Chapter 22: Nursing management of the postpartum woman at risk

Postpartum depression develops gradually, appearing within the first

-6 weeks

What would the nurse use to monitor the effectiveness of intravenous anticoagulant therapy for a postpartum woman with DEEP VEIN THROMBOSIS?

aPTT

postpartum depression screen scale

anxiety/insecurity sleep/eating, loss of self-esteem; guilt/ shame NOT FAMILY AND SOCIAL SUPPORT SYSTEM

Effective nursing management involves many aspects and being aware of subtle changes in the client. Which finding should alert the nurse to a potential infection in the client?

- Temperature of 38C or higher after the first 24 hours after childbirth

The nurse understands that this client is at greatest risk for hemorrhage during which time during the postpartum period?

- FIRST 3 DAYS RATIONALE:

While assessing a postpartum woman, the nurse palpates a contracted uterus. Perineal inspection reveals a steady stream of bright-red blood trickling out of the vagina. She just voided 200ml of clear yellow urine. Which condition would the nurse suspect?

- Laceration rationale: lacerations typically present with a firm contracted uterus and a steady stream of unclothed bright-red blood.

Which instruction would the nurse include in the teaching plan for a postpartum woman with mastitis?

- "Try applying warm compresses to your breasts to encourage the milk to be released" Rationale: warm compresses promote the let down reflex, encouraging the milk to be released.

DIC CAN OCCUR SECONDARY TO WHICH PRIMARY CONDITIONS?

- Abruptio placenta, severe preeclampsia, septicemia

Methylergonovine is order for a woman experiencing postpartum hemorrhage. The nurse monitors the woman closely for which adverse effects?

- Seizures rationale: Seizure, hypertension, uterine cramping, nausea, vomiting, and palpitations are adverse effects of methylergonovine.

When review the clients history, the nurse notes she has a history of ASTHMA. Which medication would be contraindicated in her case?

-Carboprost (NOT OF ASTHMA CLIENTS) rationale: Carboprost is contraindicated with asthma due to the risk of bronchial spasms.

A woman present to her first postpartum visit reporting she does not feel well. Which findings would lead the nurse to suspect that she has developed metritis?

- Pain on both sides of the abdomen -Leukocytosis -Foul smelling lochia

4 T's for causes of Postpartum hemorrhage

Tone tissue thrombin trauma