
  • Limit visitors
  • Educate woman and family regarding prevention of
    thrombus reoccurrence

12
Postpartum Psychosocial Complications
  • Postpartum blues
  • Self-limiting
  • Postpartum depression
  • One of two symptoms exist most/all day
  • Identify risk factors
  • Screen at postpartum visits

13
Postpartum Psychosis
  • Onset within first 8 weeks after childbirth
  • Distinguishing signs hallucinations, agitation,
    confusion, suicidal/homicidal thoughts,
    delusions, sleep disturbances, loss of touch with
    reality
  • Requires hospitalization

14
Psychosocial Postpartal Nursing Care
  • Teach to seek help if feeling overwhelmed
  • Encourage rest
  • Support bonding
  • Perform holistic assessment
  • Advocate for home follow-up

15
Postpartum Nursing for Vulnerable Populations
  • Victims of abuse
  • Undocumented immigrants
  • Limited Access to care/homelessness
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