Postpartum Complications and Care

Flashcards covering key vocabulary, conditions, assessments, and management strategies related to postpartum complications and care, including hemorrhage, infections, and psychosocial recovery phases.

Retained Placental Fragments

Tissue remaining in the uterus after delivery, preventing proper uterine cramping and increasing the risk of infection and hemorrhage.

Postpartum Trauma (Laceration/Episiotomy)

Injury to the perineum, vaginal wall, or cervix during delivery, indicated by heavy bleeding with a firm fundus, often presenting as a continuous trickle of bright red blood.

Heavy Bleeding (Postpartum)

Saturating a perineal pad in less than two hours, according to the textbook definition.

Excessive Bleeding (Postpartum)

Saturating a perineal pad in less than fifteen minutes, according to the textbook definition.

Hematoma (Postpartum)

A collection of blood in the tissue, often caused by trauma, presenting with severe, unrelenting perineal pain and sometimes visible bulging or internal bleeding.

Small Hematoma

Typically defined as less than three to five centimeters; managed with pain treatment and ice packs to promote vasoconstriction.

Retroperitoneal Hematoma

An internal collection of blood, often unseen externally, indicated by vital signs such as tachycardia and hypotension without visible external bleeding.

Subinvolution

Failure of the uterus to involute (contract) down appropriately for the postpartum day, often caused by retained placental fragments and a common cause of late postpartum hemorrhage.

Thrombin (Postpartum Hemorrhage cause)

Refers to a patient's ability to clot blood; clotting issues are a less common but serious cause of hemorrhage, potentially due to underlying disorders or massive blood loss.

Disseminated Intravascular Coagulation (DIC)

A secondary disorder causing a collapse of the blood's clotting ability due to depleted clotting factors, often triggered by massive blood loss (e.g., abruption, previa, HELLP syndrome).

HELLP Syndrome

Hemolysis, Elevated Liver enzymes, Low Platelets; a severe complication of preeclampsia that can lead to DIC.

TXA (Transamic Acid)

A medication used to minimize blood loss, primarily from a clotting standpoint, and listed as a uterotonic drug.

Wound Infection (Postpartum)

Infection at a C-section incision, episiotomy, or laceration repair site, assessed using RIDA criteria.

REEDA Assessment

An acronym for evaluating wound healing and potential infection: Redness, Edema, Ecchymosis (bruising), Drainage (purulent), and Approximation.

Mastitis

A postpartum-specific breast infection, typically presenting unilaterally around day 3-5 when transitional milk comes in, with symptoms like redness, tenderness, warmth, lumps, chills, and enlarged lymph nodes.

Mastitis Management

Includes full course antibiotics, rest, hydration, comfort, warm compresses, and continuing to breastfeed from the affected breast first (unless an abscess or nipple lesions are present).

Endometritis

A postpartum-specific infection of the endometrium (uterine lining), with key symptoms including foul-smelling lochia, fever (>100.4 F), tenderness, subinvolution, tachycardia, and pain.

Endometritis Prevention

Involves good hand hygiene, wiping front to back, using squirt bottles instead of wiping, and avoiding tampons, douching, and intercourse for six weeks postpartum.

Postpartum UTI

Urinary tract infection common in postpartum women, with symptoms like pain, burning, or bleeding during urination, fever, fatigue, and nausea; often influenced by diuresis.

Deep Vein Thrombosis (DVT) Prevention (Postpartum)

Strategies include frequent ambulation, maintaining good hydration, and avoiding crossing legs while sitting or lying.

Deep Vein Thrombosis (DVT) Treatment (Postpartum)

Management for an existing clot, including bed rest, elevating the affected leg, applying a TED hose to the unaffected leg, and administering anticoagulants like heparin/warfarin.

Normal Postpartum Physiological Response

Rapid diuresis of 2,000 to 3,000 cc's of urine per day for the first few days and a higher-than-normal white blood cell count (up to 25,000-30,000).

Fundal Assessment (Initial Action)

The key first step is to ask the patient to urinate to ensure an empty bladder for an accurate assessment of uterine position and firmness.

Boggy Uterus

A soft, poorly contracted uterus; the initial nursing intervention is to massage the fundus to promote firmness and reduce bleeding.

Normal Bowel Elimination Postpartum

Typically returns two to three days after delivery, often delayed by labor and delivery events, pain, or narcotic use.

Lochia Rubra

First stage of postpartum uterine discharge, lasting approximately the first three days, characterized by a ruby red color.

Lochia Serosa

Second stage of postpartum uterine discharge, typically from day four to fourteen, characterized by a pinkish color due to leukocytes.

Lochia Alba

Final stage of postpartum uterine discharge, lasting approximately two to six weeks, characterized by a whitish, brownish, or yellowish color.

Taking In Stage (Rubins' Phases)

The initial postpartum psychosocial phase (1-2 days), where the mother reflects on the childbirth experience, focuses on her own needs, and is dependent on others for care.

Taking Hold Stage (Rubins' Phases)

The second postpartum psychosocial phase (day 3-10), where the mother is ready to learn, resumes control, and focuses on caring for herself and her baby.

Letting Go Stage (Rubins' Phases)

The final postpartum psychosocial phase, where the mother adapts to and accepts her new role as a parent within the family unit.

Engorgement (Bottle Feeding)

Breast fullness and discomfort in non-breastfeeding mothers; managed by standing with back to shower water, wearing a well-fitting bra constantly, and applying ice packs for 10 minutes.